Luensmann D, Meyler J. Truth or myth: All multifocal fitting steps are the same across different brands? Optician: https://www.opticianonline.net/content/features/are-all-multifocal-fitting-steps-the-same-across-brands/ 2023, October 6:

Luensmann D, Schulze M, Guthrie S, Woods J, Jones L. Evaluating the change in symptoms when symptomatic daily disposable lens wearers are refit with delefilcon A Optometry's Meeting ePosters Virtual Event, Jun 13, 2023

Luensmann D, Schulze M, Guthrie S, Woods J, Jones L. Early lens handling experience of neophyte wearers fitted contralaterally with a hydrogel and a silicone hydrogel daily disposable contact lens Optometry's Meeting ePosters Virtual Event, Jun 13, 2023

Luensmann D, Tucker AW, Voltz K, Guthrie S, Woods J, Vega J. Orthokeratology Lens Fit Success Using a New Software Global Specialty Lens Symposium, Las Vegas, Jan 20, 2023 [ Show Abstract ][ PDF ]

Purpose: To determine orthokeratology (Ortho-K) lens parameters in as few steps possible is beneficial for the eye care professionals (ECPs) and patient and this study investigated how the new Visavy software can help to inform the initial lens parameters.

Methods: This prospective study recruited participants aged 6-35 years and fit them with Paragon CRT or Paragon CRT Dual Axis Ortho-K lenses (CooperVision Specialty EyeCare), worn every night for 1 month. Topography images (Oculus Keratograph 5) were uploaded in the software and together with additional entries for subjective refraction and white-to-white corneal diameter, the software populated the initial lens parameters. Lens modifications for fit and/or vision were permitted at any of the following three timepoints: the dispense visit, after the first night or after one week of wear. Visual acuity (LogMAR) was determined with subjective refraction at baseline and unaided after one month of Ortho-K wear. Subjective comfort was collected after the first lens application and after one month (0-10 scale, 10=very comfortable). Subjective vision clarity was collected via home ratings just after lens application on the first night and after one month (0-10 scale, 10=Sharp, clear/ very good vision).

Rresults: Sixteen participants (12F:4M), mean age 11.3±3.2 years [7 to 18 years] were included in the analysis. The mean refraction of all 32 eyes was Sph -2.80±1.38DS [-1.00 to -5.75DS] and Cyl -0.56±0.46DC [0.00 to -1.25DC]. Best-corrected visual acuity prior to lens insertion was 0.00±0.01 logMAR and unaided vision after 1 month was +0.09±0.11 logMAR. Remaining correction after 1 month was Sph -0.12±0.46DS [+0.75 to -1.25DS]. Almost all lens designs predicted by the software were considered acceptable (fit and vision) by the investigator with just one lens requiring a modification after the first night due to corneal staining. Comfort ratings were significantly better after 1 month (7.8 ± 1.4) compared to the dispense visit (5.2 ± 2.2)(p<0.01). Vision clarity ratings were also better after 1 month (8.4 ± 1.5) compared to after the first night (7.0 ± 3.2)(p=0.02).

Conclusions: The Visavy software could help determine acceptable lens parameters for the Paragon CRT or Paragon CRT dual axis Ortho-K lenses in 97% of eyes (31 of 32 eyes). This high initial success rate has the potential to reduce chair time and assist ECPs to confidentially fit these lenses to their patients.

Morgan P, Woods CA, Tranoudis IG, Efron N, Jones L, Faccia L, Rivadeneira D, Teufl M, Grupcheva CN, Jones D, Rodriguez Cely LM, Adsersen A, Santodomingo-Rubido J, Bloise L, Erdinest N, Montani G, Itoi M, Bendoriene RL, Mulder J, van der Worp E, can Mierlo T, Romualdez-Oo J, Abesamis-Dichoso C, Gonzalez-Meijome JM, Macedo-de-Araujo RM, Johansson O, Hsiao J, Nichols JJ. International contact lens prescribing in 2022 Contact Lens Spectrum 2023;38, January: 28-35

Ng A, Tan J, Read S, Alster Y, Bosworth C, Jones L. AZR-MD-001 Improved Tear Film Stability and Symptoms of Meibomian Gland Dysfunction in a 6-Month Study American Academy of Optometry, New Orleans, October 12, 2023 [ Show Abstract ]

Purpose: Abnormalities of the tear film and subsequent ocular surface disease symptoms can be caused by meibomian gland dysfunction (MGD). In a Phase
2 clinical trial, AZR-MD-001 topical ointment (selenium sulfide, 0.5% or 1.0% concentration) was investigated as a new treatment for MGD.
Changes in tear film stability, meibomian gland secretion and ocular surface symptoms were monitored in adults with signs and symptoms of
MGD.

