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University of Houston
1.
Skidmore, Kelsea V.
Tear Exchange and Midday Fogging.
Degree: MS, Physiological Optics and Vision Science, 2017, University of Houston
URL: http://hdl.handle.net/10657/4596 
► Purpose: Approximately 30% of scleral gas-permeable lens (SGP) wearing patients are affected by midday fogging (MDF). The purpose of this study was to determine the…
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▼ Purpose: Approximately 30% of
scleral gas-permeable
lens (SGP) wearing patients are affected by midday fogging (MDF). The purpose of this study was to determine the influence of post-
lens tear exchange and other fitting characteristics on the presence or absence of MDF.Methods: 33 subjects were recruited for this study. 23 subjects were habitual SGP wearers (11 MDF, 12 non-MDF subjects), and 10 were non-SGP wearing normal controls. At the study visit, dry eye symptoms were quantified (TERTC DryEye Questionnaire), and
lens-fitting characteristics were evaluated using ocular coherence tomography and biomicroscopy. Tear exchange rates were measured using the Fluorotron fluorophotometer. The procedure was to instill high molecular weight fluorescein(FITC) Dextran into the tear film reservoir beneath the SGP, and measure the tear fluid fluorescein concentration every 5-30 minutes over a period of 4 hours. The tear reservoir fluorescein concentrations were plotted to measure the fluorescein decay from within the tear fluid, which was used to calculate the tear exchange rate. Statistical analysis was done using student t-test and ANOVA.Results: In this study, there was less tear exchange in the MDF group (mean: 0.111%) when compared to the nonMDF group (mean: 0.417%), although statistical significance was not reached due to the high variability of the exchange rates (p = 0.26). There was no significant difference between the tear film reservoir thickness in the MDF (283um) and nonMDF (326um)groups (p = 0.53), or with dry eye scores (mean of 29.5 in MDF, 30.4 in nonMDF) (p = 0.91).Conclusions: In this study, there is no clear relationship between the amount of tear exchange during SGP wear and the incidence of MDF. Tear exchange may indeed be a factor, although additional studies are needed to clarify its role, and to further explore other contributing factors that may be involved in modulating the occurrence of MDF.
Advisors/Committee Members: Bergmanson, Jan P. (advisor), Miller, William L. (committee member), Marsack, Jason D. (committee member).
Subjects/Keywords: Scleral lens; Midday fogging; Tear exchange
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APA (6th Edition):
Skidmore, K. V. (2017). Tear Exchange and Midday Fogging. (Masters Thesis). University of Houston. Retrieved from http://hdl.handle.net/10657/4596
Chicago Manual of Style (16th Edition):
Skidmore, Kelsea V. “Tear Exchange and Midday Fogging.” 2017. Masters Thesis, University of Houston. Accessed March 01, 2021.
http://hdl.handle.net/10657/4596.
MLA Handbook (7th Edition):
Skidmore, Kelsea V. “Tear Exchange and Midday Fogging.” 2017. Web. 01 Mar 2021.
Vancouver:
Skidmore KV. Tear Exchange and Midday Fogging. [Internet] [Masters thesis]. University of Houston; 2017. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10657/4596.
Council of Science Editors:
Skidmore KV. Tear Exchange and Midday Fogging. [Masters Thesis]. University of Houston; 2017. Available from: http://hdl.handle.net/10657/4596
University of Waterloo
2.
Yeung, Debby.
Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population.
Degree: 2019, University of Waterloo
URL: http://hdl.handle.net/10012/14624
► PURPOSE The purpose of this study is to investigate the impact varying the limbal clearance (LC) has on the clinical performance of scleral lenses and…
(more)
▼ PURPOSE
The purpose of this study is to investigate the impact varying the limbal clearance (LC) has on the clinical performance of scleral lenses and the levels of inflammatory mediators in the tear film of keratoconic patients. The specific aims of each chapter are outlined.
In Chapter, 3 a group of keratoconic patients were fitted with a scleral lens of both high and low LC, with a constant CCC.
In Chapter 4, the subjective response, ocular response and clinical performance of scleral lenses having varying LC were investigated.
In Chapter 5, the changes in the level of inflammatory mediators in the tear film of keratoconic patients with scleral lenses wear with varying LC were determined.
In Chapter 6, the association between clinical performance and tear cytokine changes that varied with scleral lens wear with low and high LC was discussed.
