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Biomedical subjects

J C Mainstone

Publications and source records attributed to J C Mainstone.

8 recordsLinked to original sources

Analysis of tear film breakup on Etafilcon A hydrogel lenses.

PURPOSE: There is a need to understand better the biomaterial characteristics responsible for tear film stability during hydrogel lens wear. The underlying cause of pre-lens tear film instability may be indicated by the distribution of sites of breakup. The purpose of this study was to compare the distribution of rupture sites during wear of a common biomaterial to that without lenses. METHODS: A videokeratography unit, the Topographic Modeling System, was used to capture an image of the tear film at the moment of breakup. Forty measurements were made for each of ten subjects, and the resultant rupture site distributions evaluated. The pre-lens tear film breakup locations were studied for Acuvue (Etafilcon A) disposable contact lenses using the same technique. RESULTS: There was a statistically significant trend for pre-corneal tear film breaks to occur more commonly in parameniscal zones than in areas overlying the central cornea (ANOVA, p = 0.002). With the Etafilcon A lenses, a significant difference in breakup frequency between the two regions was not observed. CONCLUSIONS: The pre-corneal tear film findings are consistent with the meniscus model of tear film stability; however, the biomaterial surface characteristics of Etafilcon A give other factors a more dominant role in tear film rupture.

Biocompatible Materials↗

Rigid lens dynamics: lid effects.

PURPOSE: Lid architecture, lid tension, blink action, and blink rate may all influence rigid lens centration and stability. The aims of this study were to assess the nature of the relationship between lid geometry and lens position and to examine the influence of lens-lid interactions on the association between lens position and lens center of gravity and mass. METHODS: Eight subjects (four with high riding lenses and four with low riding lenses) participated in the study. Each subject was fit with 12 lenses-six designs in each of two materials. Lens center of gravity was calculated and lens mass was measured in every case. For each lens, the following four lens dynamics variables were assessed over a five blink cycle for both the vertical and horizontal meridians: 1) initial lens position; 2) settled lens position; 3) amount of lens movement; and 4) rate of lens movement. Lower lid position and palpebral aperture height were measured for each subject. RESULTS: Graphical analysis showed that a low upper lid position and small palpebral aperture promoted superior lens decentration, while a high upper lid position and wide palpebral aperature predisposed an individual to inferior lens decentration. Significant lid-lens overlap was a common finding with high riding lenses in both the initial and settled lens positions. The results also suggested that while a rigid lens tended to become more stable as the lens center of gravity shifted further behind the corneal apex, this gravitational effect was reduced for lenses that interacted with the upper lid. CONCLUSIONS: Lid geometry can influence rigid lens centration and stability by modifying the effects of lens design and lens mass. We recommend that consideration be given to the nature of potential lens-lid interactions prior to lens fitting.

Blinking↗

Corneal topography and myopia. A cross-sectional study.

PURPOSE: Central corneal curvature is known to vary with refractive error, but the relation between corneal topography and ametropia is less clear. The current study was conducted to determine whether a relation exists between corneal asphericity and myopia. Associations between corneal asphericity and each of the components of refraction also were examined. METHODS: Corneal asphericity and apical radius of curvature were determined for 113 eyes (spherical equivalent refractive error +0.25 diopter [D] to -9.88 D) by fitting a conicoid equation to videokeratoscopic data. Computerized videokeratoscopic images were recorded using a Topographic Modeling System. Keratometry also was performed on each eye. Anterior chamber depth, lens thickness, vitreous chamber depth, and axial length were measured with a hand-held biometric ruler. RESULTS: A low but statistically significant positive correlation was found between corneal asphericity (Q) and spherical equivalent refractive error (r = 0.275, P < 0.01). Significant relations also were observed between Q and vitreous chamber depth (r = 0.17, P < 0.1) and between Q and axial length (r = 0.24, P < 0.05). The association between Q and corneal radius of curvature was found not to be significant. Eyes with higher levels of myopia had steeper central corneal curvatures, deeper anterior and vitreous chambers, and greater axial lengths. CONCLUSIONS: A tendency for the cornea to flatten less rapidly in the periphery with increasing myopia was shown. Decreased peripheral corneal flattening also was observed in association with increasing vitreous chamber depth and increasing axial length. These findings have implications for refractive surgery outcomes, schematic eye modeling, contact lens design, and ocular aberration analysis.

Adolescent↗

Relationship between tear-meniscus parameters and tear-film breakup.

