Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit

James S. Wolffsohn; Ali Tharoo; Nikita Lakhlani

doi:10.1016/j.clae.2014.11.203

Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit

James S. Wolffsohn^*, Ali Tharoo, Nikita Lakhlani

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

PURPOSE: To examine the optimum time at which fluorescein patterns of gas permeable lenses (GPs) should be evaluated.

METHODS: Aligned, 0.2mm steep and 0.2mm flat GPs were fitted to 17 patients (aged 20.6±1.1 years, 10 male). Fluorescein was applied to their upper temporal bulbar conjunctiva with a moistened fluorescein strip. Digital slit lamp images (CSO, Italy) at 10× magnification of the fluorescein pattern viewed with blue light through a yellow filter were captured every 15s. Fluorescein intensity in central, mid peripheral and edge regions of the superior, inferior, temporal and nasal quadrants of the lens were graded subjectively using a +2 to -2 scale and using ImageJ software on the simultaneously captured images.

RESULTS: Subjectively graded and objectively image analysed fluorescein intensity changed with time (p<0.001), lens region (centre, mid-periphery and edge: p<0.05) and there was interaction between lens region with lens fit (p<0.001). For edge band width, there was a significant effect of time (F=118.503, p<0.001) and lens fit (F=5.1249, p=0.012). The expected alignment, flat and steep fitting patterns could be seen from approximately after 30 to 180s subjectively and 15 to 105s in captured images.

CONCLUSION: Although the stability of fluorescein intensity can start to decline in as little as 45s post fluorescein instillation, the diagnostic pattern of alignment, steep or flat fit is seen in each meridian by subjective observation from about 30s to 3min indicating this is the most appropriate time window to evaluate GP lenses in clinical practice.

Original language	English
Pages (from-to)	110-114
Number of pages	5
Journal	Contact Lens and Anterior Eye
Volume	38
Issue number	2
Early online date	24 Dec 2014
DOIs	https://doi.org/10.1016/j.clae.2014.11.203
Publication status	Published - Apr 2015

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Contact lens and anterior eye. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Wolffsohn, JS, Tharoo, A & Lakhlani, N, 'Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit' Contact lens and anterior eye, vol 38, no. 2 (2015) DOI: http://dx.doi.org/10.1016/j.clae.2014.11.203

Keywords

rigid gas permeable
fit evaluation
fluorescein
gas permeable

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10.1016/j.clae.2014.11.203

Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit
NOTICE: this is the author’s version of a work that was accepted for publication in Contact lens and anterior eye. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Wolffsohn, JS, Tharoo, A & Lakhlani, N, 'Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit' Contact lens and anterior eye, vol 38, no. 2 (2015) DOI: http://dx.doi.org/10.1016/j.clae.2014.11.203
Accepted author manuscript, 363 KB

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title = "Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit",

abstract = "PURPOSE: To examine the optimum time at which fluorescein patterns of gas permeable lenses (GPs) should be evaluated.METHODS: Aligned, 0.2mm steep and 0.2mm flat GPs were fitted to 17 patients (aged 20.6±1.1 years, 10 male). Fluorescein was applied to their upper temporal bulbar conjunctiva with a moistened fluorescein strip. Digital slit lamp images (CSO, Italy) at 10× magnification of the fluorescein pattern viewed with blue light through a yellow filter were captured every 15s. Fluorescein intensity in central, mid peripheral and edge regions of the superior, inferior, temporal and nasal quadrants of the lens were graded subjectively using a +2 to -2 scale and using ImageJ software on the simultaneously captured images.RESULTS: Subjectively graded and objectively image analysed fluorescein intensity changed with time (p<0.001), lens region (centre, mid-periphery and edge: p<0.05) and there was interaction between lens region with lens fit (p<0.001). For edge band width, there was a significant effect of time (F=118.503, p<0.001) and lens fit (F=5.1249, p=0.012). The expected alignment, flat and steep fitting patterns could be seen from approximately after 30 to 180s subjectively and 15 to 105s in captured images.CONCLUSION: Although the stability of fluorescein intensity can start to decline in as little as 45s post fluorescein instillation, the diagnostic pattern of alignment, steep or flat fit is seen in each meridian by subjective observation from about 30s to 3min indicating this is the most appropriate time window to evaluate GP lenses in clinical practice.",

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author = "Wolffsohn, {James S.} and Ali Tharoo and Nikita Lakhlani",

note = "NOTICE: this is the author{\textquoteright}s version of a work that was accepted for publication in Contact lens and anterior eye. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Wolffsohn, JS, Tharoo, A & Lakhlani, N, 'Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit' Contact lens and anterior eye, vol 38, no. 2 (2015) DOI: http://dx.doi.org/10.1016/j.clae.2014.11.203",

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AU - Wolffsohn, James S.