METHODS
For Chapter 3: based on the corneal sagittal depth at a chord of 15.0mm, participants were fitted with two sets of scleral lenses with the same central sagittal depth and varying limbal clearances (LC) which differed by 50µm. Lenses were worn in a randomly assigned order for a two-week period. Lens fitting parameters including central and limbal clearances were measured with the Visante™ OCT and compared.
In Chapter 4: visual analog scales were completed concerning vision, comfort, burning and dryness. Corneal and conjunctival responses to lens wear, such as limbal and bulbar hyperemia, corneal swelling based on pachymetric values, and corneal staining as seen on biomicroscopy were observed and compared.
In Chapter 5: tear samples were collected from both the inferior tear meniscus using the flush tear method, and from the pool of tears in the bowl of the inverted scleral lens using a microcapillary tube. Subsequently, tear cytokine analysis was performed using a multiplex electro-chemi-luminescent array (Meso Scale Discovery, Rockville, MD) instrument. Levels of IL-1, -6, -8, TNF-α, MMP-1 and -9 were compared using a Student t-test statistical analysis.
In Chapter 6: correlations between cytokine levels and clinical parameters using the Pearson correlation coefficient (r) were performed. P values of less than 0.05 and p less than 0.10 for tear data were considered to be statistically different.
RESULTS
In Chapter 3, 11 subjects (22 eyes) were fitted with scleral lenses of a sagittal depth of 4.539±0.240mm for low LC and 4.550±0.243mm for high LC (p=0.877). There was no difference in CCC between low and high LC (p=0.671 for initial CCC, and p=0.475 for final CCC). The initial limbal clearances, before lens settling were 159.9 ±45.02µm for low the low LC lenses, and 194.07±66.10µm for high LC lenses (p<0.05). The final limbal clearances, after lens settling, were123.74±56.68µm and 167.31±69.75µm for the low LC and high LC lenses, respectively (p=0.006). There were significant differences between the nasal and temporal limbal clearances, with more clearance found temporally (p<0.001).
In Chapter 4, compared to baseline, both low and high LC lenses resulted…
Subjects/Keywords: Scleral Lens; Keratoconus; Cytokines; Inflammatory Biomarkers; Contact Lens
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APA (6th Edition):
Yeung, D. (2019). Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population. (Thesis). University of Waterloo. Retrieved from http://hdl.handle.net/10012/14624
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Yeung, Debby. “Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population.” 2019. Thesis, University of Waterloo. Accessed March 01, 2021.
http://hdl.handle.net/10012/14624.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Yeung, Debby. “Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population.” 2019. Web. 01 Mar 2021.
Vancouver:
Yeung D. Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population. [Internet] [Thesis]. University of Waterloo; 2019. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10012/14624.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Yeung D. Comparative Clinical Performance of Scleral Lenses with Varying Limbal Clearance in a Keratoconic Population. [Thesis]. University of Waterloo; 2019. Available from: http://hdl.handle.net/10012/14624
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
3.
Soeters, N.
Applications and advantages of corneal crosslinking for treatment of keratoconus.
Degree: 2015, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/311050
► Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although…
(more)
▼ Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although the prevalence is low (1:2000), the impact on quality of life is high. Despite much effort, still no cure has been found for keratoconus.
Although it does not cure keratoconus, CXL can be considered a revolutionary contribution, since it is the only treatment option for progressive cases. CXL is a relatively low invasive procedure to increase corneal rigidity. The treatment is performed a follows: after epithelial removal, isotonic riboflavin drops are applied to the cornea for 30 minutes and subsequently ultraviolet-A irradiation starts for 30 minutes. Reasons to remove the epithelium are that it acts a barrier for riboflavin molecules to enter the stroma, in addition to the fact that epithelium absorbs UV light. Due to the removal of epithelium, patients sensate (sometimes intensive) pain during the first postoperative hours, which extinguishes in the next day(s). Other known symptoms are blurry vision and photofobia. Complete healing of the corneal epithelium is generally within 5 days, and the risk of early post-operative complications (3-8%) is mostly related to epithelial healing. Transepithelial CXL whereby the epithelium is left intact might avoid epithelial healing problems and would be a less painful procedure.
In general, standard (epithelium-off) CXL has been shown to be an effective treatment with a high success rate (92%) of halting keratoconus progression. In our randomized controlled trial, transepithelial CXL performed significantly less than standard epithelium-off CXL. In 23% of eyes that underwent transepithelial CXL, keratoconus progression continued after 1 year. Progression was halted in 100% in the group with standard epithelium-off CXL. Therefore, we do not recommend replacing the standard CXL treatment for transepithelial CXL.
