Cont Lens Anterior Eye [JOURNAL]
Sun
200 papers
Multifocal contact lenses for preoperative simulation of enhanced monofocal and extended depth of focus intraocular lenses using adaptive optics.
Giacopinelli L, Carrasco-Rojo S, Ould Haddi IB … +3 more , Albarrán-Diego C, Garzón N, García-Montero M
Cont Lens Anterior Eye · 2026 Jun · PMID 42166835 · Publisher ↗
PURPOSE: To evaluate whether multifocal contact lenses (CLs) can serve as preoperative simulators of postoperative vision with enhanced monofocal and extended depth of focus (EDOF) intraocular lenses (IOLs), using the Si...
PURPOSE: To evaluate whether multifocal contact lenses (CLs) can serve as preoperative simulators of postoperative vision with enhanced monofocal and extended depth of focus (EDOF) intraocular lenses (IOLs), using the SimVis Gekko™ adaptive-optics visual simulator. METHODS: Twenty-four presbyopic subjects (mean age 54.9 ± 5.0 years; range 46-63) underwent monocular simulation of two daily disposable multifocal CLs (1-Day Acuvue® Moist Multifocal, medium addition; and Biotrue® ONEday for Presbyopia, high addition) and two IOLs (Tecnis® Eyhance™, enhanced monofocal; and LuxSmart™, EDOF) using the SimVis Gekko™ under photopic conditions and a fixed 3 mm pupil aperture. Monocular defocus curves were obtained from -3.00 to +1.00 D in 0.50 D steps. Area under the curve (AUC), negative-defocus cutoff at the 0.2 logMAR threshold, and defocus slopes from linear mixed-effects models were compared across lens conditions for both raw and offset corrected datasets. RESULTS: Both CLs exhibited a systematic -0.50 D myopic offset relative to the IOL simulations, consistent with their center-near design. After applying a +0.50 D vergence correction, AUC values were comparable across all four designs (p = 0.18). At the 0.2 logMAR threshold, LuxSmart showed the widest functional range (cutoff -2.38 ± 0.66 D) and Biotrue the narrowest (-1.69 ± 0.53 D). Mixed-effects modeling indicated equivalent defocus slopes between 1-Day Acuvue Moist and Tecnis Eyhance after vergence alignment (p = 0.894), while LuxSmart showed greater defocus tolerance and Biotrue degraded significantly faster (p = 0.005). CONCLUSIONS: Once the intrinsic -0.50 D myopic offset is compensated, the 1-Day Acuvue Moist Multifocal closely replicates the through-focus visual performance of the Tecnis Eyhance IOL, supporting its use as a practical preoperative simulator for patients being considered for enhanced monofocal implantation. Multifocal CLs combined with adaptive optics simulation may assist surgeons in tailoring IOL selection and improve shared decision-making before cataract surgery.
Screening thresholds and the effects of age and sex on anterior chamber angle in a Chinese population: The examination of anterior chamber in Taiwan using swept-source OCT (EXACTS) study.
Chen KY, Chan HC, Chan CM
Cont Lens Anterior Eye · 2026 Jun · PMID 42160895 · Publisher ↗
INTRODUCTION: Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness and is expected to increase in aging Asian populations. This study established normative swept-source anterior segment optica...
INTRODUCTION: Primary angle-closure glaucoma (PACG) is a major cause of irreversible blindness and is expected to increase in aging Asian populations. This study established normative swept-source anterior segment optical coherence tomography (SS-ASOCT) measurements of anterior chamber angle (ACA) parameters in healthy Chinese individuals and derived percentile-based screening thresholds for referral, while evaluating the effects of age and sex on angle configuration. METHODS: This observational cross-sectional study included 602 eyes from 301 healthy phakic Chinese participants without prior intraocular surgery, laser peripheral iridotomy, or corneal opacity. Participants were stratified by age (0-19, 20-39, 40-59, 60-79, and ≥ 80 years) and sex. Using SS-ASOCT (ANTERION®), ACA, scleral spur angle (SSA), angle opening distance (AOD), and trabecular-iris space area (TISA) were measured at 500 and 750 µm on the temporal and nasal sides. Values below the 20th percentile were considered provisional percentile-based screening thresholds for ophthalmologic or glaucoma specialist referral rather than diagnostic criteria for angle closure. RESULTS: Mean age was 54.84 ± 19.22 years, 56.1% were female, and 45.0% were aged 60-79 years. Temporal parameters were consistently greater than nasal parameters at both 500 and 750 µm (all p < 0.001). For ACA500, the 10th percentile values were 20° temporally and 18° nasally, and the 20th percentile values were 27.2° and 25°, respectively; for SSA500, corresponding values were 20°/18° and 27°/24°. ACA showed strong positive correlations with SSA, AOD, and TISA (r = 0.800-0.950; all p < 0.001). All ACA-related parameters showed moderate negative correlations with age (r = -0.460 to -0.525; all p < 0.001), with marked narrowing from 40 years onward and generally lower values in older age groups. Males consistently demonstrated significantly wider angles than females across ACA, SSA, AOD, and TISA measurements at both distances. CONCLUSION: ACA parameters vary significantly by age, sex, and meridian in phakic Chinese eyes. Values below the 20th percentile may serve as practical percentile-based screening thresholds for ophthalmologic or glaucoma specialist referral. Age-related narrowing is substantial from 40 years onward, while males exhibit wider angles than females.