AU - Tharoo, Ali

AU - Lakhlani, Nikita

N1 - NOTICE: this is the author’s version of a work that was accepted for publication in Contact lens and anterior eye. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Wolffsohn, JS, Tharoo, A & Lakhlani, N, 'Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit' Contact lens and anterior eye, vol 38, no. 2 (2015) DOI: http://dx.doi.org/10.1016/j.clae.2014.11.203

PY - 2015/4

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N2 - PURPOSE: To examine the optimum time at which fluorescein patterns of gas permeable lenses (GPs) should be evaluated.METHODS: Aligned, 0.2mm steep and 0.2mm flat GPs were fitted to 17 patients (aged 20.6±1.1 years, 10 male). Fluorescein was applied to their upper temporal bulbar conjunctiva with a moistened fluorescein strip. Digital slit lamp images (CSO, Italy) at 10× magnification of the fluorescein pattern viewed with blue light through a yellow filter were captured every 15s. Fluorescein intensity in central, mid peripheral and edge regions of the superior, inferior, temporal and nasal quadrants of the lens were graded subjectively using a +2 to -2 scale and using ImageJ software on the simultaneously captured images.RESULTS: Subjectively graded and objectively image analysed fluorescein intensity changed with time (p<0.001), lens region (centre, mid-periphery and edge: p<0.05) and there was interaction between lens region with lens fit (p<0.001). For edge band width, there was a significant effect of time (F=118.503, p<0.001) and lens fit (F=5.1249, p=0.012). The expected alignment, flat and steep fitting patterns could be seen from approximately after 30 to 180s subjectively and 15 to 105s in captured images.CONCLUSION: Although the stability of fluorescein intensity can start to decline in as little as 45s post fluorescein instillation, the diagnostic pattern of alignment, steep or flat fit is seen in each meridian by subjective observation from about 30s to 3min indicating this is the most appropriate time window to evaluate GP lenses in clinical practice.

AB - PURPOSE: To examine the optimum time at which fluorescein patterns of gas permeable lenses (GPs) should be evaluated.METHODS: Aligned, 0.2mm steep and 0.2mm flat GPs were fitted to 17 patients (aged 20.6±1.1 years, 10 male). Fluorescein was applied to their upper temporal bulbar conjunctiva with a moistened fluorescein strip. Digital slit lamp images (CSO, Italy) at 10× magnification of the fluorescein pattern viewed with blue light through a yellow filter were captured every 15s. Fluorescein intensity in central, mid peripheral and edge regions of the superior, inferior, temporal and nasal quadrants of the lens were graded subjectively using a +2 to -2 scale and using ImageJ software on the simultaneously captured images.RESULTS: Subjectively graded and objectively image analysed fluorescein intensity changed with time (p<0.001), lens region (centre, mid-periphery and edge: p<0.05) and there was interaction between lens region with lens fit (p<0.001). For edge band width, there was a significant effect of time (F=118.503, p<0.001) and lens fit (F=5.1249, p=0.012). The expected alignment, flat and steep fitting patterns could be seen from approximately after 30 to 180s subjectively and 15 to 105s in captured images.CONCLUSION: Although the stability of fluorescein intensity can start to decline in as little as 45s post fluorescein instillation, the diagnostic pattern of alignment, steep or flat fit is seen in each meridian by subjective observation from about 30s to 3min indicating this is the most appropriate time window to evaluate GP lenses in clinical practice.

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ER -

Optimal time following fluorescein instillation to evaluate rigid gas permeable contact lens fit

Abstract

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Keywords

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