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Biomedical subjects

Desmond Fonn

Publications and source records attributed to Desmond Fonn.

21 records · Page 2Linked to original sources

A comparison of three different scales for rating contact lens handling.

PURPOSE: To compare the validity, responsiveness, and reliability of three subjective rating scales applied to soft contact lens (SCL) handling. METHODS: Fifty-four adapted SCL wearers handled three different types of lenses on two occasions and rated the handling with each scale: visual analogue scales (VAS), 20-interval visual analogue scales with descriptors (VAD) and Likert rating scales with five intervals (LRS). RESULTS: There were significant differences between the scales (p < 0.01) and between the subjective ratings of lens handling (p < 0.001). VAS showed the least variability, exhibited the highest construct validity, were the most responsive, and were the most reliable: interclass correlations (0.63), coefficient of repeatability (27.5), and correlation between test and retest (Spearman r = 0.65, [all p < 0.05]). Higher repeatability, because of the fewer intervals of LRS, was not demonstrated and, generally, LRS was the least satisfactory scale. Handling was rated as easiest using VAD and most difficult using LRS. CONCLUSIONS: Although all three scales can be used to provide measures of lens handling, VAS may provide a simple and repeatable tool for measuring subjective responses.

Contact Lenses, Hydrophilic↗

Effect of lens base curve on subjective comfort and assessment of fit with silicone hydrogel continuous wear contact lenses.

PURPOSE: To study the effect of base curve on subjective comfort of silicone hydrogel extended wear lenses. METHODS: Ninety-five subjects were first trial fitted with 8.6-mm base curve lotrafilcon A (Focus Night & Day) lenses and then with 8.4-mm lenses only if poor subjective comfort or poor fit was present. Comfort and fit were assessed after 15 min. Subjects with discomfort or signs of poor fit were then trial fitted with 8.4-mm lenses. RESULTS: Of 190 eyes, 74.2% were fitted with 8.6-mm lenses, and 23.7% required 8.4-mm lenses. Two (2.1 %) subjects could not be fitted with either base curve. Mean steep keratometry (K) reading for eyes dispensed with 8.6-mm lenses was 43.88 D and 45.56 D for eyes dispensed in the 8.4-mm lenses (p < 0.001). CONCLUSIONS: A clinically useful criterion showing the need for 8.4-mm lenses was steep K of > or = 45.50 D; 77% of these eyes required the steeper lens for good comfort and fit. Subjective discomfort with 8.6-mm lenses was also a useful signal for the need of a steeper lens; mean comfort scores for those subjects rose from 6.33 with 8.6-mm lenses to 9.44 with the 8.4-mm lenses for eyes requiring the steeper lens (p < 0.001).

Adult↗

The ocular response to extended wear of a high Dk silicone hydrogel contact lens.

PURPOSE: A four-month extended wear clinical trial was conducted to compare the ocular effects of a high Dk Balafilcon A silicone hydrogel lens and a low Dk HEMA 38.6 per cent H20 soft lens. METHOD: Twenty-four subjects who were adapted to daily wear of soft lenses wore a high Dk lens in one eye and a low Dk HEMA lens in the other eye for four months on an extended wear basis after one week of daily wear. Thirteen progress evaluations were conducted using standard clinical procedures. RESULTS: Eighteen subjects (75 per cent) completed the study. The high Dk lens induced significantly less bulbar and limbal injection and corneal vascularisation than the low Dk HEMA lens (p < 0.05). Epithelial microcysts were observed only in the eyes wearing the low Dk lens. A significant increase in myopia was found in the eyes wearing the low Dk HEMA lens (mean = 0.50 D, p < 0.01) compared to the insignificant myopic increase of 0.06 D in the eyes wearing the high Dk lens. Three subjects developed small infiltrates in the high Dk lens wearing eyes and significantly more post-lens debris was observed under the high Dk lens. Six subjects developed papillary conjunctivitis in the eye wearing silicone hydrogel lenses but only two of those were discontinued from the study. CONCLUSION: No hypoxia-related effects were observed with extended wear of the high Dk Balafilcon A silicone hydrogel lens.

Adult↗