PURPOSE: Several flaws exist with the lipid-diffusion model for tear-film breakup. The aim of this study was to test an alternative model of tear-film rupture in which the negative hydrostatic pressure in each tear meniscus (related to the tear-meniscus radius of curvature) is proposed to influence the formation of breaks in the tear film. METHODS: Measurements of noninvasive breakup time (NIBUT) and tear-meniscus radius of curvature, height, width, and cross-sectional area (TMC, TMH, TMW, and XSA) were made for 15 aqueous-deficient dry-eye and 15 age-matched control subjects. An optic section of the inferior tear meniscus (colored with a minute volume of fluorescein) was photographed at x120 magnification, and images were computer analyzed. RESULTS: A significant positive correlation was found between log NIBUT and TMC (r2 = 0.141; p < 0.05). Furthermore, all subjects with TMC < 0.340 mm had NIBUT < 15 s, and two thirds of subjects with TMC > 0.340 mm had NIBUT > 15 s. There was a moderate linear relationship between TMH and log NIBUT, indicating an association between tear volume and tear stability. TMC, TMH, and tear meniscus XSA measurements all showed good reliability. CONCLUSIONS: The association between highly curved tear menisci and rapid tear-film breakup times is consistent with the meniscus model of tear-film rupture. However, a causal relationship has yet to be established.

Administration, Topical↗

Lens adherence and postlens tear film changes in closed-eye wear of hydrogel lenses.

BACKGROUND: Lens adherence and a reduced postlens tear film circulation have been suggested as factors contributing to some adverse reactions in extended wear of hydrogel contact lenses. In this study, we determined lens fitting and postlens tear film characteristics during closed-eye wear. METHODS: Twenty subjects wore hydrogel lenses for 3 h of eye closure, followed by 30 min of open-eye wear. Lens movement was measured with a video biomicroscope. Postlens tear film appearances in specular reflection were classified as either amorphous, or as one of four color intensity grades, where a colored appearance was taken as indicative of a depleted postlens tear film. RESULTS: All subjects showed lens adherence (movement < 0.1 mm) and postlens tear film depletion within 45 min of eye closure. These changes were sustained for the remainder of the closed-eye period, but were reversed within 15 min of eye opening. Lens adherence was associated with colored postlens tear film patterns of any intensity. CONCLUSION: Closed-eye wear was invariably associated with the onset of lens adherence and postlens tear film depletion. This finding emphasizes the need for adequate lens movement during the open-eye phase of extended wear.

Adhesiveness↗

Tear meniscus measurement in the diagnosis of dry eye.

PURPOSE: Assessment of the tear film meniscus is a quantitative, minimally invasive, direct measurement of tear film quantity. The aim of this study was to assess the efficacy of tear meniscus parameter measurement in the diagnosis of dry eye. METHODS: Tear meniscus radius of curvature, height, width and cross-sectional area (TMC, TMH, TMW, XSA) were determined by photographing an optic section of the inferior tear meniscus (colored with a min volume of fluorescein) at 12 x magnification, and then scanning developed images into a computer analysis program. Fifteen dry eye subjects and 15 age-matched controls were assessed. Dry eye subjects satisfied the criteria of a rose bengal staining score >/= 1, and a mean phenol red thread 15s wetted length </= 10 mm. RESULTS: TMC, TMH and XSA were all reduced in magnitude in the dry eye group compared to the control group (mean +/- SD; TMC: 0.314 +/- 0.160 mm vs. 0.545 +/- 0.259 mm, TMH: 0.244 +/- 0.089 mm vs. 0.461 +/- 00.173 mm, XSA: 0.0082 +/- 0.0048 mm2 vs. 0.0176 +/- 0.0103 mm2, ANOVA, p < 0.05). Both TMC and TMH showed good diagnostic accuracy (166.7% and 160% respectively), with a dry eye referent value of </=0.35 mm for each parameter. TMC and TMH also showed strong correlations with the cotton thread test, non-invasive breakup time, and ocular surface staining scores (p < 0.01). TMH was the most powerful predictor of tear film insufficiency. CONCLUSIONS: This study has shown tear meniscus assessment to be a useful alternative to existing tests for dry eye.

Aged↗

The influence of center of gravity and lens mass on rigid lens dynamics.

PURPOSE: Center of gravity and lens mass have both been shown to influence rigid lens centration and stability. The purpose of this study was to investigate the relative contributions of these two factors to rigid lens dynamics. METHODS: Eight subjects (four with high-riding lenses and four with low-riding lenses) participated in the study. Each subject was fit with 12 lenses-six designs in each of two materials. Center of gravity and lens mass were recorded in every case. For each lens, four lens dynamics variables were assessed over a five-blink cycle for both the vertical and the horizontal meridians: 1) initial lens position; 2) settled lens position; 3) amount of lens movement; and 4) rate of lens movement. RESULTS: Multiple regression and correlation analysis showed that center of gravity influences initial and settled lens position, in both the horizontal and the vertical meridians. Mass alone was found not to be a significant predictor of rigid lens dynamics. The effect of center of gravity on settled vertical lens position was only apparent when high rider and low rider subgroups were analyzed separately, with a posterior movement of the center of gravity being associated with a lowering of the settled lens position for high rider subjects, and a raising of the settled lens position for low rider subjects. The results suggest that a rigid lens will become more stable as the center of gravity is shifted further behind the lens vertex, but this effect is reduced as lens mass is increased. CONCLUSIONS: The location of the center of gravity of a rigid lens influences its on-eye centration and stability more so than does lens mass.

Contact Lenses↗