Methods: For this multicenter, double-masked, vehicle-controlled, parallel-group trial (NCT03652051), 245 adults were randomized to receive treatment
(AZR-MD-001 0.5% [n=82] or AZR-MD-001 1.0% [n=83]) or vehicle (n=80) twice a week before bed. Eligible patients were ≥18 years old, had a
Meibomian Gland Secretion (MGS) score ≤12 in both eyes, and an Ocular Surface Disease Index (OSDI) score from 13 to 33, and TBUT <10
seconds. Prespecified co-primary endpoints were change from baseline in Meibomian Glands Yielding Liquid Secretion (MGYLS) and OSDI score at
month 3. Tear film stability was considered improved if tear breakup time (TBUT; with 2% fluorescein sodium) increased by more than 2 seconds
from month 3 onward. Patients were defined as asymptomatic if their OSDI score was <13. Statistical differences from baseline were calculated
for visit days 14, 45 (1.5 months), 90 (3 months), 135 (4.5 months), and 180 (6 months). Co-primary endpoints were evaluated using a
hierarchical approach that controlled for family-wise Type I error, using an ANCOVA model. Responder endpoints were evaluated via Cochran-
Mantel-Haenszel test using Wilson-Hilferty transformation.

Results: AZR-MD-001 0.5% achieved statistically significant improvements vs vehicle for both co-primary endpoints, MGYLS (p=0.0004) and OSDI score
(p=0.0438), at month 3, which continued through to month 6 (MGYLS: p=0.0002; OSDI: p=0.0135). Tear film stability (TBUT) significantly
increased from baseline in both treatment groups compared with vehicle at month 3 (AZR-MD-001 0.5% mean change=2.2 s, p<0.0001 vs
vehicle; AZR-MD-001 1.0%=1.5 s, p=0.0187 vs vehicle; vehicle=0.5 s), with increases generally sustained at month 6 but no longer significant vs
vehicle (0.5%=2.3 s; 1.0%=1.3 s; vehicle=1.6 s; p>0.05 vs vehicle for both concentrations). Many patients treated with AZR-MD-001 were
considered asymptomatic for disease (OSDI 0.05 vs vehicle; vehicle=28%),
which was sustained for the 0.5% concentration and improved for 1.0% concentration at month 6 (0.5%=48%, p=0.0333 vs vehicle; 1.0%=50%
p=0.0205 vs vehicle; vehicle=30%).

Conclusion: Compared to vehicle, AZR-MD-001 significantly improved meibomian gland secretions and tear film stability, which resulted in clinically significant
improvements in ocular symptoms after 6 months of treatment.

Ng AY. Fast Forward to the Future: Going Green with Daily Disposables Contact Lens Spectrum 2023;38, June: 47

Ng AY, Jones L. CLs: Addressing core questions about sustainability Optician 2023, April 7: 16-17

Nichols,J. J., Morgan,P. B., Jones,L. W., Efron, N Bibliometric Analysis of Ophthalmic Journals JAMA Ophthalmology 2023;141(7):651-657 [ Show Abstract ]

KEY POINTS
Question: What articles, journals, authors, institutions, and countries in the ophthalmic literature are the most highly cited and prolific and have the highest h-index for ophthalmic journal articles?

Findings: In this qualitative study, the h-index for ophthalmic journal articles was determined to be 494, which appeared comparable with the journal literature of other medical disciplines.

Meaning: While these analyses excluded ophthalmology articles in general medical journals, they suggest a strong ophthalmic research base underpins eye care, with ophthalmology having the highest h-index across a range of ophthalmic and vision disciplines contributing to this literature.

ABSTRACT
Importance: The primary vehicle for reporting and testing advances in eye care is refereed ophthalmic journals, which can be characterized using targeted bibliometric analyses.