Longitudinal rebalancing of axial length asymmetry in anisometropic children under orthokeratology: a large-scale cohort study.
Huang K, Wang L, Ma R … +5 more , Han M, Chen W, Lei X, Hu Y, Yang X
Cont Lens Anterior Eye · 2026 Jun · PMID 42155159 · Publisher ↗
PURPOSE: To characterize longitudinal changes in axial length (AL) in anisometropic children undergoing orthokeratology, focusing on eye-specific elongation and change in inter-ocular AL difference (IALD). METHODS: This...
PURPOSE: To characterize longitudinal changes in axial length (AL) in anisometropic children undergoing orthokeratology, focusing on eye-specific elongation and change in inter-ocular AL difference (IALD). METHODS: This retrospective longitudinal study included 79,409 visits from 9,978 orthokeratology-treated children (8,133 isometropic, 1,845 anisometropic). Propensity score-matched (PSM) subsets were constructed for the more-myopic (PSM1, n = 3,682) and less-myopic eyes (PSM2, n = 2,326). Linear mixed-effects models based on the full cohort estimated AL changes and their associations with baseline inter-ocular spherical equivalent refraction (SER) difference, adjusting for age, gender, axial length, and corneal curvature. RESULTS: After matching, anisometropic children exhibited modestly slower axial elongation than isometropic controls in both eyes (more-myopic: 0.093 ± 0.156 vs. 0.110 ± 0.158 mm/year; less-myopic: 0.133 ± 0.156 vs. 0.146 ± 0.161 mm/year; both P < 0.05). Linear mixed‑effects models revealed a dose‑dependent rebalancing effect: each 1‑D increase in baseline inter‑ocular SER difference was associated with 0.020 mm less annual elongation in the more‑myopic eye and 0.016 mm more in the less‑myopic eye (both P < 0.001), leading to a faster reduction in IALD (β = - 0.036 mm/year per D; P < 0.001). Younger age and a smaller initial IALD predicted successful isometropic conversion (defined as achieving an IALD < 0.4 mm), a group which exhibited markedly faster IALD reduction than those with persistent anisometropia (-0.081 vs. - 0.030 mm/year; P < 0.001). CONCLUSIONS: In anisometropic children undergoing orthokeratology, greater baseline anisometropia was associated with an asymmetric pattern of axial growth, characterised by stronger suppression in the more-myopic eye and comparatively less suppression in the less-myopic eye. This anisometropia-dependent modulation was associated with an accelerated reduction in the inter‑ocular AL difference, suggesting that orthokeratology facilitates progressive inter‑ocular convergence in children with higher baseline anisometropia. The treatment-driven heterogeneity and age-dependent sensitivity highlight a critical window for early clinical intervention.
A shadow looms on the horizon of the contact lens market: Emerging threat or potential opportunity?
Zeri F, Tavazzi S, Naroo SA
Cont Lens Anterior Eye · 2026 Jun · PMID 42140149 · Publisher ↗
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The potential role of artificial intelligence in the diagnosis of Acanthamoeba keratitis-a scoping review.
Valsamidis TN, Mohr KM, Hjortdal JØ
Cont Lens Anterior Eye · 2026 Jun · PMID 42114398 · Publisher ↗
BACKGROUND: Acanthamoeba keratitis (AK) is a severe, sight-threatening infectious disease with a rising global incidence, linked to the increasing use of contact lenses. Clinical diagnosis is complicated by the nonspecif...
BACKGROUND: Acanthamoeba keratitis (AK) is a severe, sight-threatening infectious disease with a rising global incidence, linked to the increasing use of contact lenses. Clinical diagnosis is complicated by the nonspecific nature of early symptoms and limitations in current diagnostic methods. Recently, Artificial Intelligence (AI) and Deep Learning (DL) have been applied to ocular imaging to aid in diagnosis. OBJECTIVE: The primary objective of this scoping review is to evaluate the diagnostic performance of AI and DL algorithms for AK across different imaging modalities and to identify the methodological gaps necessary to apply these methods in a clinical setting. METHODS: This review followed the PRISMA for Scoping Reviews guidelines. A systematic search was conducted on PubMed, Embase, Web of Science, IEEE Xplore and the Cochrane Library, to identify original research applying AI/DL for AK diagnosis in humans using ocular imaging, published up to October 28, 2025. RESULTS: Nine studies using DL algorithms were included. Imaging modalities included slit-lamp photography (n = 4), in vivo confocal microscopy (IVCM) (n = 4), and smartphone-captured images (n = 1). In internal validation, models demonstrated high diagnostic capability, with Area Under the Curve (AUC) values frequently exceeding 0.90. Slit-lamp models generally achieved high specificity (>94%) with variable sensitivity (68.3%-89.2%). IVCM models reported more varying sensitivities ranging from 55.0% to 96.0%. The smartphone study reported a strong AUC of 0.99. Only three studies performed external validation. CONCLUSION: The use of AI and deep learning algorithms show promise in diagnosing AK. Internal performance metrics vary but are sometimes comparable to current diagnostic methods. However, real-world applicability is currently limited by small sample sizes, heterogeneity in available data, and scarcity of external validation. Future research must prioritize multi-center validation and standardized methodologies to ensure clinical utility.