We also analyzed the epithelium-off CXL effect in patients at the pediatric age (<18 years). In young patients, keratoconus progression can be rapid and intervention with CXL has been advised as soon as any clinical sign of progression is noted. For the last years, there is a trend to perform CXL in patients < 18 years directly after the diagnosis is made, instead of waiting for signs of progression (as is the case in adults ≥ 18 years). This is important, since visual acuity is often still very good at this point and although risks of post-operative complications are low, a clear communication with parents and more than average patient care is mandatory when treating young patients. In our study, we found an equally safe result in pediatric patients compared to patients from 18-26 and >26 years old. Furthermore, pediatric patients showed more visual improvement compared to the other groups. An uncertainty in pediatric patients is the duration of the CXL effect. The turnover rate of stromal collagen ranges between 2 and 7 years. Since the renewed collagen might not have the same…
Advisors/Committee Members: Imhof, S.M., Koning-Tahzib, N.G. de.
Subjects/Keywords: keratoconus; crosslinking; CXL; topography; pachymetry; keratometry; visual acuity; transepithelial; scleral lens
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APA ·
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APA (6th Edition):
Soeters, N. (2015). Applications and advantages of corneal crosslinking for treatment of keratoconus. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/311050
Chicago Manual of Style (16th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Doctoral Dissertation, Universiteit Utrecht. Accessed March 01, 2021.
http://dspace.library.uu.nl:8080/handle/1874/311050.
MLA Handbook (7th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Web. 01 Mar 2021.
Vancouver:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2015. [cited 2021 Mar 01].
Available from: http://dspace.library.uu.nl:8080/handle/1874/311050.
Council of Science Editors:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Doctoral Dissertation]. Universiteit Utrecht; 2015. Available from: http://dspace.library.uu.nl:8080/handle/1874/311050
Universiteit Utrecht
4.
Visser, E.S.
Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.
Degree: 2015, Universiteit Utrecht
URL: http://dspace.library.uu.nl:8080/handle/1874/322813
► Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly…
(more)
▼ Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly as a result of restoring visual function and/or reduction of ocular discomfort and pain.
Scleral lenses are an important front-line tool for managing many corneal disorders refractory to other treatment measures and that otherwise would require keratoplasty. These disorders include conditions in which the cornea requires suitable optical correction in irregular surface, as well as to relieve symptoms, provide mechanical correction and/or facilitate corneal healing in ocular surface disease.
The fundaments for the research projects in this thesis started with the development of two key innovations (back-surface toric and tangential design) in
scleral lenses by our team. These innovations are important steps towards maximizing patient comfort and optimizing
scleral lens performance. The clinical and patient-oriented benefits of these internationally renowned breakthroughs are discussed in this thesis.
This thesis starts with a general introduction of the fundamental properties, complications, and indications of
scleral lenses. Subsequently the role of
scleral lenses in the context of other contact
lens types is examined and made accessible for practitioners, by supplying a
lens selection algorithm. Furthermore the focus of the research is on the indications and performance of modern
scleral lenses, including the recent advances in
scleral lens technologies (i.e., back-surface toric and tangential
scleral lenses). Lastly, the use of
scleral lenses following a relatively new treatment option for keratoconus (corneal crosslinking, or CXL) is evaluated, and the effect of
scleral lens use on corneal physiology is examined.
Advisors/Committee Members: Imhof, S.M., Lelij, A. van der.
Subjects/Keywords: scleral lens; keratoconus; keratoplasty; dry eye disease; corneal crosslinking
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APA ·
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Manager
APA (6th Edition):
Visser, E. S. (2015). Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/322813
Chicago Manual of Style (16th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Doctoral Dissertation, Universiteit Utrecht. Accessed March 01, 2021.
http://dspace.library.uu.nl:8080/handle/1874/322813.
MLA Handbook (7th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Web. 01 Mar 2021.
Vancouver:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2015. [cited 2021 Mar 01].
Available from: http://dspace.library.uu.nl:8080/handle/1874/322813.
Council of Science Editors:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Doctoral Dissertation]. Universiteit Utrecht; 2015. Available from: http://dspace.library.uu.nl:8080/handle/1874/322813
Universidade do Minho
5.
Oliveira, Cristina Daniela Moreira.
Edema corneal com lentes esclerais
.
