Moezzi A, Ruston D. Truth or myth: Daily disposable hydrogel wearers should be refitted into DD silicone hydrogel lenses? Optician: https://www.opticianonline.net/content/features/truth-or-myth-daily-disposable-hydrogel-wearers-should-be-refitted-into-dd-silicone-hydrogel-lenses/ 2024, April 5:

Mohseni,M., Shokrollahi,P., Barzin, J. Gelatin/O-carboxymethyl chitosan injectable self-healing hydrogels for ibuprofen and naproxen dual release International Journal of Biological Macromolecules 2024;263, Part 1(April):Art No 130266 [ Show Abstract ]

Recently, a significantly greater clinical benefit has been reported with a combination of glucosamine sulfate and nonsteroidal anti-inflammatory drugs (NSAIDs) compared to either treatment alone for the growing osteoarthritis (OA) disease. So, this study introduces hydrogels using O-carboxymethyl chitosan (O-CMC, structurally akin glucosamine glycan), and Gelatin type A (GA) in a 1:2 ratio with β-glycerophosphate (βGPh) at varying percentages (5 %, 12.5 %, and 15 %). We show that hydrogel properties, adaptable for drug delivery or tissue engineering, can be fine-tuned based on OCMC:βGPh ratio. CMC/GA/βGPh-12.5 exhibited a swelling rate of 189 %, compressive stress of 164 kPa, and compressive modulus of 3.4 kPa. The self-healing hydrogel also exhibited excellent injectability through a 21-gauge needle, requiring only 5 N of force. Ibuprofen and Naproxen release from CMC/GA/βGPh-12.5 and CMC/GA/βGPh-15 of designed dimensions (bi-layer structures of different diameter and height) were measured, and drug release kinetics were estimated using mathematical equations (MATLAB and polyfit program). CMC/GA/βGPh-12.5 demonstrated significant antibacterial effects against E. coli and S. aureus, a high cell survival rate of 89 % against L929 fibroblasts, and strong cell adhesion, all indicating biocompatibility. These findings underscore potential of these hydrogels as promising candidates for treating inflammatory diseases such as osteoarthritis.

Morgan P, Woods CA, Tranoudis IG, Efron N, Jones L, Faccia L, Rivadeneira D, Grupcheva CN, Jones D, Rodriguez Cely LM, Adsersen A, Santodomingo-Rubido J, Muselier-Mathieu A, Vegh M, Erdinest N, Montani G, Itoi M, Bendoriene RL, Mulder J, van der Worp E, van Mierlo T, Ystenaes AE, Romualdex-Oo J, Abesamis-Dichoso C, Gonzalez-Meijome JM, Macedo-de-Araujo RM, Johansson O, Hsiao J, Nichols JJ. International contact lens prescribing in 2023 Contact Lens Spectrum 2024;39, January/February: 20-22,24,26-28

Morgan,P., Efron,N., Woods,C. A., Jones,D. A., Jones,L., Nichols,J. International trends in daily disposable contact lens prescribing (2000–2023): An update Contact Lens Anterior Eye 2024;Online ahead of print [ Show Abstract ]

Purpose
Daily disposable contact lenses offer numerous benefits in terms of ocular health and wearer convenience. The purpose of this work is to update earlier surveys by describing global trends in daily disposable lens fitting between 2000 and 2023.

Method
An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 265,106 daily wear soft lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of daily disposable lens fitting.

Results
Overall, daily disposable lens prescribing increased over time, from 17.1 % of daily wear soft lens fits in 2000 to 46.7 % in 2023 (p < 0.0001). There were significant differences between countries in daily disposable lens prescribing (p < 0.0001), and between the percentage of males fitted with daily disposable lenses, as a proportion of all daily wear soft lenses (37.2 %), compared to females (35.2 %) (p < 0.0001). Daily disposable lens wearers are slightly younger at fitting than reusable soft lens wearers (31.0 vs 31.2 years, respectively) (p < 0.0001), although this difference is not clinically meaningful. Analysis of 50,240 daily wear soft lenses fitted recently (2019–2023) were found to be prescribed for the following replacement frequencies: daily – 47 %; monthly – 42 %; 1–2 weekly – 9 %; and ≥3 monthly – 2 %.