Comment on "Effect of orthokeratology on ocular dominance in Chinese myopic children: A 1-year longitudinal study".
Sun B, Zheng K
Cont Lens Anterior Eye · 2026 May · PMID 42086427 · Publisher ↗
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Original article preliminary exploratory finding of anti-defocus (ADF) contact lenses on binocular vision.
Liou JC, Chen PH, Tung HC … +3 more , Tung TY, Chang CW, Cheng CY
Cont Lens Anterior Eye · 2026 Jun · PMID 42085830 · Publisher ↗
PURPOSE: This study investigated the short-term functional adaptation and impact of three distinct anti-defocus (ADF) contact lens designs on comprehensive binocular visual functions. METHODS: This prospective, randomize...
PURPOSE: This study investigated the short-term functional adaptation and impact of three distinct anti-defocus (ADF) contact lens designs on comprehensive binocular visual functions. METHODS: This prospective, randomized crossover trial enrolled 35 subjects with clinically significant visual symptoms (CISS ≥ 21; COVD-QOL ≥ 20). Three ADF designs were evaluated: plus-horizontal (PH-ADF), minus-horizontal (MH-ADF), and plus-annular (Ring-ADF). Binocular vision assessments-including visual acuity, accommodative amplitude (AA), accommodative lag (via fused cross cylinder, FCC), relative accommodation (NRA/PRA), contrast sensitivity, phoria, fixation disparity (FD), and accommodative/vergence facility-were conducted at baseline and after 7-10 days of wear. RESULTS: Ring-ADF significantly enhanced near visual acuity and AA while maintaining superior focusing precision (FCC) and fixation stability (FD); however, it induced a more rigid accommodative state by reducing accommodative facility and relative ranges (NRA/PRA). Conversely, both horizontal designs (PH-ADF and MH-ADF) induced a significant increase in accommodative lag. PH-ADF promoted an exophoric shift, whereas MH-ADF elicited a significant esophoric shift and a statistically significant deterioration in stereoacuity, though thresholds remained within the functional range. All designs improved functional field of awareness, with Ring-ADF demonstrating superior high-spatial-frequency contrast sensitivity. CONCLUSION: Peripheral defocus configuration and polarity are critical determinants of binocular status. While Ring-ADF showed superior accommodative stability, horizontal designs significantly modulated vergence and lag. These findings suggest that ADF geometries can be tailored to specific binocular profiles, though long-term impact requires further investigation.
Reimagining dry eye disease management - a multimodal approach targeting the key pathophysiological drivers.
Hilmi MR, Wolffsohn JS
Cont Lens Anterior Eye · 2026 Jun · PMID 42085829 · Publisher ↗
PURPOSE: Traditional dry eye disease (DED) diagnosis and subclassification often relies on limited metrics, failing to capture its complex heterogeneity. Aligning with the TFOS DEWS III framework, this study aimed to imp...
PURPOSE: Traditional dry eye disease (DED) diagnosis and subclassification often relies on limited metrics, failing to capture its complex heterogeneity. Aligning with the TFOS DEWS III framework, this study aimed to implement a novel, multimodal DED evaluation strategy, determining the prevalence of the pathophysiological DED drivers and identifying clinically relevant phenotypic clusters within a DED population. METHODS: A prospective, cross-sectional study was conducted at a university-based clinic. A total of 615 participants (aged 20-45) meeting TFOS DEWS II diagnostic criteria underwent a comprehensive, standardized battery of ocular surface tests. These tests assessed nine predefined drivers across three domains: tear film (lipid, aqueous, mucin/glycocalyx deficiency), eyelid anomalies (lid closure, lid margin health), and ocular surface abnormalities (anatomical misalignment, cellular damage/disruption, primary inflammation/oxidative stress and neurosensory dysfunction). Cluster analysis was performed to identify distinct DED phenotypes based on these drivers. RESULTS: The prevalence of the drivers varied considerably. Mucin/glycocalyx deficiency (identified by conjunctival staining) was most common (88%), while incomplete lid closure was least prevalent (24%). Other notable prevalences included aqueous deficiency (61%), meibomian gland dysfunction (43%), bulbar hyperaemia (48%), and reduced corneal sensitivity (37%). Cluster analysis revealed a robust four-cluster model (Silhouette score = 0.40), effectively partitioning the cohort into distinct subgroups. The clusters identified demonstrated a progressive increase in driver involvement and severity, with Cluster 1 associated with early signs (e.g., lid wiper and conjunctival staining) and Cluster 4 representing severe, multi-driver disease. CONCLUSION: This study confirms the heterogeneous prevalence of DED drivers in a clinical population. The identification of four distinct phenotypic clusters validates a shift from a binary spectrum DED classification towards a precision medicine approach. By deconstructing DED into its constituent pathological elements, this multimodal framework enables clinicians to phenotype patients and tailor targeted therapies to their dominant drivers, ultimately advancing personalized DED management.