Degree: 2013, Universidade do Minho
URL: http://hdl.handle.net/1822/28063
► Nos últimos cinco anos houve um aumento do uso de lentes esclerais rígidas permeáveis aos gases de grande diâmetro, uma vez que estas lentes são…
(more)
▼ Nos últimos cinco anos houve um aumento do uso de lentes esclerais rígidas
permeáveis aos gases de grande diâmetro, uma vez que estas lentes são altamente eficazes
na correção de irregularidades da córnea. As lentes esclerais oferecem conforto e boa
acuidade visual, no entanto pouco se sabe sobre os seus efeitos a longo prazo na saúde
ocular. Esta falta de conhecimento é preocupante, porque estas lentes são muitas vezes
adaptadas em córneas já comprometidas. Existe também uma falta de consenso sobre qual
a quantidade ideal de lágrima que deve existir entre a lente e a córnea. Uma maior
espessura de filme lacrimal pós-lente poderá reduzir a disponibilidade de oxigénio da
córnea, levando à formação de edema corneal.
De modo a verificar a relação entre filme lacrimal pós-lente e edema corneal
induzido em adaptações de lentes de contato esclerais, realizou-se em oito sujeitos duas
adaptações de lentes esclerais: uma com maior quantidade de filme lacrimal pós-lente que
outra. As lentes foram colocadas em todos os sujeitos no olho direito e somente durante
3h, em condições de olho aberto.
Na adaptação com menor espessura de filme lacrimal pós-lente (60,04 ± 54,30μm),
o edema médio observado foi de 1,66±1,12% e a transmissibilidade ao oxigénio média
do sistema lente escleral – lágrima – córnea calculada foi de 46,35±7,70 barrer/cm.
Na adaptação com maior espessura de filme lacrimal pós-lente (266,66 ± 27,6μm),
o edema médio observado foi de 4,27±1,19% e a transmissibilidade ao oxigénio média
do sistema lente escleral – lágrima – córnea calculada foi de 21,28±3,37 barrer/cm.
Os resultados obtidos permitem afirmar que uma maior espessura de filme lacrimal
pós- lente provoca maior edema corneal comparativamente com uma menor espessura de
filme lacrimal pós-lente.
Advisors/Committee Members: González-Méijome, José Manuel (advisor), Diaz-Rey, José Alberto (advisor).
Subjects/Keywords: Lentes esclerais;
Edema corneal;
Transmissibilidade ao oxigénio;
Filme lacrimal pós-lente;
Scleral lenses;
Corneal edema;
Oxygen transmissibility;
Post- lens tear film
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APA ·
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Manager
APA (6th Edition):
Oliveira, C. D. M. (2013). Edema corneal com lentes esclerais
. (Masters Thesis). Universidade do Minho. Retrieved from http://hdl.handle.net/1822/28063
Chicago Manual of Style (16th Edition):
Oliveira, Cristina Daniela Moreira. “Edema corneal com lentes esclerais
.” 2013. Masters Thesis, Universidade do Minho. Accessed March 01, 2021.
http://hdl.handle.net/1822/28063.
MLA Handbook (7th Edition):
Oliveira, Cristina Daniela Moreira. “Edema corneal com lentes esclerais
.” 2013. Web. 01 Mar 2021.
Vancouver:
Oliveira CDM. Edema corneal com lentes esclerais
. [Internet] [Masters thesis]. Universidade do Minho; 2013. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/1822/28063.
Council of Science Editors:
Oliveira CDM. Edema corneal com lentes esclerais
. [Masters Thesis]. Universidade do Minho; 2013. Available from: http://hdl.handle.net/1822/28063
6.
Visser, E.S.
Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.
Degree: 2015, University Utrecht
URL: http://dspace.library.uu.nl/handle/1874/322813
;
URN:NBN:NL:UI:10-1874-322813
;
urn:isbn:978-90-393-6425-3
;
URN:NBN:NL:UI:10-1874-322813
;
http://dspace.library.uu.nl/handle/1874/322813
► Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly…
(more)
▼ Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly as a result of restoring visual function and/or reduction of ocular discomfort and pain.
Scleral lenses are an important front-line tool for managing many corneal disorders refractory to other treatment measures and that otherwise would require keratoplasty. These disorders include conditions in which the cornea requires suitable optical correction in irregular surface, as well as to relieve symptoms, provide mechanical correction and/or facilitate corneal healing in ocular surface disease.
The fundaments for the research projects in this thesis started with the development of two key innovations (back-surface toric and tangential design) in
scleral lenses by our team. These innovations are important steps towards maximizing patient comfort and optimizing
scleral lens performance. The clinical and patient-oriented benefits of these internationally renowned breakthroughs are discussed in this thesis.
