Purpose

To investigate the relationship between the real contact lens imprint into the conjunctival tissue, observed by optical coherence tomography (OCT) and conjunctival staining and contact lens wearing comfort.

Methods

17 participants (mean age = 26.6 SD ± 3.6 years; 7 females) were fitted with three different contact lenses base curves of the same silicone hydrogel custom lens type (Visell 50; Hecht Contactlinsen, Au, Germany) in a randomised order. One lens was optimally fitted according to the manufacturer's recommendation, one fitted 0.4 mm flatter and one fitted 0.4 mm steeper. After 4 h of lens wear the contact lens edge in the area of the conjunctiva was imaged nasally and temporally using OCT (Optovue iVue SD-OCT). To correct the artefact due to optical distortion with OCT, the imprint of all worn lenses was measured on a glass plate afterwards. Conjunctival staining in the limbal region after 4 h of lens wear was classified using the CCLRU Grading Scale. Comfort scoring was based on visual analog scales from 0 (very poor) to 100 (excellent).

Results

The mean conjunctival imprint of all contact lens edges was 32.0 ± 8.1 μm before and 7.3 ± 6.5 μm after distortion correction of the OCT images. The distortion corrected conjunctival imprint with the 0.4 mm steeper lens (11.5 ± 6.2 μm) was statistically significantly greater compared to the optimally fitted lens (6.5 ± 5.9 μm) (One-way ANOVA followed Tukey-test; p = 0.017) and greater compared to the 0.4 mm flatter lens (3.9 ± 5.3 μm) (p < 0.001). There was no statistically significant difference between the optimally fitted lens and the 0.4 mm flatter lens (p = 0.209). The nasally measured imprint (11.4 ± 9.0 μm) was significantly greater than the temporally measured (3.3 ± 7.6 μm) (p < 0.001). There was no statistically significant correlation between the amount of conjunctival imprint and the graded conjunctival staining (p = 0.346) or the wearer’s comfort (p = 0.735).

Conclusions

Contact lens edges imaged by OCT exhibited displacement artefacts. The observed conjunctival imprints are a combination of real conjunctival compression and artefacts. A deeper imprint of the contact lens into the conjunctiva caused by a steeper base curve was not related to clinically significant staining or changes in comfort after 4 h of lens wear. The observed differences between nasal and temporal imprint are likely to be caused by variations of conjunctival thickness and the shape of the underlying sclera.

中文翻译：

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光学相干图像观察到的隐形眼镜相关眼表组织变化的临床意义

目的

研究光学相干断层扫描（OCT）和结膜染色观察到的真实隐形眼镜印记进入结膜组织与隐形眼镜佩戴舒适度之间的关系。

方法

17 名参与者（平均年龄 = 26.6 SD ± 3.6 岁；7 名女性）以随机顺序安装了相同硅水凝胶定制镜片类型（Visell 50；Hecht Contactlinsen，Au，Germany）的三种不同隐形眼镜基曲线。一个镜头根据制造商的建议进行了最佳安装，一个安装了 0.4 毫米的平坦度，一个安装了 0.4 毫米的陡度。镜片佩戴 4 小时后，使用 OCT (Optovue iVue SD-OCT) 对结膜区域的隐形眼镜边缘进行鼻部和颞部成像。为了用 OCT 校正光学畸变造成的伪影，随后在玻璃板上测量了所有佩戴镜片的印记。使用 CCLRU 分级量表对镜片佩戴 4 小时后角膜缘区域的结膜染色进行分类。舒适度评分基于从 0（非常差）到 100（优秀）的视觉模拟量表。

结果

所有隐形眼镜边缘的平均结膜印记在 OCT 图像畸变校正前为 32.0 ± 8.1 μm，在畸变校正后为 7.3 ± 6.5 μm。与最佳拟合镜片 (6.5 ± 5.9 μm) 相比，使用 0.4 mm 更陡透镜 (11.5 ± 6.2 μm) 的畸变校正结膜印记在统计学上显着更大（单向方差分析遵循 Tukey 检验；p = 0.017）和更大的比较到 0.4 mm 更平坦的镜头 (3.9 ± 5.3 μm) (p < 0.001)。最佳拟合镜片和 0.4 毫米扁平镜片之间没有统计学上的显着差异（p = 0.209）。经鼻测量的印记 (11.4 ± 9.0 μm) 显着大于经时间测量的 (3.3 ± 7.6 μm) (p < 0.001)。结膜印记的数量与分级结膜染色之间没有统计学上的显着相关性（p = 0.

结论

OCT 成像的隐形眼镜边缘显示出位移伪影。观察到的结膜印记是真实结膜压迫和伪影的结合。由较陡的基曲线引起的隐形眼镜在结膜中的更深印记与临床上显着的染色或镜片佩戴 4 小时后舒适度的变化无关。观察到的鼻部和颞部印记之间的差异可能是由结膜厚度和下方巩膜形状的变化引起的。