Corrigendum to "Minor reduction in the back optical zone diameter of orthokeratology lenses delays axial elongation in children with myopia" [Cont. Lens Anterior Eye 49(3) (2026) 102632].
Chen Y, Mei L, Feng Y … +3 more , Zhang S, Huang H, Xu J
Cont Lens Anterior Eye · 2026 Jun · PMID 42019228 · Publisher ↗
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Effect of a thermo-mechanical action device on symptoms, signs and tear lipid profile in patients with evaporative dry eye disease.
Rawal BR, Franklin VJ, Blanco-Vázquez M … +3 more , Naroo SA, Shah S, Gil-Cazorla R
Cont Lens Anterior Eye · 2026 Jun · PMID 42001606 · Publisher ↗
PURPOSE: To evaluate the effect of a thermo-mechanical action device on symptoms, signs and overall tear lipid profile in patients with evaporative dry eye. METHODS: A prospective, controlled, open-label research was con...
PURPOSE: To evaluate the effect of a thermo-mechanical action device on symptoms, signs and overall tear lipid profile in patients with evaporative dry eye. METHODS: A prospective, controlled, open-label research was conducted, involving participants with an Ocular Surface Disease Index (OSDI) score > 23 and a Non-Invasive Tear Break-Up Time (NIBUT) of less than 10 s. Participants attended 5 research visits. Participants underwent three sessions of Tixel® therapy on both eyes only at visits 1, 2, and 3. The initial 4 visits were spaced by a span of 2 weeks ± 5 days. The 5th appointment occurred 20 weeks after the 1st visit. During each visit, clinical measures including the OSDI score, the standard patient evaluation of ocular dryness questionnaire (SPEED) score, and NIBUT were documented. Tear samples, from the left eye only, were obtained during each visit and analysed using high-performance lipid chromatography to evaluate the lipid concentrations present. RESULTS: The study comprised 7 females and 3 males, with a mean age of 42 ± 9 years. No adverse occurrences were documented. A significant difference was noted in the mean OSDI score (45.11 ± 18.70 vs 21.72 ± 21.25, P < 0.001), the SPEED score (14.70 ± 1.70 vs 8.80 ± 6.12, P < 0.05), and the NIBUT (4.73 ± 2.37 vs 8.01 ± 2.32, P < 0.05) between visit 1 and visit 5. Despite individual variability in tear lipid content and the influence of sample volume, some participants showed an increase in total lipid levels following therapy. CONCLUSIONS: The study demonstrated a significant improvement in the signs and symptoms of dry eye disease following Tixel® treatment, with no adverse events observed during the investigation. The findings indicate that Tixel® treatment is a promising therapeutic option for evaporative dry eye disease, warranting further investigation into its effects on tear lipids.
TearNET: Validation of a convolutional neural network for grading of tear ferning patterns using deep learning.
Krishnan A, Gundeti P, Konda N
Cont Lens Anterior Eye · 2026 Jun · PMID 41967396 · Publisher ↗
PURPOSE: Tear-ferning patterns are microscopic crystallization formed when the solvent in the tears evaporates, and the solutes congregate to form a fern-like crystal structure. The ferning patterns are affected by the b...
PURPOSE: Tear-ferning patterns are microscopic crystallization formed when the solvent in the tears evaporates, and the solutes congregate to form a fern-like crystal structure. The ferning patterns are affected by the biomolecular properties of the tear and can be used to screen for dry eye disease (DED). However, manual grading of tear-ferning patterns based on Rolando's grading system is subjective and inconsistent. This study aims to validate TearNET - a convolutional neural network-based deep learning algorithm, for the automated grading of tear-ferning patterns. METHODS: Tear samples from 80 healthy participants (160 eyes) were collected, and the ferning patterns were imaged under a microscope. Two examiners independently graded the samples, confirming grading reliability. The age and gender of participants were recorded, along with temperature and humidity in the lab during sample collection. The TearNET model was trained on these samples using a 70% training and 30% testing data split. The model's sensitivity, specificity, recall, and F-scores were estimated for performance evaluation. RESULTS: Tear ferning patterns varied significantly with age (p < 0.001) and gender (p < 0.001). Variation in room temperature and humidity showed no significant variation (p > 0.05) on the tear ferning pattern. The TearNET model achieved 81% accuracy in classifying patterns, with notable performance for Types 3 and 4 grades. CONCLUSIONS: Overall, the TearNET model demonstrates promising performance in classifying tear ferning patterns according to Rolando's grade, particularly excelling in differentiating individual grade patterns. The model demonstrated effective training convergence, validating its potential for future clinical applications in dry eye disease screening.
