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To determine if there are corneal curvature and refractive error changes associated with hydrogel lens wear, 27 patients wearing F series Bausch & Lomb SOFLENS-TM contact lenses were examined regularly for nine months. During the first month of lens wear, a mean corneal steepening of 0.23 DK plus or minus 0.18 and an increase in with-the-rule toricity were found, which persisted during the following eight months of wear. A mean increase in myopia of 0.35 DS plus or minus .211 DS was found after nine months of lens wear for five randomly selected patients. This amount of change was statistically significant and was highly correlated with the observed corneal steepening. Their lenses were removed after nine months of lens wear. Both corneal changes and the increase in myopia persisted during the 14 days after lens removal. If long term studies with larger samples show similar results, the effect of hydrogel lenses on corneal curvature and refractive error will have to be considered in the decision to fit this type of lens.

Central corneal thickness changes during the wearing of hydrogel lenses under closed-eye conditions were measured for two subjects. Each wore an investigational ultrathin BauschLomb Soflens contact lens (series X-176) on one eye only under closed-eye conditions for periods ranging from 30 min to 6 hr. The other eye served as a control. Corneal thickness of the control eyes increased gradually and reached a maximum increase of about 4% at the end of the 4-hr wearing trial. Corneal thickness in the experimental eyes also increased with wearing time during the first 4 hr and then remained fairly constant up to a wearing time of 6 hr. The maximum thickness increases for the two subjects were 9.8 and 9.1%, respectively. About 80% of the maximum corneal thickness change was present after 3 hr of closed-eye contact lens wear. The corneal thickness in the control eye returned to baseline 80 min after removal of the contact lens. Corneal thickness of one experimental eye returned to baseline 2 hr after the contact lens was removed.

Forty-six patients who were unable to wear polymethylmethacrylate (PMMA) contact lenses, owing mainly to corneal edema and associated symptoms, were fitted with gas-permeable hard Polycon lenses of the same dimensions. Thirty-one patients (67%) wore the POLYCON lenses successfully. Thirteen (28%) did not, because of discomfort. For 2 patients, the results were unknown. None of the 46 patients exhibited observable edema with the POLYCON lenses. For a group of 5 patients (10 eyes), mean corneal thickness change after 8 hr of lens wear was insignificant. Oxygen transmissibility of these lenses is approximately 5.0 X 10(-11) (cm2 X ml O2)/(sec X ml X mm Hg), a value less than that for hydrogel lenses which produce more edema. It is predicted that gas-permeable hard lenses will eventually replace PMMA lenses.

Hydrogen peroxide disinfection has caused discomfort for some soft contact lens wearers even though the solution was neutralized properly. The discomfort could be due to the endpoint pH of the system used or the residual H2O2 concentration. Using a digital pH meter and H2O2 concentration detection strips, we measured the pH and H2O2 concentration of seven different hydrogen peroxide disinfection systems over their recommended disinfection and neutralization cycles to determine their time courses and endpoint values. The final pH of the seven systems varied from 6.15 to 7.74 pH units. All systems resulted in residual H2O2 concentrations below threshold values. These findings indicated that the final pH may be the cause of patient discomfort after hydrogen peroxide disinfection and neutralization.

Ten myopic patients with no previous contact lens experience were fitted with similarly designed Silcon and Polycon II contact lenses so that we could evaluate and compare the patients' responses to these lens types in a double masked fashion. None of the patients had any contraindications to contact lens wear. The Silcon lens is a cross-linked silicone resin lens with a reported DK value of 16 X 10(-11). The Polycon II lenses is a combination PMMA-Silicone lens with a reported DK value of 12 X 10(-11). After a thorough contact lens pre-fitting evaluation, each patient was fitted in a random fashion with a Silcon lens on one eye and a Polycon II lens on the other. Patient response was evaluated by the standard of success of Sarver and Harris. No statistically significant differences were found in the patients responses to the two lens types. Nine of the patients were successful with the Silcon lenses while all 10 patients were successful with the Polycon II lenses.

Central and peripheral corneal thickness was monitored during the wearing of Bausch and Lomb SOFLENS® Contact Lenses. The results showed that a generalized and equal swelling occurred in the central and peripheral cornea. This generalized swelling explains the absence of significant spectacle blur and/or changes in corneal curvature. ®SOFLENS is a registered trademark of Bausch & Lomb, Inc. AUTHOR'S ADDRESS: Dr. Timothy L. Sanders School of Optometry University of California Berkeley, California 94720

Previous investigators have shown that thin polymethyl methacrylate (PMMA) contact lenses (less than or equal to 0.12 mm) flex on toric corneas, thereby altering the residual astigmatism. The present study was designed to evaluate the flexure and residual astigmatism of gas permeable Polycon contact lenses on toric corneas and compare the results with those obtained with PMMA lenses on the same corneas. Eight subjects (16 eyes) with corneal toricities ranging from 1.25 to 4.25 D wore four pairs of identical Polycon and PMMA lenses. The only lens parameter that varied was center thickness, which ranged from 0.07 to 0.16 mm. Flexure and residual astigmatism were measured on all corneas with all lenses in a double-masked fashion. Our results indicate that Polycon lenses undergo significantly more flexure and alter residual astigmatism more on toric corneas than PMMA lenses at all center thicknesses evaluated. For both materials, flexure and residual astigmatism increased as center thickness decreased. The clinical implications of these findings are discussed.

