The time course and nature of corneal oedema during sealed miniscleral contact lens wear

Stephen J. Vincent; David Alonso-Caneiro; Michael J. Collins

doi:10.1016/j.clae.2018.03.001

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The time course and nature of corneal oedema during sealed miniscleral contact lens wear

Journal article

Peer reviewed

The time course and nature of corneal oedema during sealed miniscleral contact lens wear

Stephen J. Vincent, David Alonso-Caneiro and Michael J. Collins

Contact Lens & Anterior Eye, Vol.42(1), pp.49-54

2019

DOI: https://doi.org/10.1016/j.clae.2018.03.001

PMID: 29548929

Abstract

scleral contact lens

corneal oedema

epithelium

stroma

oxygen

Purpose: To examine the magnitude and time course of central epithelial, stromal and total corneal thickness changes during sealed miniscleral contact lens wear and the influence of initial central corneal clearance upon these thickness changes. Methods: High-resolution OCT images were captured over an 8 h period of miniscleral contact lens wear (using a rotationally symmetric 16.5 mm diameter lens) in 15 young, healthy participants with normal corneae. Corneal thickness data were derived from OCT images using semi-automated image processing techniques over the central 4 mm. Results: Changes in stromal and total corneal thickness followed a similar pattern throughout lens wear with oedema first detected 15 min after lens insertion (0.47 +/- 0.09% increase in stromal and total corneal thickness, both p < 0.01) which peaked after 90 min of lens wear (1.36 +/- 0.24% increase in stromal and 1.18 +/- 0.20% increase in total corneal thickness, both p < 0.01) and gradually decreased thereafter. Epithelial thickness increased slightly during the first 30 min of lens wear (0.56 +/- 0.30% increase, p > 0.05), then rapidly decreased reaching a minimum thickness 480 min after lens insertion (2.38 +/- 0.70% decrease, p < 0.05). The maximum total corneal oedema, maximum stromal oedema, and maximum epithelial thinning were not associated with the initial central corneal clearance or the extent of lens settling over the 8 h period (all p > 0.05). Greater initial central corneal clearance resulted in less oxygen concentration reaching the cornea (similar to 2% less) based on previously published data, which manifested as similar to 0.5% more central corneal oedema. Conclusions: Scleral lens induced corneal oedema is stromal in nature. On average, central stromal and total corneal thickness increased rapidly following lens insertion and peaked after 90 min, while central epithelial thickness gradually decreased throughout lens wear consistent with natural diurnal variation. A greater initial central corneal clearance resulted in reduced oxygen delivery to the cornea, which had minimal short-term impact upon healthy eyes, however, minimising central corneal clearance may be important in eyes with reduced endothelial cell function to minimise hypoxic stress.

Details

Title: The time course and nature of corneal oedema during sealed miniscleral contact lens wear
Authors: Stephen J. Vincent (Corresponding Author) - Queensland University of Technology
David Alonso-Caneiro (Author) - Queensland University of Technology
Michael J. Collins (Author) - Queensland University of Technology
Publication details: Contact Lens & Anterior Eye, Vol.42(1), pp.49-54
Publisher: Elsevier BV
DOI: 10.1016/j.clae.2018.03.001
ISSN: 1476-5411
PMID: 29548929
Grant note: IHBI Vision and Eye Program Research Development Grant
Organisation Unit: School of Science, Technology and Engineering
Language: English
Record Identifier: 99972397202621
Output Type: Journal article