This thesis starts with a general introduction of the fundamental properties, complications, and indications of
scleral lenses. Subsequently the role of
scleral lenses in the context of other contact
lens types is examined and made accessible for practitioners, by supplying a
lens selection algorithm. Furthermore the focus of the research is on the indications and performance of modern
scleral lenses, including the recent advances in
scleral lens technologies (i.e., back-surface toric and tangential
scleral lenses). Lastly, the use of
scleral lenses following a relatively new treatment option for keratoconus (corneal crosslinking, or CXL) is evaluated, and the effect of
scleral lens use on corneal physiology is examined.
Advisors/Committee Members: Imhof, S.M., Lelij, A. van der.
Subjects/Keywords: scleral lens; keratoconus; keratoplasty; dry eye disease; corneal crosslinking
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APA ·
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Manager
APA (6th Edition):
Visser, E. S. (2015). Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. (Doctoral Dissertation). University Utrecht. Retrieved from http://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; http://dspace.library.uu.nl/handle/1874/322813
Chicago Manual of Style (16th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Doctoral Dissertation, University Utrecht. Accessed March 01, 2021.
http://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; http://dspace.library.uu.nl/handle/1874/322813.
MLA Handbook (7th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Web. 01 Mar 2021.
Vancouver:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Internet] [Doctoral dissertation]. University Utrecht; 2015. [cited 2021 Mar 01].
Available from: http://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; http://dspace.library.uu.nl/handle/1874/322813.
Council of Science Editors:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Doctoral Dissertation]. University Utrecht; 2015. Available from: http://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; http://dspace.library.uu.nl/handle/1874/322813
Universitat Autònoma de Barcelona
7.
Bausili Portabella, Maria Montserrat.
Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera.
Degree: Departament de Cirurgia, 2019, Universitat Autònoma de Barcelona
URL: http://hdl.handle.net/10803/668328
► INTRODUCTION: This study shows the survival function of sclera-sutured intraocular lens (IOL) and the in those cases without capsular support, it is not exempted of…
(more)
▼ INTRODUCTION: This study shows the survival function of sclera-sutured intraocular
lens (IOL) and the in those cases without capsular support, it is not exempted of possible complications, such as suture breakage and luxation or subluxation of the IOL. PURPOSE: The purpose of this study was to evaluate the long-term stability of
scleral-sutured IOL and analyze possible causes of suture breakage. METHODS: This is a retrospective study of consecutive cases. We included all patients that underwent a
scleral-sutured IOL with a follow-up longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), Intraocular pressure (IOP), axial length, and slit-lamp examination), intraoperative data (characteristics of the
scleral flaps, suture material and
scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis. RESULTS: Three hundred and forty-five consecutive cases of
scleral-sutured IOL were included. Twenty-five eyes underwent a second operation after a prior sutured IOL due to suture breakage and three of them needed a third surgery. Younger adults, use a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow up of 10 years. The probability of surviving of the
scleral-sutured IOL at 10 years after surgery was 0.79. Visual acuity and intraocular pressure were stable all over the years. CONCLUSION:
Scleral-sutured posterior chamber IOL in eyes with lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on younger adults or myopic eyes are required to demonstrate long-term safety in those special cases.
Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Nadal Reus, Jeroni (director), Barraquer, Rafael I. (Rafael Ignasi) (director), García Arumí, José (director).
Subjects/Keywords: Afàquia; Afaquia; Aphakia; Sutura escleral; Sutura escleral; Scleral suture; Lent intraocular; Lente intraocular; Intraocular lens; Ciències de la Salut; 617
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APA (6th Edition):
Bausili Portabella, M. M. (2019). Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera. (Thesis). Universitat Autònoma de Barcelona. Retrieved from http://hdl.handle.net/10803/668328
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Bausili Portabella, Maria Montserrat. “Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera.” 2019. Thesis, Universitat Autònoma de Barcelona. Accessed March 01, 2021.
http://hdl.handle.net/10803/668328.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Bausili Portabella, Maria Montserrat. “Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera.” 2019. Web. 01 Mar 2021.
Vancouver:
Bausili Portabella MM. Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera. [Internet] [Thesis]. Universitat Autònoma de Barcelona; 2019. [cited 2021 Mar 01].
Available from: http://hdl.handle.net/10803/668328.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Bausili Portabella MM. Supervivencia a largo plazo de las lentes intraoculares de cámara posterior suturadas a esclera. [Thesis]. Universitat Autònoma de Barcelona; 2019. Available from: http://hdl.handle.net/10803/668328
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
8.
Visser, E.S.
Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.
Degree: 2015, University Utrecht
URL: https://dspace.library.uu.nl/handle/1874/322813
;
URN:NBN:NL:UI:10-1874-322813
;
urn:isbn:978-90-393-6425-3
;
URN:NBN:NL:UI:10-1874-322813
;
https://dspace.library.uu.nl/handle/1874/322813
► Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly…
(more)
▼ Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly as a result of restoring visual function and/or reduction of ocular discomfort and pain.
Scleral lenses are an important front-line tool for managing many corneal disorders refractory to other treatment measures and that otherwise would require keratoplasty. These disorders include conditions in which the cornea requires suitable optical correction in irregular surface, as well as to relieve symptoms, provide mechanical correction and/or facilitate corneal healing in ocular surface disease.
The fundaments for the research projects in this thesis started with the development of two key innovations (back-surface toric and tangential design) in
scleral lenses by our team. These innovations are important steps towards maximizing patient comfort and optimizing
scleral lens performance. The clinical and patient-oriented benefits of these internationally renowned breakthroughs are discussed in this thesis.
This thesis starts with a general introduction of the fundamental properties, complications, and indications of
scleral lenses. Subsequently the role of
scleral lenses in the context of other contact
lens types is examined and made accessible for practitioners, by supplying a
lens selection algorithm. Furthermore the focus of the research is on the indications and performance of modern
scleral lenses, including the recent advances in
scleral lens technologies (i.e., back-surface toric and tangential
scleral lenses). Lastly, the use of
scleral lenses following a relatively new treatment option for keratoconus (corneal crosslinking, or CXL) is evaluated, and the effect of
scleral lens use on corneal physiology is examined.
Advisors/Committee Members: Imhof, S.M., Lelij, A. van der.
Subjects/Keywords: scleral lens; keratoconus; keratoplasty; dry eye disease; corneal crosslinking
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Chicago ·
MLA ·
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APA (6th Edition):
Visser, E. S. (2015). Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. (Doctoral Dissertation). University Utrecht. Retrieved from https://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; https://dspace.library.uu.nl/handle/1874/322813
Chicago Manual of Style (16th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Doctoral Dissertation, University Utrecht. Accessed March 01, 2021.
https://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; https://dspace.library.uu.nl/handle/1874/322813.
MLA Handbook (7th Edition):
Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Web. 01 Mar 2021.
Vancouver:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Internet] [Doctoral dissertation]. University Utrecht; 2015. [cited 2021 Mar 01].
Available from: https://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; https://dspace.library.uu.nl/handle/1874/322813.
Council of Science Editors:
Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Doctoral Dissertation]. University Utrecht; 2015. Available from: https://dspace.library.uu.nl/handle/1874/322813 ; URN:NBN:NL:UI:10-1874-322813 ; urn:isbn:978-90-393-6425-3 ; URN:NBN:NL:UI:10-1874-322813 ; https://dspace.library.uu.nl/handle/1874/322813
9.
Soeters, N.
Applications and advantages of corneal crosslinking for treatment of keratoconus.
Degree: 2015, University Utrecht
URL: http://dspace.library.uu.nl/handle/1874/311050
;
URN:NBN:NL:UI:10-1874-311050
;
urn:isbn:978-94-6295-132-7
;
URN:NBN:NL:UI:10-1874-311050
;
http://dspace.library.uu.nl/handle/1874/311050
► Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although…
(more)
▼ Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although the prevalence is low (1:2000), the impact on quality of life is high. Despite much effort, still no cure has been found for keratoconus.
Although it does not cure keratoconus, CXL can be considered a revolutionary contribution, since it is the only treatment option for progressive cases. CXL is a relatively low invasive procedure to increase corneal rigidity. The treatment is performed a follows: after epithelial removal, isotonic riboflavin drops are applied to the cornea for 30 minutes and subsequently ultraviolet-A irradiation starts for 30 minutes. Reasons to remove the epithelium are that it acts a barrier for riboflavin molecules to enter the stroma, in addition to the fact that epithelium absorbs UV light. Due to the removal of epithelium, patients sensate (sometimes intensive) pain during the first postoperative hours, which extinguishes in the next day(s). Other known symptoms are blurry vision and photofobia. Complete healing of the corneal epithelium is generally within 5 days, and the risk of early post-operative complications (3-8%) is mostly related to epithelial healing. Transepithelial CXL whereby the epithelium is left intact might avoid epithelial healing problems and would be a less painful procedure.
In general, standard (epithelium-off) CXL has been shown to be an effective treatment with a high success rate (92%) of halting keratoconus progression. In our randomized controlled trial, transepithelial CXL performed significantly less than standard epithelium-off CXL. In 23% of eyes that underwent transepithelial CXL, keratoconus progression continued after 1 year. Progression was halted in 100% in the group with standard epithelium-off CXL. Therefore, we do not recommend replacing the standard CXL treatment for transepithelial CXL.
We also analyzed the epithelium-off CXL effect in patients at the pediatric age (<18 years). In young patients, keratoconus progression can be rapid and intervention with CXL has been advised as soon as any clinical sign of progression is noted. For the last years, there is a trend to perform CXL in patients < 18 years directly after the diagnosis is made, instead of waiting for signs of progression (as is the case in adults ≥ 18 years). This is important, since visual acuity is often still very good at this point and although risks of post-operative complications are low, a clear communication with parents and more than average patient care is mandatory when treating young patients. In our study, we found an equally safe result in pediatric patients compared to patients from 18-26 and >26 years old. Furthermore, pediatric patients showed more visual improvement compared to the other groups. An uncertainty in pediatric patients is the duration of the CXL effect. The turnover rate of stromal collagen ranges between 2 and 7 years. Since the renewed collagen might not have the same…
Advisors/Committee Members: Imhof, S.M., Koning-Tahzib, N.G. de.
Subjects/Keywords: keratoconus; crosslinking; CXL; topography; pachymetry; keratometry; visual acuity; transepithelial; scleral lens
Record Details
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Record Details
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Cite
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❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Soeters, N. (2015). Applications and advantages of corneal crosslinking for treatment of keratoconus. (Doctoral Dissertation). University Utrecht. Retrieved from http://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; http://dspace.library.uu.nl/handle/1874/311050
Chicago Manual of Style (16th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Doctoral Dissertation, University Utrecht. Accessed March 01, 2021.
http://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; http://dspace.library.uu.nl/handle/1874/311050.
MLA Handbook (7th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Web. 01 Mar 2021.
Vancouver:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Internet] [Doctoral dissertation]. University Utrecht; 2015. [cited 2021 Mar 01].
Available from: http://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; http://dspace.library.uu.nl/handle/1874/311050.
Council of Science Editors:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Doctoral Dissertation]. University Utrecht; 2015. Available from: http://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; http://dspace.library.uu.nl/handle/1874/311050
10.
Soeters, N.
Applications and advantages of corneal crosslinking for treatment of keratoconus.
Degree: 2015, University Utrecht
URL: https://dspace.library.uu.nl/handle/1874/311050
;
URN:NBN:NL:UI:10-1874-311050
;
urn:isbn:978-94-6295-132-7
;
URN:NBN:NL:UI:10-1874-311050
;
https://dspace.library.uu.nl/handle/1874/311050
► Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although…
(more)
▼ Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although the prevalence is low (1:2000), the impact on quality of life is high. Despite much effort, still no cure has been found for keratoconus.
Although it does not cure keratoconus, CXL can be considered a revolutionary contribution, since it is the only treatment option for progressive cases. CXL is a relatively low invasive procedure to increase corneal rigidity. The treatment is performed a follows: after epithelial removal, isotonic riboflavin drops are applied to the cornea for 30 minutes and subsequently ultraviolet-A irradiation starts for 30 minutes. Reasons to remove the epithelium are that it acts a barrier for riboflavin molecules to enter the stroma, in addition to the fact that epithelium absorbs UV light. Due to the removal of epithelium, patients sensate (sometimes intensive) pain during the first postoperative hours, which extinguishes in the next day(s). Other known symptoms are blurry vision and photofobia. Complete healing of the corneal epithelium is generally within 5 days, and the risk of early post-operative complications (3-8%) is mostly related to epithelial healing. Transepithelial CXL whereby the epithelium is left intact might avoid epithelial healing problems and would be a less painful procedure.
In general, standard (epithelium-off) CXL has been shown to be an effective treatment with a high success rate (92%) of halting keratoconus progression. In our randomized controlled trial, transepithelial CXL performed significantly less than standard epithelium-off CXL. In 23% of eyes that underwent transepithelial CXL, keratoconus progression continued after 1 year. Progression was halted in 100% in the group with standard epithelium-off CXL. Therefore, we do not recommend replacing the standard CXL treatment for transepithelial CXL.