Objective: To identify all ophthalmic journals and evaluate citation metrics relating to articles, journals, authors, institutions, and countries published therein.

Design and Setting: A bibliometric analysis was undertaken of all ophthalmic journals included in the Scopus database (Elsevier). The search was restricted to all article types published in ophthalmic journals in English from inception through November 18, 2022. After excluding general medical journals, journals published in a language other than English, and spurious titles unrelated to the ophthalmic field, the Scopus database was found to list 335 ophthalmic journal titles that have published 471 184 articles, constituting the data set for this analysis. The 20 most highly cited articles were identified. Rank-order lists by article count were assembled for journals, authors, institutions, and countries.

Main Outcomes and Measures: An h-index for ophthalmic journal articles was derived from citations and article counts for each constituent of each category.

Results: The h-index for ophthalmic journal articles was determined to be 494. The journal with the highest h-index was Ophthalmology (h-index, 297). The journal with the greatest number of articles was American Journal of Ophthalmology (38 441 articles). The most highly cited article was by Quigley and Broman, 2006 (5147 citations), concerning the epidemiology of glaucoma. The author with the highest h-index for ophthalmic journal articles was Ronald Klein, MD (h-index, 126), and the most prolific was Carol L. Shields, MD (1400 articles). Johns Hopkins University (h-index, 215) was the institution with the highest h-index for ophthalmic journal articles, and Harvard University was the most prolific (10 071 articles). The United States was the nation with the highest h-index for ophthalmic journal articles (h-index, 444) and was the most prolific (180 017 articles).

Conclusions and Relevance: In this study, the most highly cited articles published in ophthalmic journals were revealed, as well as the leading journals, authors, institutions, and countries. While excluding ophthalmology articles in general medical journals, this investigation affords a means of identifying highly cited authors, institutions, and countries which individuals or institutions can use as a guide regarding contributions to the field.

Nichols,J. J., Morgan,P. B., Jones,L. W., Efron, N The history of optometry journals from a bibliometric perspective Hindsight 2023;54(2):36-43 [ Show Abstract ]

The rich history of optometric journal publications has been well documented, but the scientific impact of all optometry journals over all time has not been published. This work aims to determine the most impactful papers, authors, institutions and countries publishing in optometry journals. A h-index for “optometry journal publications” (the “hOJP-index”) was derived for each constituent of each category to serve as a measure of impact. The hOJP-index for the 34,565 papers published in all optometry journals is 136; these papers have been cited 294,239 times. Optometry and Vision Science is the most impactful and prolific journal (hOJP=118; n=13,095 papers). The most highly cited paper, by Richard Armstrong, is entitled “When to use the Bonferroni correction” (1,172 citations). Australian optometrist Nathan Efron is the most impactful and prolific author (hOJP=41; n=273). UNSW Sydney and the University of California, Berkeley are the most impactful institutions (both hOJP=58), and UNSW Sydney is the most prolific (n=963). The most impactful and prolific nation is the United States (hOJP=109; n=12,050). This quantitative bibliometric analysis demonstrates an impactful optometric research base enshrined in optometry journals.

Nogueira C. Fast Forward to the Future: Antibacterial coatings Contact Lens Spectrum 2023;38, April: 49

Pereira-da-Mota,A. F., Vivero-Lopez, M., Garg,P., Phan,C-M., Concheiro,A., Jones,L., Alvarez-Lorenzo,C. In vitro–in vivo correlation of drug release profiles from medicated contact lenses using an in vitro eye blink model Drug Delivery and Translational Research 2023;13(4):1116-1127 [ Show Abstract ]

There is still a paucity of information on how in vitro release profiles from drug-loaded contact lenses (CLs) recorded in 3D printed eye models correlate with in vivo profiles. This work aims to evaluate the release profiles of two drug-loaded CLs in a 3D in vitro eye blink model and compare the obtained results with the release in a vial and the drug levels in tear fluid previously obtained from an animal in vivo study. In vitro release in the eye model was tested at two different flow rates (5 and 10 µL/min) and a blink speed of 1 blink/10 s. Model CLs were loaded with two different drugs, hydrophilic pravastatin and hydrophobic resveratrol. The release of both drugs was more sustained and lower in the 3D eye model compared to the in vitro release in vials. Interestingly, both drugs presented similar release patterns in the eye model and in vivo, although the total amount of drugs released in the eye model was significantly lower, especially for resveratrol. Strong correlations between percentages of pravastatin released in the eye model and in vivo were found. These findings suggest that the current 3D printed eye blink model could be a useful tool to measure the release of ophthalmic drugs from medicated CLs. Nevertheless, physiological parameters such as the composition of the tear fluid and eyeball surface, tear flow rates, and temperature should be optimized in further studies.