Tear fluid immuno-inflammatory signatures in contact lens-induced discomfort.
Nair AP, Sethu S, Nagaraj H … +7 more , Kumar V, Nagaraj S, Fadli Z, Chemaly M, Song XY, Ghosh A, Liang B
Cont Lens Anterior Eye · 2026 Jun · PMID 41935474 · Publisher ↗
PURPOSE: Contact lens-induced discomfort (CLD), a key reason behind discontinuation of CL wear, is associated with an altered ocular surface immune profile. Hence, this study investigated the status of immuno-inflammator...
PURPOSE: Contact lens-induced discomfort (CLD), a key reason behind discontinuation of CL wear, is associated with an altered ocular surface immune profile. Hence, this study investigated the status of immuno-inflammatory factors in the tear fluid (TF) of CLD subjects. METHODS: Thirty-nine CL users grouped based on CLD status and types of CL participated in this non-masked multi-visit study. CLDEQ-8 score was used to group the 39 habitual CL wearers as those with (n = 18) and without (n = 21) CLD. Enrolled subjects used either of the two types of CL: 1-Day Acuvue®Moist (CL-A) and DAILIES® AquaComfort Plus® (CL-D). Discomfort was determined by the Visual Analogue Scale (VAS) score. TF and VAS score were collected during CL wear (immediately before and after CL wear) and CL free (morning and evening) periods. TF collected using Schirmer's strip was analyzed for the levels of 49 immuno-inflammatory factors using multiplex ELISA. RESULTS: VAS scores were significantly lower in CLD subjects compared with those without CLD, during CL wear and CL free periods. Multivariate analysis suggests TF immuno-inflammatory factors' levels to be influenced by CLD status and/or lens type interaction. Levels of C3a, C4a, IL-10, and sIL-1R1 were significantly higher in CLD subjects compared to those without CLD during both CL wear and CL free periods. No significant differences in the VAS scores and TF factor levels were observed between the CL types within the study groups. CONCLUSION: Inherent perturbations in ocular surface immuno-inflammatory factors' levels were observed in CLD subjects with minimal effects or influence of the CL types studied.
A review of the last 10 years regarding protein and lipid deposition on soft contact lenses.
Garcia-Queiruga J, Nores-Palmas N, Martinez-Perez C
Cont Lens Anterior Eye · 2026 Jun · PMID 41932130 · Publisher ↗
PURPOSE: To synthesize recent evidence on protein and lipid deposition on soft contact lenses (CLs) and to clarify how material chemistry and surface properties influence biomolecule interactions. METHODS: A structured n...
PURPOSE: To synthesize recent evidence on protein and lipid deposition on soft contact lenses (CLs) and to clarify how material chemistry and surface properties influence biomolecule interactions. METHODS: A structured narrative review of studies published between 2015 and 2025 was conducted, and the review protocol was registered in the PROSPERO database (registration number: CRD420261333929). Electronic searches of PubMed, Web of Science, and Scopus identified in vitro, ex vivo, and in vivo investigations evaluating protein and/or lipid interactions with hydrogel and silicone hydrogel (SiHy) CL materials. Data were qualitatively synthesized according to material class, surface modification strategy, biomolecule type, localization, and reported functional outcomes. RESULTS: Fourteen studies met the inclusion criteria. Ionic, high-water content hydrogels consistently exhibited high protein uptake, predominantly through bulk absorption, while preserving enzymatic activity of key tear proteins such as lysozyme. In contrast, unmodified SiHy CLs showed lower total protein deposition but greater susceptibility to nonpolar lipid adsorption. Imaging-based analyses revealed that surface-localized lipid deposition had greater functional relevance than bulk lipid diffusion. Biomimetic surface-modified SiHy incorporating MPC or PMPC demonstrated marked resistance to surface-associated protein and lipid fouling. CONCLUSION: Protein and lipid deposition on soft CLs is primarily governed by material chemistry and surface design rather than deposition quantity alone. Surface-associated fouling, especially lipid adsorption, plays a central role in tear film instability, supporting a functional, material-dependent framework for evaluating and optimizing contact lens performance.
Associations of tear film characteristics with contact lens discomfort during daily disposable wear of contact lens polymers.
Kumar M, Dumpati S, Vijay AK … +4 more , Masoudi S, Naduvilath TJ, Raj A, Willcox M
Cont Lens Anterior Eye · 2026 Jun · PMID 41911617 · Publisher ↗
PURPOSE: This study investigated tear film parameters during the wear of two daily disposable contact lenses composed of different polymers and examined their association with symptoms of contact lens discomfort. METHODS...
