PubMed · 1027834
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L N Kline, T J Deluca. 1976. Arcuate staining.. https://pubmed.ncbi.nlm.nih.gov/1027834/
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PURPOSE: To compare central corneal thickness measurements as a function of contact lens wear in patients presenting for refractive surgery. SETTING: Gimbel Eye Centre, Saskatoon, Saskatchewan, Canada. METHODS: A retrospective study of charts yielded 634 eyes meeting the inclusion criterion. Pachymetry measurements of spectacle-wearing control eyes were compared to those of full-time soft contact lens wearers and rigid gas-permeable contact lens wearers. All measurements were taken with the DGH ultrasonic pachymeter by a single observer. RESULTS: Soft contact lens wearers had a mean reduction in corneal thickness measurements of 22 micrometers compared to the control population (P =.00001). Rigid gas-permeable lens wearers had a reduction of 24 micrometers compared to the control population (P =.00001). CONCLUSION: There was a clinically significant reduction in corneal thickness measurements associated with full-time contact lens wear.
Fluid-ventilated, gas-permeable scleral lenses are a valuable front-line tool in the management of severe ocular surface disease. In addition to enhancing vision, they have the potential to reduce greatly the disabling ocular pain and photophobia associated with SJS, TEN, and ocular cicatricial pemphigoid. They are also useful in healing some PEDs that are refractory to all other treatment strategies and in reducing PED recurrence in stem cell-deficient and neurotrophic corneas. The therapeutic benefits of these lenses are provided by the oxygenated aqueous environment they create over the corneal epithelium. The oxygenated precorneal fluid compartment that is maintained at neutral pressure protects the epithelial surface from the desiccating effects of exposure to air and the friction generated by blinking and avoids the shearing forces generated during the blink-induced movement of soft lenses.
A retrospective review of case notes of consecutive patients referred to a contact lens clinic after unsuccessful refractive surgery was carried out to determine the success of contact lens fitting. The main outcome variables in determining success were visual improvement, contact lens tolerance, fitting characteristics and wearing time. Thirteen eyes were fitted with conventional rigid gas permeable (CRGP), 10 with soft and 19 with reverse geometry rigid gas permeable contact lenses (RVG). The mean spectacle visual acuity (VA) was 6/9 (20/30) [range: 6/24 (20/80) to 6/5 (20/15)] and the mean VA after contact lens fitting was 6/6 (20/20) [range: 6/18 (20/60) to 6/5 (20/15)]. Of the 42 eyes, the contact lens VA was better than spectacle acuity in 25 (59.5%) eyes, equal in 14 (33.3%) and worse in three (7.1%). A total of 33 (78.6%) eyes were still wearing their lenses at the last visit. Contact lenses can be a valuable method of managing poor VA after refractive surgery.