Phan C-M. Enhanced ocular drug delivery with spherical nucleic acids and screening methods thereof Centre for Eye and Vision Research Conference, Hong Kong, May 18, 2023

Phan C-M. Development of photoresponsive drug delivery systems and in vitro models for testing thereof Centre for Eye and Vision Research Conference, Hong Kong, May 18, 2023

Phan C-M. Fast Forward to the Future: 3D Printing of Specialty Contact Lenses Contact Lens Spectrum 2023;38, August: 43

Phan C-M, Chan V, Walther H, Pereira da Mota A, Lorenzo CA, Jones L. Developing a High-throughput in vitro Eye Model for Evaluating Ocular Drug Delivery with Contact Lenses XXV Biennial Meeting of the International Society for Eye Research, Feb 21, 2023 [ Show Abstract ]

Purpose: To develop a high-throughput in vitro eye model for evaluating ocular drug delivery with contact lenses (CLs).
Method: The eye model was designed using CAD software and manufactured using a combination of fabrication methods, including moulding, CNC machining, laser cutting, and 3D printing. The model consists of an eyeball, an upper and lower eyelid, and a collection tray to collect flow-through fluid. The portion of the upper eyelid that comes into contact with the eyeball is moulded with a highly wettable and durable polyvinyl alcohol hydrogel. The centre of the eyeball is designed with a 300 µm thick, 15 mm diameter cut-out that allows for a contact lens to be mounted. Simulated tear fluids can be delivered through an inlet located on the upper eyelid using a pump. During each blink cycle, the eyelid slides and flexes across the eyeball to create an artificial tear film layer. The blink distance, speed and rate are actuated using a motor controlled by an Arduino board and software. The release of a red dye from two CLs (etafilcon A and senofilcon A) and the release of two drugs (resveratrol and pravastatin sodium) from drug-loaded CLs were evaluated using the model and compared to the traditional vial testing method. Phosphate buffered saline (PBS) was used as the simulated tear fluid and infused into the model at 5 µL/min, at a blink rate of 1 blink/10 s.
Results: The fluid flows from the inlet, spreads across the eye, accumulates in the lower eyelid and then flows into the collection tray via gravity. During this process, approximately 25% of the fluid originally injected into the model was lost due to evaporation, nonspecific absorption, and residual dead volume. Overall, the release of the dye and drugs from the CLs was higher in a vial compared with the eye model. Interestingly, the drug release profiles from the drug-loaded CLs on the eye model were similar to in vivo results previously collected from a rabbit study, although the total amount of drugs released was significantly less. 9 or 24 CLs can be tested with one syringe or peristaltic pump, respectively.
Conclusion: The current eye model developed from this study could be used to measure the release of ophthalmic drugs or comfort agents from CLs in a high-throughput manner. However, further work is required to fine-tune the parameters of the model, such as the composition of the tear fluid, blink rate, tear flow rates, and temperature, to better simulate in vivo conditions.

Phan CM, Ramasamy M, Ho B, Hui A, Jones L. Fabrication of a microfluidic chip using 3D printing for evaluating ocular cytotoxicity The Association for Research in Vision and Ophthalmology, New Orleans, LA, USA, April, 2023 [ Show Abstract ][ PDF ]

Purpose: To develop a PDMS (polydimethyl siloxane) microfluidic chip to evaluate ocular cytotoxicity with ophthalmic formulations and materials.