PURPOSE: This study investigated tear film parameters during the wear of two daily disposable contact lenses composed of different polymers and examined their association with symptoms of contact lens discomfort. METHODS: A prospective, randomized, investigator-masked crossover study was conducted over two months with 20 participants wearing Somofilcon A or Verofilcon A daily disposable lenses. Tear meniscus height (TMH), non-invasive tear breakup time (NITBUT), and lipid layer thickness (LLT) were measured at the beginning of the study and after one month of wearing each lens type, both with lenses in-situ and after removal following at least six hours of wear. Symptoms were assessed using the Contact Lens Dry Eye Questionnaire (CLDEQ-8) and a visual analog scale (VAS). Differences in parameters between lens types and time points were analyzed using repeated measures ANOVA. Associations between tear film parameters and subjective comfort scores were assessed using Pearson's correlation coefficients. Statistical significance was set at p < 0.05. RESULTS: The NITBUT-average significantly improved with Verofilcon A (12.98 ± 4.27 s; p < 0.001) and Somofilcon A (12.30 ± 3.46 s; p < 0.001) compared to baseline (9.31 ± 3.29 s), with no significant difference between the lenses (p = 0.456). Significant changes in VAS comfort and CLDEQ-8 scores from baseline were observed for both lens types (p < 0.001). For Verofilcon A, CLDEQ-8 scores decreased, and VAS comfort increased while CLDEQ-8 scores negatively correlating with NITBUT-first break (r = -0.4637, p = 0.0455) and NITBUT-average (r = -0.5758, p < 0.001). i.e. a smaller CLDEQ-8 score (better comfort) associated with longer NITBUT.During Somofilcon A wear, CLDEQ-8 increased, and VAS comfort scores decreased, and VAS negatively correlated with NITBUT-first break (r = -0.5334, p = 0.018) and TMH (r = -0.4856, p = 0.0351). CONCLUSIONS: Whilst better comfort with Verofilcon A was associated with improved NITBUT, correlations were moderate, and further studies are required to draw stronger conclusions. LLT showed no association with symptoms. Lens material and surface properties, along with ocular surface factors likely influence comfort outcomes.
Comparing the short-term effects of wearing hydrogel and silicone hydrogel soft contact lenses on the bulbar conjunctival microvasculature and tear film.
Sun Y, Xu Z, Shen J … +3 more , Xia J, Lu F, Hu L
Cont Lens Anterior Eye · 2026 Jun · PMID 41894862 · Publisher ↗
PURPOSE: To compare the short-term effects of etafilcon A hydrogel and senofilcon A silicone hydrogel soft contact lenses (SCLs) on the ocular surface. METHODS: This prospective, double-masked, randomised crossover study...
PURPOSE: To compare the short-term effects of etafilcon A hydrogel and senofilcon A silicone hydrogel soft contact lenses (SCLs) on the ocular surface. METHODS: This prospective, double-masked, randomised crossover study required 20 participants to wear etafilcon A hydrogel and senofilcon A silicone hydrogel SCLs for seven days each, separated by a two-week washout period. Ocular examinations were conducted at baseline, and on day 1 and day 7 of lens wear. Bulbar conjunctival microvasculature assessment included vessel diameter (D), axial blood flow velocity (Va), cross-sectional blood flow velocity (Vs), blood flow volume (Q), and monofractal dimension (Dbox). Tear film analysis comprised tear meniscus height (TMH), first noninvasive tear break-up time (f-NIBUT), and average noninvasive tear break-up time (av-NIBUT). Participants completed the Ocular Surface Disease Index (OSDI) questionnaire at baseline and day 7 and the Visual Analogue Scale (VAS) on day 1 and day 7. RESULTS: At baseline, no significant differences were observed between hydrogel and silicone hydrogel SCLs. On day 1 and day 7, both SCLs demonstrated increased Va, Vs, and Q, and reduced TMH, compared with baseline (p < 0.05). Silicone hydrogel SCLs exhibited higher Va, Vs, and Q values on day 1 (p < 0.05), while hydrogel SCLs showed shorter f-NIBUT on day 7 (p < 0.05). Both SCLs displayed increased OSDI and VAS scores over time (p < 0.05), with silicone hydrogel SCLs yielding higher VAS scores than hydrogel SCLs on day 7 (p < 0.05). Univariate analysis suggested that lens wear time (β = 5.1, p = 0.010), lens material (β = 4.2, p = 0.032), Va (β = 4870, p = 0.037) and Vs (β = -6586, p = 0.039) were significantly associated with VAS scores; however, only lens wear time and lens material remained significant in the multivariable model. CONCLUSIONS: After seven days wear, etafilcon A hydrogel SCLs were associated with greater tear film instability, while senofilcon A silicone hydrogel SCLs resulted in greater conjunctival hyperaemia and more pronounced subjective discomfort.
Optimizing hyaluronic acid therapy for dry eye disease: a systematic review, meta-analysis, and meta-regression by concentration and comparator type.
Martinez-Perez C, Sánchez-González MC, Sánchez-González JM
Cont Lens Anterior Eye · 2026 Jun · PMID 41887128 · Publisher ↗
PURPOSE: To evaluate the clinical efficacy of HA-based eye drops for the treatment of DED, stratified by concentration and comparator type, through a systematic review, meta-analysis, and meta-regression. METHODS: A comp...
PURPOSE: To evaluate the clinical efficacy of HA-based eye drops for the treatment of DED, stratified by concentration and comparator type, through a systematic review, meta-analysis, and meta-regression. METHODS: A comprehensive literature search was conducted across PubMed, Web of Science, Scopus, and the Cochrane Library, identifying 39 randomized controlled trials involving 3,469 patients. Outcomes included the OSDI, TBUT, Schirmer's test, and corneal staining. Subgroup analyses compared HA to placebo, inactive lubricants, active compounds, and HA-based combinations. HA concentration groups were analyzed separately (≤0.1%, 0.15-0.18%, 0.2-0.3%). Risk of bias and publication bias were assessed using the Cochrane tool and funnel plots. Certainty of evidence was evaluated using GRADE. RESULTS: HA-based formulations showed significant improvements in symptoms, especially in the 0.15-0.18% subgroup (MD = -14.23; p < 0.001), with consistent benefits in Schirmer's test. Comparisons with placebo, other lubricants, and active agents showed that HA was associated with greater improvement in patient-reported symptoms (OSDI), while objective signs (TBUT and staining) showed variable and often non-significant results. Monotherapy with HA outperformed HA-based combinations in OSDI. The most consistent efficacy and tolerability were observed in intermediate HA concentrations. No significant publication bias was detected. CONCLUSION: HA eye drops, particularly formulations within the 0.15-0.18% range, were associated with meaningful improvements in patient-reported symptoms and were generally well tolerated, supporting their use as a first-line option for mild-to-moderate DED within the limitations of formulation heterogeneity.
Validity and reliability of the Nepali version of the ocular surface disease index questionnaire for assessing quality of life in dry eye patients.
Ghimire R, Regmi S, Karki R … +2 more , Binita KC, Marasini S
Cont Lens Anterior Eye · 2026 Jun · PMID 41880864 · Publisher ↗
PURPOSE: To develop a Nepali version of the Ocular Surface Disease Index (OSDI) questionnaire to assess the impact of dry eye disease on quality of life in the Nepalese population. The study also aimed to compare objecti...
PURPOSE: To develop a Nepali version of the Ocular Surface Disease Index (OSDI) questionnaire to assess the impact of dry eye disease on quality of life in the Nepalese population. The study also aimed to compare objective signs of dry eye with subjective symptoms and to evaluate the reliability and validity of the Nepali OSDI. METHODS: A single-centre, cross-sectional, observational instrument validation study was conducted. The translation process involved forward translation, backward translation, refinement, and quality evaluation. Participants completed the Nepali OSDI questionnaire alongside the Dry Eye Questionnaire-5 (DEQ-5) and underwent clinical tests, including Schirmer's II, tear break-up time, tear meniscus height, and meibography to confirm the diagnosis of dry eye. A total of 274 participants completed the questionnaire, with 62 completing it again 7 days after the first session to assess test - retest reliability. Internal consistency was evaluated using Cronbach's alpha for three factors: ocular symptoms, visual function and environmental triggers. Test-retest reliability was assessed using the intraclass correlation coefficient. RESULTS: The mean age of participants was 39.6 ± 12.8 years (55.1% were female). Internal consistency was excellent (Cronbach's alpha = 0.90), with subscale alphas of 0.83 for ocular symptoms, 0.78 for visual function, and 0.82 for environmental triggers. Construct validity was confirmed by exploratory factor analysis (Kaiser - Meyer - Olkin = 0.864; Bartlett's test, p < 0.001), which identified three factors explaining 62.6% of the variance. Test-retest reliability was excellent (intraclass correlation coefficient = 0.953; 95% confidence interval, 0.92-0.97; p < 0.01). A strong correlation with DEQ-5 scores (r = 0.653, p < 0.01) supported concurrent validity. CONCLUSION: These results indicate that the Nepali OSDI is clinically comparable to the English version and support its use in both clinical practice and research.
Fitting efficacy and ocular surface safety of digitally customized orthokeratology lenses in patients with moderate myopia and high curvature corneas.
Yu J, Hu J
Cont Lens Anterior Eye · 2026 Jun · PMID 41865602 · Publisher ↗
PURPOSE: To investigate fitting characteristics, ocular surface safety, and myopia control efficacy of digitally customized orthokeratology (OK) lenses in moderate myopia patients with high curvature corneas (flat K ≥ 44...