Conclusion
There has been a substantial increase in daily disposable lens fitting throughout the first 24 years of this century. The gradual nature of this increase is commensurate with the staged introduction of daily disposable lens designs and expanded parameter ranges over the survey period.

Morgan,P., Efron,N., Woods,C. A., Jones,D. A., Jones,L., Nichols,J. International trends in prescribing extended wear soft contact lenses (2000–2023): An update Contact Lens Anterior Eye 2024;Online ahead of print [ Show Abstract ]

Purpose
Extended wear has long been considered as the ultimate contact lens modality in terms of user convenience. The purpose of this work is to update earlier surveys by describing international trends in extended wear soft lens fitting between 2000 and 2023, inclusive.

Method
An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 282,142 soft contact lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of extended wear soft lens fitting.

Results
Over the duration of the work there was a very small decrease in the prescribing of extended wear soft lenses (p < 0.0001). More detailed inspection shows that prescribing of these lenses steadily increased from 5.8 % of all soft lens fits in 2000 to 11.6 % in 2007, then steadily decreased to 5.2 % in 2023. Of all soft contact lenses prescribed to males, 9.2 % were fitted for extended wear, compared with 6.7 % for females (p < 0.0001). The mean age of extended wear soft lens wearers at fitting was 34.7 ± 14.7 years, compared to 31.1. ± 14.10 years for daily soft lens wearers (p < 0.0001). Analysis of 1,948 recent extended wear soft lens fits (2019–2023, inclusive), in terms of material type, revealed that, on average, 86 % and 14 % of extended wear soft lenses were fitted using silicone hydrogel and hydrogel materials, respectively.

Conclusion
A modest increase in extended wear soft lens prescribing from 2000 to 2007 corresponded with the introduction of high oxygen transmissibility silicone hydrogel lenses. However, prescribing of this lens type declined thereafter, probably due to ongoing concerns over their increased rate of microbial keratitis, resulting in a prescribing rate in 2023 (5.2%) that was little different to that observed in 2000 (5.8%).

Morrison S, Compton J, Jones L. Global Contact Lens forum: What's New and Sexy in Contacts? Vision Expo East, New York, USA, Mar 14, 2024

Morrison S, Compton J, Jones L, Davison J. Global Contact Lens forum: Level Up Your Contact Lens Practice - The Business of Contact Lenses Vision Expo East, New York, USA, Mar 14, 2024

Morrison S, Sorkin S, Fadel D, Severinsky B, Seira P. Rapid Fire CE Breakout: Contemporary Topics in Specialty Contact Lenses Global Specialty Lens Symposium, Las Vegas, Jan 19, 2024

Nagaarudkumaran N, Ngo W. Impaired Autophagy Dysregulates the Immune Response of the Corneal Epithelium under Hyperosmolar Stress American Academy of Optometry Meeting, Indianapolis, Nov 6, 2024 [ Show Abstract ]

Purpose: The regulation of inflammatory responses is imperative to the health of the ocular surface. Ocular aging can disrupt this regulatory process, thereby contributing to the decline of tissue function and the progression of ocular surface disease (OSD). OSD is associated with age and its core mechanism is inflammation; however, the cellular mechanism linking aging to inflammation remains elusive. A decline in autophagic function is a hallmark of cellular aging, and thus may be used to model ocular aging in vitro. The purpose of this study was to investigate the effect of impaired autophagy on the inflammatory responses from human corneal epithelial cells (HCEC) under hyperosmotic stress.

Methods: Immortalized HCEC were treated with an autophagy inhibitor, 5 mM 3-methyladenine (3-MA) or 100 µM chloroquine (CQ), for 24 hours. Untreated HCEC served as the control. Following the treatment period, HCEC were exposed to hyperosmolar media (500 mmol/kg via sodium chloride), or isomolar media (295 mmol/kg) for 6 hours. The cell supernatants were subsequently collected for inflammatory protein quantification. The pro-inflammatory cytokines interleukin (IL)-1β, IL-6, IL-8, and tumour necrosis factor (TNF)-α, and the immunoregulatory protein thrombospondin-1 (TSP-1) were quantified using electrochemiluminescence immunoassays. This experiment was conducted in technical replicates of three and was repeated three times. Inflammatory protein expression was normalized to the respective untreated HCEC control condition under either isomolar or hyperosmolar stress.