Methods: The microfluidic chip was designed using CAD software (FreeCAD), and the moulds of the chips were printed using (1) a stereolithography (SLA) and (2) digital light processing (DLP) 3D printer. The printed moulds were washed with isopropyl alcohol (IPA), UV-cured for 1-hour at 60oC, followed by heating in an oven at 120oC for 2 hours to remove any unreacted polymers. The surface of the chips was smoothed with sandpaper with increasing grit, followed by an application of nail polish. The moulds were then cast with PDMS, a gas-permeable and clear polymer commonly used for the fabrication of microfluidic chips. The moulds and chips were imaged using SEM (scanning electron microscopy). The light transmittance of the chips was also measured. The PDMS top half of the chip was adhered to a microscope slide using medical-grade double-sided tape. For a pilot study, the PDMS chips were sterilized via autoclaving, coated with 0.1% polydopamine to improve their surface wettability, and then seeded with immortalized human corneal epithelial cells (HCEC). After 2 days of incubation in a nutrient media broth (no flow), cell adhesion and growth were evaluated using light microscopy.

Results: Both 3D printers were able to print moulds with high resolution, with channel dimensions as low as 50 µm, and with faster print times for the DLP printer. SEM images revealed that moulds that were both sanded and had a nail coating were significantly smoother than the original 3D-printed moulds. The chips cast from the polished moulds were transparent, with >85% transmittance from 450-700 nm, and could be used to image cells through a microscope. The microfluidic chips were able to handle flow rates up to 1 mL/min for 24 hours without any signs of leakage. HCEC cells were able to adhere and grow on the coated PDMS microfluidic chip after 2 days.

Conclusion: This study showed that SLA and DLP printers could be used to fabricate PDMS microfluidic chips as a low-cost rapid prototyping approach. The fabricated chips were clear and could be used to incorporate HCEC cells. Future work will examine the viability of cells under different flow rates and shear stress conditions on these chips.

Phan,C. M., Ross,M., Fahmy,M., McEwen,B., Hofmann,I., Chan,V. Clark-Baba,C., Jones,L. Evaluating Viscosity and Tear Breakup Time of Contemporary Commercial Ocular Lubricants on an In Vitro Eye Model Translational Vision Science & Technology 2023;12(6):29 [ Show Abstract ]

Purpose: To evaluate the link between the viscosity of ophthalmic formulation and tear film stability using a novel in vitro eye model.

Methods: The viscosities and noninvasive tear breakup time (NIKBUT) of 13 commercial ocular lubricants were measured to evaluate the correlation between viscosity and NIKBUT. The complex viscosity of each lubricant was measured three times for each angular frequency (ranging from 0.1 to 100 rad/s) using the Discovery HR-2 hybrid rheometer. The NIKBUT measurements were performed eight times for each lubricant using an advanced eye model mounted on the OCULUS Keratograph 5M. A contact lens (CL; ACUVUE OASYS [etafilcon A]) or a collagen shield (CS) was used as the simulated corneal surface. Phosphate-buffered saline was used as a simulated fluid.

Results: The results showed a positive correlation between viscosity and NIKBUT at high shear rates (at 10 rad/s, r = 0.67) but not at low shear. This correlation was even better for viscosities between 0 and 100 mPa*s (r = 0.85). Most of the lubricants tested in this study also had shear-thinning properties. OPTASE INTENSE, I-DROP PUR GEL, I DROP MGD, OASIS TEARS PLUS, and I-DROP PUR had higher viscosity in comparison to other lubricants (P < 0.05). All of the formulations had a higher NIKBUT than the control (2.7 ± 1.2 seconds for CS and 5.4 ± 0.9 seconds for CL) without any lubricant (P < 0.05). I-DROP PUR GEL, OASIS TEARS PLUS, I-DROP MGD, REFRESH OPTIVE ADVANCED, and OPTASE INTENSE had the highest NIKBUT using this eye model.

Conclusions: The results show that the viscosity is correlated with NIKBUT, but further work is necessary to determine the underlying mechanisms.

Powell S, Jones L. Contact lens wear over a lifetime Optometry Today: https://www.aop.org.uk/ot/life-in-practice/practitioner-stories/2023/12/07/contact-lens-wear-over-a-lifetime 2023, December 7:

Qiu S. Fitting Multifocal Scleral Lenses for Unilateral Central Corneal Scar Contact Lens Spectrum 2023;38; October, Scleral and Specialty Contact Lens Case Reports: 18

Ramasamy M, Ho B, Phan CM, Jones L. Fabrication of a microfluidic chip for ophthalmic drug delivery studies using 3D printing The Association for Research in Vision and Ophthalmology, New Orleans, LA, USA, April, 2023 [ Show Abstract ]

Purpose: To develop a microfluidic chip for testing the release of ocular drugs from soft contact lenses using 3D printing.