Thin contact lenses flex on toric corneas, thus changing the residual astigmatism. Our study evaluated the flexure and induced astigmatism of CABCURVE cellulose acetate buterate (CAB) contact lenses on toric corneas and compared the results with those found for polymethyl methacrylate (PMMA) and Polycon lenses. Ten subjects (20 eyes) with corneal toricities ranging from 1.12 to 3.12 D wore six CABCURVE lenses with center thicknesses from 0.10 to 0.20 mm. Flexure and induced residual astigmatism were measured on all corneas with all lenses in a double-masked fashion. We found that all the CABCURVE lenses flexed on the toric corneas and altered residual astigmatism. Both flexure and induced residual astigmatism increased as center thickness decreased, and were greater than with PMMA or Polycon lenses of similar dimensions. These findings should be considered when deciding which lens type to fit on patients with toric corneas.

The rotation lathe-cut HydroCurveTM gel contact lens was measured on six eyes to evaluate the parameters that influence lens rotation and to determine if this lens could be used to correct astigmatism. Of the 72 observations made, 73.6% showed some lens rotation, and 33.4% of the sample rotated more than 5 degrees per 10 blinks. Of the observations in which rotation was noted, 88.7% were encyclorotation. These results are similar to those found for spin-cast hydrogel lenses. None of the lens parameters evaluated seemed to be related to lens rotation, whereas the eye parameters studied were. Lenses were more likely to rotate on eyes with smaller corneal diameters, smaller palpebral apertures, and corneal curvatures steeper than 4 3.00 DK (X2, N =72, p less than 0.05). Our findings indicate that some method of lens stabilization will be needed before lathe-cut hydrogel lenses can be used to effectively correct astigmatism.

Six subjects were fitted binocularly with both nonprism and prism-ballast spherical HydrocurveTM contact lenses to evaluate lens rotation on toric corneas. The 1/2 delta and the 1 delta lenses rotated significantly less than the equivalent nonprism lenses. For 11 of 12 eyes, 1/2 delta was sufficient to stabilize the lens.

This study was designed to investigate the effects of various contact lens tints on color vision. Color vision performance of eight subjects was evaluated with the Farnsworth-Munsell 100 Hue Test while each subject wore each of 13 differently tinted contact lenses. No significant differences in color vision were found with the various lenses. However, performance on the test was affected by repetition. Regardless of the lens tints tested, color discrimination for the blue quadrant of the 100 Hue Test was the poorest. Further research is needed to determine the effect of tinted contact lenses on scotopic and mesopic vision.

The Blairex Water Purifier (previously called The Blairex Deionizer) is a filtration unit designed to purify tap water for uses that require distilled or deionized water. The unit is intended to offer soft contact lens wearers a more convenient and safe method of obtaining distilled water when using salt tablets or enzymatic cleaning tablets. In this study, the safety of these units was analyzed from a microbiological point of view. The microbial starting state of 18 factory sealed Blairex Water Purifiers was evaluated by filtering sterile water through each unit and enumerating the organisms in the effluent. Then a known number of specific microorganisms was filtered through each unit. For the next 30 days, subsequent sterile distilled water filtrations were done each day. The effluent was collected with each filtration and enumerated for microorganisms. The results indicated that the majority of Blairex units tested were not sterile from the onset. Several Blairex units evaluated did support bacterial growth, as the bacteria that were passed through the unit on day 1 of the study were found in the effluent in increasing numbers with use. The clinical implications of our findings are discussed. Each time Blairex units were obtained for evaluation, the units appeared different in either filter attachments, plastic composition, or shape. The results varied according to which type of Blairex unit was tested.

The effects of monovision (MV) contact lens wear on the performance of occupational-type nearpoint tasks was evaluated on 18 presbyopic subjects (ages 44 to 67 years) by comparing MV performance (MV condition) to that with distance contact lenses with reading glasses (BV condition). Each subject had correctable distance visual acuity of 6/6 (20/20) in each eye, at least 60 sec arc of near stereopsis, good ocular health, and no previous MV experience. Time performance and error performance for 3 nearpoint occupational tasks (pointers and straws, card filing, and letter editing) were measured with the MV correction and BV correction. Measurements were taken at dispensing and at 2 weeks and 8 weeks after dispensing. Subjects were instructed to wear the MV soft spherical contact lenses at least 8 h per day. We measured BV time performance to be better than MV time performance by 2.8 to 5.7% and also measured an increased number of errors with MV.