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Biomedical subjects

M J Remba

Publications and source records attributed to M J Remba.

7 recordsLinked to original sources

Interobserver and intraobserver reliability of a classification scheme for corneal topographic patterns.

AIMS: To determine the interobserver and the intraobserver reliability of a published classification scheme for corneal topography in normal subjects using the absolute scale. METHOD: A prospective observational study was done in which 195 TMS-1 corneal topography maps in the absolute scale were independently classified twice by three classifiers--a cornea fellow, an ophthalmic technician, and an optometrist. From these observations the interobserver reliability for each category and the intraobserver reliability for each observer were determined in terms of the median weighted kappa statistic for each category and for each observer. RESULTS: For interobserver reliability, the median weighted kappa statistic for each category varied from 0.72 to 0.97 and for intraobserver reliability the range was 0.79 to 0.98. CONCLUSION: This classification scheme is extremely robust and even in the hands of less experienced observers with minimal training it can be relied upon to provide consistent results.

Corneal Topography↗

The Tangent Streak rigid gas permeable bifocal contact lens.

An in-office clinical investigation to determine the fitting success rate and frequency and reasons for lens performance failure was conducted, using the Tangent Streak, a new rigid gas permeable bifocal contact lens. The patient population consisted of 34 highly screened presbyopic patients qualifying for a translating bifocal lens. The results revealed nearly 60% of all eyes were fitted successfully with the first lens ordered and an additional 22.4% met success criteria after a second lens order, for a total of 82.1% success. The average number of lenses needed to attain success was calculated to be 1.8 lenses per eye. Analysis of reasons for lens reorder, and frequency and types of lens modification is also summarized, and provides added information regarding the "customized" nature of this specialty lens.

Adult↗

Results of the extended wear contact lens survey of the Contact Lens Section of the American Optometric Association.

Surveys of contact lens practice, comparing the use of daily wear and extended wear cosmetic soft contact lenses, were distributed to almost 3,000 members of the Contact Lens Section of the American Optometric Association. There were 759 responses received of which 440 were considered valid for analysis. The results of our analysis suggest that slightly more physiological complications are encountered with extended than with daily wear of contact lenses. Most optometrists (96%), however, are satisfied with this modality and continue prescribing extended wear lenses, although many have decreased the number of days over which patients are advised to use the lenses before removal and cleaning. Most of the respondees now favor medium water content, thin lens designs for extended wear use, with 70% of them suggesting weekly removal, cleaning and aseptization. Peroxide cleaning regimens are most popular for this function.

Contact Lenses, Extended-Wear↗

Part II. Clinical evaluation of toric hydrophilic contact lenses.

Five toric hydrogel contact lenses have been approved for marketing by the FDA and several more await final approval in the near future. Clinical use of these special design lenses for correction of astigmatism has increased during the past year, improvements in lens design and fabrication are taking place, but problems remain. Analysis of the reasons for fitting failures show that lens quality and axis mislocation are the primary causes of lens performance failures.

Astigmatism↗

Clinical evaluation of FDA approved toric hydrophilic soft contact lenses (Part I).

Three toric hydrogel contact lenses have been approved by the FDA, Durasoft TT, Hydromarc, and Hydrocurve II. These all incorporate prism ballast as the major axis stabilizing feature, but differ in diameter and placement of the cylinder. Correct cylinder axis positioning and maintenance of meridional stability are essential to fitting success.

Astigmatism↗