Methods: The microfluidic chips were designed using CAD (computer-aided design) software consisting of a top and bottom portion. The top portion comprised of inlet, outlet, and channels for fluid flow. The lower portion contained a dome-shaped mount to mount a contact lens. The chips were printed using clear resin on a commercial stereolithography (SLA) 3D-printer. The printed chips were washed in isopropyl alcohol (IPA) for 30 minutes, air dried and UV cured for 30 minutes. The top and bottom portions of the chip were fused by applying a thin layer of resin, followed by UV-curing for 10 minutes. In another design iteration, moulds for the chips were 3D printed and casted with polydimethylsiloxane (PDMS). The two halves of the PDMS chips were fused using double-sided adhesive tape. In a preliminary study, two commercial contact lenses, etafilcon A and senofilcon A, were soaked in 2 ml of red food dye for 2 hours. The release of the dye was measured using the PDMS chip with phosphate-buffered saline at a flow rate of 1.5 L/min over 24 hours via absorbance at 520 nm. The dye extraction from both lenses was
performed by incubating the dye-soaked lenses in 1:1 acetonitrile/water solution for 24 hours with gentle shaking.

Results: Both the chip and moulds were printed in less than 5 hours, with a minimum resolution of 50 μm. The resulting resin and PDMS chips can also be sterilized by autoclaving. The top and bottom parts of the chips were completely sealed such that no leakage was detected at a flow rate of up to 100 μL/min for 24 hours. The release kinetics of the dye was linear throughout the 24 h period for both lens types under the current parameters. The total amount of dye released after 24 h was higher for etafilcon A (26.26 mg/lens) than senofilcon A (18.41 mg/lens), which corresponded to approximately 83.1% and 40.01% release, respectively. Both the lens types were still visibly red after 24 hours. The output of the microfluidic chip could be used as an input for subsequent analyses.

Conclusions: This study showed a cost- and time-efficient approach to fabricate a microfluidic chip for evaluating drug release from contact lenses. Future work will examine the release profile of various ocular drugs from contact lenses using different flow conditions.

Ramaswamy,M., Ho,B., Phan,C. M., Qin,N., Ren,C. L., Jones,L. Inexpensive and rapid fabrication of PDMS microfluidic devices for biological testing applications using low cost commercially available 3D printers Journal of Micromechanics and Microengineering 2023;33(10):105016 [ Show Abstract ]

Polydimethylsiloxane (PDMS) elastomers have been extensively used in the development of microfluidic devices, capable of miniaturizing biomolecular and cellular assays to the microliter and nanoliter range, thereby increasing the throughput of experimentation. PDMS has been widely used due to its optical clarity and biocompatibility, among other desirable physical and chemical properties. Despite the widespread use of PDMS in microfluidic devices, the fabrication process typically requires specialized facilities, instruments, and materials only available in a limited number of laboratories. To expand microfluidic research capabilities to a greater scientific population, we developed and characterized a simple and robust method of fabricating relatively inexpensive PDMS microfluidic devices using readily available reagents and commercially available 3D printers. The moulds produced from the 3D printers resolve designed microfluidic channel features accurately with high resolution ( >100 µm). The critical physical and chemical post-processing modifications we outline here are required to generate functional and optically clear microfluidic devices.

Sawyer G, Morgan P, Jones L.. Comfort is the beginning, middle and end of contact lens wearer success British Contact Lens Association Clinical Conference & Exhibition, Manchester, Jun 9, 2023

Schulze M. Fast Forward to the Future: What Happened to Super Vision? Contact Lens Spectrum 2023;38, December: 37

Schulze M, Bishop M. Truth or myth: Fitting soft multifocal CLs takes too much chair time? Optician; https://www.opticianonline.net/content/features/truth-or-myth-fitting-soft-multifocal-cls-takes-too-much-chair-time 2023, July 7: