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Central Corneal Edema with Scleral-Lens Wear
- Source :
- Kim, YH; Tan, B; Lin, MC; & Radke, CJ. (2018). Central Corneal Edema with Scleral-Lens Wear. Current Eye Research, 43(11), 1305-1315. doi: 10.1080/02713683.2018.1500610. UC Berkeley: Retrieved from: http://www.escholarship.org/uc/item/6k70p2nq, Current eye research, vol 43, iss 11
- Publication Year :
- 2018
- Publisher :
- eScholarship, University of California, 2018.
-
Abstract
- © 2018, © 2018 Taylor & Francis Group, LLC. Purpose: To evaluate the safety of scleral-lens designs, we model and clinically assess central corneal edema induced by scleral-lens wear for healthy subjects. Materials and Methods: Central corneal swelling during scleral-lens wear is measured using optical coherence tomography (OCT). Transport resistances are modeled for oxygen diffusion through the scleral lens and post-lens tear-film (PoLTF), and into the cornea. Oxygen deficiency in the cornea activates anaerobic metabolic reactions that induce corneal edema. Oxygen permeability, carbon-dioxide permeability, settled-lens PoLTF thickness, and scleral-lens thickness are varied in the calculations to mimic different lens fits. Results: Transport modeling predicts that for open eyes, increasing PoLTF thickness from 50 to 400 µm increases central corneal swelling by approximately 1–1.5% when oxygen transmissibility (Dk/L) is greater than 10 hBarrer/cm (i.e., hectoBarrer/cm). Although swelling is larger for oxygen Dk/L 40 hBarrer/cm. For closed eye, central corneal swelling is greater than 5% for an oxygen Dk/L range of 0–100 hBarrer/cm with typical lens-fitting parameters. For carbon-dioxide transmissibilities increasing from 50 to 250 hBarrer/cm and with a fixed oxygen Dk/L of 25 hBarrer/cm, calculated swelling diminishes by an additional 0.5%. Comparison of model calculations to clinical-swelling data is within the error range of the clinical measurements. Conclusions: Oxygen/metabolite transport calculations for open-eye scleral-lens wear show that typical PoLTF thicknesses fitted by clinicians (i.e., PoLTF thicknesses 25 hBarrer/cm) produce corneal swelling of less than 2% in agreement with experiment. Therefore, scleral lenses prescribed today evoke less than physiological hypoxic swelling (i.e., less than 4%) for healthy corneas during open-eye. Closed-eye wear, however, appears clinically unsafe.
- Subjects :
- computational modeling
medicine.medical_specialty
genetic structures
Contact Lenses
contact lens
Scleral lens
Eye
Ophthalmology & Optometry
Cornea
03 medical and health sciences
Cellular and Molecular Neuroscience
0302 clinical medicine
Oxygen Consumption
Corneal edema
Ophthalmology
medicine
Humans
Eye Disease and Disorders of Vision
corneal metabolism
business.industry
hypoxia
Corneal Edema
Hypoxia (medical)
Sensory Systems
eye diseases
Contact lens
030221 ophthalmology & optometry
sense organs
medicine.symptom
Central cornea
business
oxygen
030217 neurology & neurosurgery
Sclera
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Kim, YH; Tan, B; Lin, MC; & Radke, CJ. (2018). Central Corneal Edema with Scleral-Lens Wear. Current Eye Research, 43(11), 1305-1315. doi: 10.1080/02713683.2018.1500610. UC Berkeley: Retrieved from: http://www.escholarship.org/uc/item/6k70p2nq, Current eye research, vol 43, iss 11
- Accession number :
- edsair.doi.dedup.....44c4be3cb0f8e0e47b90e22d94ead1be