Results: Under hyperosmolar conditions, HCEC treated with either 3-MA or CQ exhibited a significantly lower expression of IL-1β (both p < 0.01), IL-6 (both p < 0.01), and TNF- α (both p 0.05). Under isomolar conditions, HCEC treated with either 3-MA or CQ exhibited no significant difference in IL-1β, IL-6, IL-8, and TNF-α expression when compared to untreated HCEC (all p > 0.06). Similarly, under hyperosmolar conditions HCEC treated with either 3-MA or CQ exhibited a significant reduction in TSP-1 expression in comparison to the untreated HCEC (both p < 0.01). Under isomolar conditions, HCEC treated with 3-MA or CQ, was also found to exhibit a significant reduction in TSP-1 expression compared to untreated HCEC (both p < 0.01).

Conclusion: This experiment found that disrupting autophagy alters the inflammatory response and its regulation associated with hyperosmolar stress. These findings suggest that aging reduces the ability of the corneal epithelium to control its response to inflammatory stimuli, potentially revealing a link between corneal aging and OSD.

Navascues-Cornago,M., Guthrie,S., Morgan,P., Woods,J. Determination of the Minimal Clinically Important Difference (MCID) for Ocular Subjective Responses Transl Vis Sci Technol 2024;13(8):28 [ Show Abstract ]

Purpose: To determine the minimal clinically important difference (MCID) for contact lens (CL)-related subjective responses and explore whether MCID values differ between subjective responses and study designs.
Methods: This was a retrospective analysis of data from seven one-week bilateral crossover studies and 14 one-day contralateral CL studies. For comfort, dryness, vision, or ease of insertion, participants rated on a 0-100 visual analogue scale (VAS) and indicated lens preference on a five-point Likert scale featuring strong, slight, and no preferences. For each criterion, four MCID estimates were calculated and averaged: mean VAS score difference for "slight preference," lower limit of 95% confidence interval VAS score difference for "slight preference," difference in mean VAS score difference between "slight" and "no preference" and 0.5 standard deviation of VAS scores.
Results: The four calculation methods generated a small range of MCID values. For bilateral studies, the averaged MCID was 7.2 (range 5.4-8.8) for comfort, 8.1 (5.2-10.6) for dryness, 7.1 (5.5-9.3) for vision and 7.6 (6.0-10.5) for ease of insertion. For contralateral studies, the averaged MCID was 6.9 (6.1-7.6) for comfort at insertion and 7.5 (6.8-8.2) for end-of-day comfort.
Conclusions: This work demonstrated very similar MCID values across subjective responses and study designs, in a population of habitual soft CL wearers. In all cases, MCID values were on average seven units on a 0 to 100 VAS.
Translational relevance: This work provides MCID values which are important for interpreting ocular subjective responses and planning clinical studies.

Ng AY. AZR-MD-001 Improved Tear Film Stability and Symptoms of Meibomian Gland Dysfunction in a 6-Month Study https://contactlensupdate.com/2024/04/16/azr-md-001-improved-tear-film-stability-and-symptoms-of-meibomian-gland-dysfunction-in-a-6-month-study/ 2024, 77:

Ng AY, Jones L, Chalmers R. The Importance of Contact Lens Care on Safety  NCC, Veldhoven, Netherlands, Mar 10, 2024

NG AY, Jones L, Woods J, Basuthkar S, Keir N. Diurnal changes in corneal dendritic cell density and morphology in symptomatic and asymptomatic contact lens wearers The Association for Research in Vision and Ophthalmology, Seattle, WA, May 6, 2024 [ Show Abstract ][ PDF ]

Purpose: To explore corneal dendritic cell (DC) density and morphology in soft contact lens (CL) wearers using in vivo confocal microscopy (IVCM) after different wear times, imaging with and without CLs in situ.

Methods: This was a prospective study involving hydrogel and silicone hydrogel CL wearers (17F, 3M; 29.5±10.5 years): 10 symptomatic (S-CL) and 10 asymptomatic (A-CL), by Young’s criterion and comfortable wear time. Eligible participants attended a baseline day (no CL wear, IVCM conducted in the morning (AM) and 8 hours later (PM), three separate CL wearing days (IVCM after 1, 4 or 8 hours [randomized] with CLs removed immediately before imaging and topical anesthesia), and a day where CLs were worn all day (IVCM after 1, 4 and 8 hours of CL wear, with CLs in situ during imaging and no anesthesia). At least five non-overlapping sequence scans were taken at the central and inferior cornea with the Heidelberg Retina Tomograph III with Rostock Cornea Module. Up to five images per location were analyzed with automated DC counting software. A linear mixed model was applied for all statistical analyses.

Results: At the central cornea, DC density was greater in the AM/1 hour compared to PM/8 hours (p<0.001), and for the A-CL group compared to the S-CL group (p=0.041). There was no effect of imaging with CLs in situ on DC density; DC density with and without CLs in situ strongly correlated across all time points at both corneal locations (r=0.694 to 0.843, all p≤0.01). For cell morphology, immature dendritic cells were the dominant cell type in both groups at both locations (S-CL ≥77%, A-CL ≥78%). Mature cells made up 8-15% of all DCs. The A-CL group had 5% more mature cells than the S-CL group at the inferior cornea only (p=0.034). At both locations, 5% more mature cells were observed on lens wearing days (central p=0.043, inferior p=0.027). Time of imaging was not a significant effect on the proportion of immature or mature cells at either location.

Conclusions: This study shows subtle differences in DC density and morphology between symptomatic and asymptomatic CL wearers and over the course of the day in different corneal regions. The clinical significance of these results requires further investigation. This study supports the imaging of DCs with CLs in situ, which could simplify monitoring these cells during CL wear.

Ngo W, Nagaarudkumaran N, Huynh C. Reducing Instillation Discomfort of a 0.09% Cyclosporine a Solution American Academy of Optometry Meeting, Indianapolis, Nov 8, 2024 [ Show Abstract ]

Purpose: To quantify the instillation discomfort associated with either cold or warm instillation of a cyclosporine A solution (0.09% CsA, Sun Pharmaceutical Industries Ltd., CA).

Methods: 40 participants with symptomatic aqueous deficient dry eye (Ocular Surface Disease Index >23, strip meniscometry< 5 mm) were enrolled. A drop of cold (4°C) 0.09% CsA was instilled in one eye, and a drop of warm (23°C) 0.09% CsA was instilled in the other eye. The order and eye receiving the cold drop was randomized. Participants were instructed to rate the discomfort of each eye (0=no discomfort, 10=maximal discomfort) prior to drop instillation, immediately post-instillation, and at each subsequent minute for 10 minutes (i.e., t=0, t=1, … t=10). Area under curve (AUC) was used to quantify cumulative discomfort (discomfort summed over time). Ocular surface staining (OSS), fluorescein tear breakup time (TBUT), and meibum quality (MG score) were obtained and correlated against difference in cumulative discomfort between cold and warm instillation. 0.09% CsA was stored at 4°C for 1 month and change in nanoparticle size (NanoSight, Malvern Instruments, UK) and pH was quantified.

Results: 40 participants (39.6 ± 18.9 years old, 82.5% female) completed the study. A majority of participants (n=24, 60%) experienced reduced cumulative discomfort with cold 0.09% CsA, while the remainder experienced minimal difference (n=10, 25%), or increased cumulative discomfort (n=6, 15%). For those with reduced discomfort (n=24), cumulative discomfort associated with cold instillation (median = 11.5 (2.2, 20.0)) was significantly lower (p< 0.01) than cumulative discomfort associated with warm instillation (median = 17.5 (11.2, 32.2)). Cold instillation was associated with a median reduction of 1 discomfort point immediately post-instillation, and at all subsequent time points (all p≤0.04, but not significant at t=10), compared to warm instillation. None of the clinical tests (OSDI, MG score, TBUT, OSS) correlated with difference in cumulative discomfort (all p≥0.38). There was no apparent change in mean nanoparticle size (Δ=-13.5 nm ± 29 nm; p=0.53) and pH (Δ=0.04 units; p=0.05) over 1 month of storage at 4°C.

