[Philosophy of permanent wearing of soft hydrophilic lenses, 1981-1982].
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Biomedical subjects
Publications and source records attributed to F Kreis-Gosselin.
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The most rapid method for determining the best mode of optical compensation in myopic patients following cataract operations was studied, by employing a graphic method for calculating theoretical aniseikonia and measuring subjective aniseikonia with a new stereo-projector. Several examples of the method chosen are given, this involving optical equipment--glasses, lens, myopisation--aniseikonia being reduced to a maximum.
The authors relate the results obtained with very thin soft hydrogel lenses (0,10 mm thickness) of high and low water content: the Vergo-Softcon THX of 70% water-content and the Bauch and Lomb Plano-T of 38%. The most frequent indications encountered are bullous keratopathy, epithelial defects and keratitis sicca. The results are positive in 78,2% of cases with 70% w/c soft hydrogel lenses. Results are given for cases of direct fitting of thin lenses, as well as for cases of fitting after failures of classic soft hydrogel lenses and in cases of exchanges of 40% lenses for 70% lenses. The 70% water content lenses seem to give better results main in cases of epithelial defects and keratitis sicca.
The authors relate the utility of soft hydrogel contact lenses in 19 cases of epithelial defects after penetrating corneal grafts, 8 of them being primitive and 11 secondary. Out of the 19 cases fitted with lenses, 10 have required a new keratoplasty. An attempt is made to define the indications, the advantages and the drawbacks of this therapy in observing the action of the lens on the epithelium, the stroma, the visual acuity as well as the possible problems due to the wearing of the lenses in the whole of the 19 cases. They try to understand the reasons for a new graft and they study the non-regrafted cases. They evidence the benefits of the wear of soft hydrogel lenses but the limits of their uses too.
The author has noted that the frequency of epithelial lesions appearing during the course of trials with soft hydrophilic lenses containing 40% water diminished almost completely with soft hydrophilic lenses containing 70% water. He attributes these epithelial lesions to anoxia occurring with soft hydrophilic lenses with 40% water. He compares the permeability to oxygen of different types of lenses according to their thickness. He concludes that at present the materials utilised and the thickness of the lenses do not allow permanent wear.
The author briefly explains the value in the use of fluorescein in contact lens fitting. The use of such a substance is not possible with soft hydrophilic lenses as it colours the lens. A special type of fluorescein was tested and the author explains how to use it and emphasies its value in the adaptation and control of these lenses.
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