PURPOSE: To investigate fitting characteristics, ocular surface safety, and myopia control efficacy of digitally customized orthokeratology (OK) lenses in moderate myopia patients with high curvature corneas (flat K ≥ 44 D), with low-concentration atropine as an adjunct. METHODS: 126 patients were randomized into three groups: Group A (digitally customized OK lenses + 0.01% atropine, n = 42), Group B (conventional OK lenses + 0.01% atropine, n = 41), and Group C (single-vision spectacles, n = 43). Primary outcomes included fitting qualification rate, corneal epithelial integrity, and tear film stability; axial length change was a key secondary outcome. Multiple linear regression and sensitivity analysis were performed. RESULTS: Group A had a significantly higher fitting qualification rate than Group B (1 month: 95.2% vs 80.5%, P = 0.031; 12 months: 88.1% vs 73.2%, P = 0.068). It also showed better corneal epithelial integrity, tear film stability, and slower axial elongation than Groups B and C (all P < 0.05). Fitting qualification rate and intervention type were key predictors of axial length growth. CONCLUSION: Digitally customized orthokeratology lenses combined with 0.01% atropine can significantly improve the fitting accuracy for high curvature corneas. Corneal epithelial integrity is ensured by maintaining corneal epithelial thickness and reducing corneal fluorescein staining scores. Meanwhile, this combined intervention optimizes tear film stability, ensures ocular surface safety and achieves favorable myopia control efficacy. This combined regimen is recognized as an optimal contact lens correction option for myopia patients with high curvature corneas. The adjunctive effect of low-concentration atropine needs to be further verified in combination with lens fitting status.
Consensus recommendations on tear fluid terminology: A Delphi study by the tear research network.
Schmeetz J, Agrawal R, Cifuentes-González C … +9 more , van de Sande N, Mergen B, Hagan S, Boychev N, Kilicaslan NA, Sharma N, Tear Research Network Terminology Taskforce, Bonnet C, Gijs M
Cont Lens Anterior Eye · 2026 Jun · PMID 41865601 · Publisher ↗
PURPOSE: Tear fluid is a clinically relevant body fluid frequently used in ocular disease and biomarker research. However, inconsistent terminology has limited data comparability and hindered clinical translation. This i...
PURPOSE: Tear fluid is a clinically relevant body fluid frequently used in ocular disease and biomarker research. However, inconsistent terminology has limited data comparability and hindered clinical translation. This international Delphi consensus study, conducted by the Tear Research Network, aimed to establish standardized definitions for commonly used synonyms related to tear fluid. METHODS: In two rounds of online surveys, 103 eligible professionals participated, primarily (clinical) researchers with broad international representation. RESULTS: Consensus (≥70% agreement or disagreement) was achieved on definitions including localization, source and function, as well as the context of use and sample collection. A standardized glossary was developed, with the strongest agreement (>90%) for tear fluid and tear film. The term tear fluid best describes the body fluid itself and its collected sample, while tear film refers specifically to the multilayered structure on the ocular surface. Both terms are recommended for clinical and research use and to describe the fluid analysed in various diagnostic tests. CONCLUSIONS: These recommendations support comparability, consistent reporting and interdisciplinary communication in future research.
Sociodemographic and refractive factors associated with contact lens use: Insights from a nationwide Korean survey.
Hwang SD, Jung WY, Lee S … +2 more , Kim SR, Park M
Cont Lens Anterior Eye · 2026 Jun · PMID 41844082 · Publisher ↗
PURPOSE: This study examined sociodemographic and refractive factors associated with contact lens use in Korea using data from the Korea National Health and Nutrition Examination Survey (KNHANES VIII-3, 2021). METHODS: A...
PURPOSE: This study examined sociodemographic and refractive factors associated with contact lens use in Korea using data from the Korea National Health and Nutrition Examination Survey (KNHANES VIII-3, 2021). METHODS: Among 748 participants with a lifetime history of contact lens wear, past-month wearers (PW) group were defined as those who used lenses within the 30 days prior to the survey, while those who had not were classified as past-month non-wearers (PNW) group. Demographics, refractive errors, dry eye status, purchase source, prescription status, and complications were compared between groups. Complex sample logistic regression identified predictors of continued use, and lens-type-specific characteristics were analyzed within the PW group. RESULTS: PW (53.54%) group was significantly younger (27.85 ± 0.54 years), had longer wear duration (≥5 years; 52.75%), and showed higher rates of high myopia (23.02%) than PNW group (p < 0.01). Significant predictors of continued use included younger age (OR = 0.90), longer wear duration (≥10 years: OR = 24.67), high myopia (OR = 2.52), and absence of dry eye (OR = 7.46). Within the PW group, soft lenses were most common (72.29%). Ortho-k users were the youngest (12.40 ± 0.42 years) and all received physician prescriptions. In contrast, cosmetic lens users (23.89 years) were predominantly female (94.96%), recorded the highest complication rate (32.61%), and the lowest prescription rate (7.72%). Rigid gas permeable lens users had the highest high myopia (57.40%). CONCLUSIONS: Continued contact lens wear in Korea is driven by younger age and high myopia, while dry eye remains a significant barrier. The high complication rates in cosmetic lens users compared to the medically supervised ortho-k and RGP groups, highlight the critical need for ophthalmic guidance to ensure ocular health.
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