Conclusion: A majority of participants found relatively reduced discomfort with cold instillation of 0.09% CsA solution, lasting up to 9 minutes post-instillation. No clinical signs were capable predictors of reduced discomfort. Nanoparticle size and pH appeared to be stable over 1 month of cold stora

Otchere H, Jones L, Gorbet M. Subjective Assessment of Hydra-PEG Coated and Uncoated Scleral Contact Lens Wear Among Dry Eye Subjects American Academy of Optometry Meeting, Indianapolis, Nov 8, 2024 [ Show Abstract ]

Purpose: To assess wearing habits and subjective ratings comparing Hydra-PEG coated and uncoated scleral lens wear among dry eye disease subjects and to determine the relationship between the measured parameters.

Methods: This was a prospective, double-masked, randomized, dispensing, cross-over clinical trial involving five visits, where 20 subjects with mild to moderate dry eye disease (DED) were enrolled. The first visit involved screening and baseline measurements where scleral contact lenses (SL) were trial fitted. The second visit involved randomization and dispensing of customized SL, where each pair of lenses were worn on a daily wear basis for four weeks. Also, an internally developed wearing habit and subjective questionnaire was provided to subjects and completed daily. The third visit (after 4 weeks) involved a follow-up of the first randomized SL, where the lenses were evaluated, and questionnaires reviewed. A wash-out period of at least 48 hours was allowed before dispensing and follow-up of the other pair of SL, using the same procedures and visit schedule.

Results: Eighteen females and two males were enrolled in the study. The mean age and standard deviation (SD) were 29.10 ±7.48 (range: 21-47). The overall OSDI and SPEED scores were 36.45 ± 17.08 and 12.50 ± 4.03 respectively. The overall mean and SD of the measured parameters comparing uncoated and coated SL were: Days/hours (26.00 ± 3.42/7.18 ±1.75 vs 26.10 ± 3.65/7.16 ± 1.61), Dryness (73.43 ± 19.55 vs 76.02 ± 21.78), Burning (82.18 ± 21.69 vs 83.60 ± 22.16), Vision (71.71 ± 22.69 vs 71.01 ± 22.61), and Comfort (74.52 ± 17.83 vs 73.01 ± 20.81). There were no significant differences among the measured parameters comparing uncoated and Hydra-PEG coated SL (all, p > 0.05). However, the results showed a significant correlation in almost all of the measured parameters (p 0.6).

Conclusion: This study represents the first attempt to characterize SL-related wearing habit and subjective ratings in healthy subjects with mild to moderate DED. Since there are no established cut-off points to compare our results, it is difficult to suggest that these scores can be used to make any clinical decisions. However, these scores provide some valuable information on subjective assessment and wearing behavior of DED subjects wearing SL. The results show that patients with mild to moderate DED can successfully wear SL, with some potential benefits over their usual form of vision correction. Our results also suggest that Hydra-PEG coating did not lead to additional improvements compared to uncoated lenses.

Phan,C. M., Chan,V. W. Y., Drolle,E., Hui,A., Ngo,W., Bose,S., Shows,A., Liang,S., Sharma,B., Subbaraman,L., Zheng,Y., Shi,X., Wu,J., Jones,L. Evaluating the in vitro wettability and coefficient of friction of a novel and contemporary reusable silicone hydrogel contact lens materials using an in vitro blink model Contact Lens Anterior Eye 2024;47(2):102129 [ Show Abstract ]

Purpose
To evaluate the in vitro wettability and coefficient of friction of a novel amphiphilic polymeric surfactant (APS), poly(oxyethylene)–co-poly(oxybutylene) (PEO-PBO) releasing silicone hydrogel (SiHy) contact lens material (serafilcon A), compared to other reusable SiHy lens materials.

Methods
The release of fluorescently-labelled nitrobenzoxadiazole (NBD)-PEO-PBO was evaluated from serafilcon A over 7 days in a vial. The wettability and coefficient of friction of serafilcon A and three contemporary SiHy contact lens materials (senofilcon A; samfilcon A; comfilcon A) were evaluated using an in vitro blink model over their recommended wearing period; t = 0, 1, 7, 14 days for all lens types and t = 30 days for samfilcon A and comfilcon A (n = 4). Sessile drop contact angles were determined and in vitro non-invasive keratographic break-up time (NIKBUT) measurements were assessed on a blink model via the OCULUS Keratograph 5 M. The coefficient of friction was measured using a nano tribometer.

Results
The relative fluorescence of NBD-PEO-PBO decreased in serafilcon A by approximately 18 % after 7 days. The amount of NBD-PEO-PBO released on day 7 was 50 % less than the amount released on day 1 (6.5±1.0 vs 3.4±0.5 µg/lens). The reduction in PEO-PBO in the lens also coincided with an increase in contact angles for serafilcon A after 7 days (p 0.05). The other contact lens materials had stable contact angles and NIKBUT over their recommended wearing period (p > 0.05), with the exception of samfilcon A, which had an increase in contact angle after 14 days as compared to t = 0 (p < 0.05). Senofilcon A and samfilcon A also showed an increase in coefficient of friction at 14 and 30 days, respectively, compared to their blister pack values (p < 0.05).

Conclusion
The results indicate that serafilcon A gradually depletes its reserve of PEO-PBO over 1 week, but this decrease did not significantly change the lens performance in vitro during this time frame.

Pucker A, Jones L, Redfern R. Latest Development and the Future of Dry Eye Management NCC, Veldhoven, Netherlands, Mar 10, 2024

Pucker A, Jones L, Redfern R. Latest Development and the Future of Dry Eye Management - Day 2 NCC, Veldhoven, Netherlands, Mar 11, 2024

Qiu S. Fast Forward to the Future: The Rise of Empirical Fitting and Scleral Lens Customization Contact Lens Spectrum 2024;39, January/February: 36

Qiu S, Fadel D. The Future of Scleral Lenses: Empirical Fitting and Customization American Academy of Optometry Meeting, Indianapolis, Nov 8, 2024

Qiu,S. X., Fadel,D., Hui,A. Scleral Lenses for Managing Dry Eye Disease in the Absence of Corneal Irregularities: What Is the Current Evidence? Journal of Clinical Medicine 2024;13(13):3838 [ Show Abstract ]

Scleral lenses (SLs) are large-diameter rigid contact lenses that are a mainstay treatment for eyes with corneal irregularities. In recent years, there has been increased interest in the role of managing dry eye disease (DED) with SLs, as many patients with DED have reported symptomatic relief with SL wear. The role of SLs for DED management when there are associated corneal irregularities is supported by individual case reports and studies. This has prompted practitioners to begin advocating using SLs in DED cases, even in the absence of associated corneal irregularities and other ocular surface diseases (OSDs). There have also been discussions on potentially placing SLs earlier in the treatment hierarchy of DED, where it currently sits at a more advanced level of intervention (Step 3) in the TFOS DEWS II Report. This review will present the currently available, albeit sparse, evidence that supports and suggests this practice, as well as ancillary evidence supporting the purported benefits of SL wear in DED. The advantages of SL wear, such as corneal healing, absence of tear evaporation and contact lens dehydration, and improved visual acuity with associated increased wear comfort, and how this will benefit DED patients will be explored. Conversely, the challenges associated with fitting SLs in DED patients, including increased midday fogging, poor wettability, and subjective patient satisfaction, will also be presented, as well as a discussion on the key considerations for SL fitting in this population. Overall, while more research is needed to support the use of SLs in DED patients without associated corneal irregularities and other forms of OSD, the use of these lenses may prove to have a potentially wider role given their reported ancillary benefits in these populations.

Sara,M. Hui,A., Yasir,M., Hari Kumar,P., Kalaiselvan,P., Willcox,M. Intrastromal Corneal Ring Implants Associated Bacterial Infections Current Eye Research 2024;49(10):1012-1020 [ Show Abstract ]

Purpose: This study examines the incidence of infection and resistance associated with Intracorneal Ring Segment (ICRS) implantation, a common outpatient surgical treatment for correcting refractive errors and corneal ectatic diseases. Although ICRS procedures are typically safe and reversible, there is a low but notable risk of microbial infections, which require prompt and sometimes invasive treatment.

Methods: Three electronic databases, PubMed, Web of Science (WoS), and Scopus, were utilised to search for literature according to PRISMA guidelines to identify infections related to the implantation of ICRS in the cornea between January 2000 and December 2022.

Results: Gram-positive organisms were involved in 86% of cases: 35.7% S. aureus, 25% coagulase-negative staphylococci species, 17.8% streptococci and 7.1% Nocardia species. Less commonly recorded were Gram-negative bacteria (14%), with Pseudomonas aeruginosa (circa 10%) and Klebsiella pneumonia (4%) being the most common Gram-negative bacteria. In rare cases, fungi have also been reported. ICRS-related bacterial infections can be categorised into early or late onset. Early onset infection typically manifests within the first few weeks after implantation and is often associated with contamination during surgery, unhygienic practices, or inadequate sterilisation techniques. On the other hand, late-onset infection may develop months or even years after the initial procedures and may be associated with persistent bacterial colonisation, secondary infections, or prolonged use of prophylactic antibiotics. S aureus is encountered in both early and late-onset infections, while Nocardia species and K. pneumoniae have generally been reported to occur in late-onset infections. In addition, vision recovery from S. aureus infections tends to be poor compared to other bacterial infections.

Conclusion: S. aureus is a predominant pathogen that often requires surgical intervention with poor outcomes. Early infections result from incision gaps and ring segment rubbing, while late infections are linked to prolonged antibiotic use. Further research is needed on novel antimicrobial ICRS to procure the vision.

Schulze M, Guthrie S, Ho B, Woods J, Jones L. Do Symptomatic Contact Lens Wearers Benefit from Using Lifitegrast Tear Film & Ocular Surface Society Conference, Venice, Italy, Nov 1, 2024

Schulze M, Guthrie S, Woods J, Jones L. Does Lifitegrast Improve Symptoms of Discomfort and Dryness in Symptomatic Contact Lens Wearers American Academy of Optometry Meeting, Indianapolis, Nov 8, 2024 [ Show Abstract ][ PDF ]

Purpose: To evaluate whether symptomatic contact lens (CL) wearers achieve improvements in comfort and dryness when using lifitegrast 5.0% ophthalmic solution (Xiidra) for 12 weeks.

Methods: CL wearers who rated their CL end-of-day dryness as ≥40 on a 0-100 visual analog scale (VAS; 100 = worst) and who met Young’s criteria for contact lens related dryness symptoms were classified as symptomatic CL wearers and qualified for the study. Eligible participants were asked to use lifitegrast twice/day for 12 weeks while continuing to wear their habitual contact lenses and refraining from using any other eye drops. The performance of lifitegrast was assessed after 2, 6 and 12 weeks (2W, 6W, 12W) by comparing to baseline (BL) measures for end-of-day dryness and end-of-day discomfort VAS ratings (0-100 scale; 100 worst) and the CLDEQ-8 questionnaire. Total and comfortable wear times were collected at baseline and at all study visits.

Results: A total of 40 participants completed the study (33F; mean age 30.8 ± 12.1 years). Reusable CLs were habitually worn by 35% of participants, while 65% wore daily disposable CLs. Mean (±SD) subjective ratings of CL wear-related dryness (BL: 66 ± 25; 2W: 42 ± 26; 6W: 31 ± 26; 12W: 21 ± 22) and discomfort (BL: 61 ± 27; 2W: 41 ± 27; 6W: 30 ± 26; 12W: 20 ± 22) improved over time, with significant differences after 2, 6 and 12 weeks of lifitegrast use for both end-of-day dryness and discomfort (all p< 0.01). All participants (100%) scored at least 40/100 for CL end-of-day dryness rating at baseline (inclusion criterion), and this percentage (count) dropped to 55% (22) at 2W, 25% (10) at 6W and 17% (7) at 12 weeks of lifitegrast use. CLDEQ-8 scores at 2W (16 ± 5), 6W (13 ± 6) and 12W (11 ± 6) were all significantly lower (all p0.05), there was a significant improvement (all p< 0.01) in comfortable wear time at 2 weeks (8 ± 3 hours), 6 weeks and 12 weeks (both 9 ± 3 hours) compared to baseline (6 ± 2 hours).

Conclusion: Using lifitegrast for as little as 2 weeks resulted in significant improvements in symptoms of end-of-day of discomfort and dryness and a longer comfortable wear time. Lifitegrast may be a suitable alternative for symptomatic CL wearers who are unable to achieve satisfactory comfort and dryness with alternate CLs or over-the-counter comfort enhancing drops.

Shokrollahi P. Fast Forward to the Future: Material science innovation Contact Lens Spectrum 2024;39, June: 34