We also analyzed the epithelium-off CXL effect in patients at the pediatric age (<18 years). In young patients, keratoconus progression can be rapid and intervention with CXL has been advised as soon as any clinical sign of progression is noted. For the last years, there is a trend to perform CXL in patients < 18 years directly after the diagnosis is made, instead of waiting for signs of progression (as is the case in adults ≥ 18 years). This is important, since visual acuity is often still very good at this point and although risks of post-operative complications are low, a clear communication with parents and more than average patient care is mandatory when treating young patients. In our study, we found an equally safe result in pediatric patients compared to patients from 18-26 and >26 years old. Furthermore, pediatric patients showed more visual improvement compared to the other groups. An uncertainty in pediatric patients is the duration of the CXL effect. The turnover rate of stromal collagen ranges between 2 and 7 years. Since the renewed collagen might not have the same…
Advisors/Committee Members: Imhof, S.M., Koning-Tahzib, N.G. de.
Subjects/Keywords: keratoconus; crosslinking; CXL; topography; pachymetry; keratometry; visual acuity; transepithelial; scleral lens
Record Details
Similar Records
Cite
Share »
Record Details
Similar Records
Cite
« Share
❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Soeters, N. (2015). Applications and advantages of corneal crosslinking for treatment of keratoconus. (Doctoral Dissertation). University Utrecht. Retrieved from https://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; https://dspace.library.uu.nl/handle/1874/311050
Chicago Manual of Style (16th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Doctoral Dissertation, University Utrecht. Accessed March 01, 2021.
https://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; https://dspace.library.uu.nl/handle/1874/311050.
MLA Handbook (7th Edition):
Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Web. 01 Mar 2021.
Vancouver:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Internet] [Doctoral dissertation]. University Utrecht; 2015. [cited 2021 Mar 01].
Available from: https://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; https://dspace.library.uu.nl/handle/1874/311050.
Council of Science Editors:
Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Doctoral Dissertation]. University Utrecht; 2015. Available from: https://dspace.library.uu.nl/handle/1874/311050 ; URN:NBN:NL:UI:10-1874-311050 ; urn:isbn:978-94-6295-132-7 ; URN:NBN:NL:UI:10-1874-311050 ; https://dspace.library.uu.nl/handle/1874/311050
11.
Nixon, Alex D.
Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes.
Degree: MS, Vision Science, 2014, The Ohio State University
URL: http://rave.ohiolink.edu/etdc/view?acc_num=osu1397498763
► The purpose of this study is to investigate whether scleral lenses have vision performance advantages compared to soft contact lenses in normal eyes. Previous studies…
(more)
▼ The purpose of this study is to investigate whether
scleral lenses have vision performance advantages compared to soft
contact lenses in normal eyes. Previous studies reported that rigid
contact lenses can increase or decrease optical aberrations of the
eye depending on the quantity of aberrations at baseline.1 Soft
contact lenses have generally increased optical aberrations
compared to baseline. 2 3 Conclusions regarding optical quality
with contact lenses have been inconsistent due to variability in
study design, variability in contact
lens parameters, differing
lens fitting protocols, the specific measurements taken and the
instruments used to take those measurements. This study will
minimize variability due to rigid
lens decentration and movement on
eye by using a larger, more stable
scleral design. The study will
also include clinically relevant vision performance testing such as
high contrast visual acuity, low contrast visual acuity, and
contrast sensitivity. The hypothesis is that
scleral lenses improve
vision performance compared to soft contact lenses due to a
reduction in optical aberrations of the eye. 14 subjects were fit
with the Onefit P&A (Blanchard Lab, Manchester, NH) and Air
Optix Aqua or Air Optix for Astigmatism (Alcon, Ft. Worth, TX)
contact lenses. Measurements were taken at baseline and separate
lens evaluation visits scheduled after completion of the contact
lens fits. The order the contact lenses were worn was randomized
and the lenses were worn for six hours prior to each
lens
evaluation visit. The primary outcomes were Bailey-Lovie high and
low contrast visual acuity (10% Michelson), MARS contrast
sensitivity, and higher-order aberrations, measured with the
Complete Ophthalmic Analysis System (COAS). Secondary outcomes were
scleral lens clearance and sodium fluorescein corneal epithelial
staining. The corneal clearance was estimated using images from the
Heidelberg Spectralis optical coherence tomographer. There was no
difference between the contact lenses in measurements of high
contrast visual acuity (p=0.61), low contrast visual acuity
(p=0.96), and contrast sensitivity (p=0.30). The Air Optix lenses
had significantly reduced coma Z(3,1). The Onefit P&A lenses
had significantly reduced trefoil Z(3,3) (p=0.01) and spherical
aberration Z(4,0) (p<0.01). The Onefit P&A
lens tended to
have lower root-mean-square (RMS), but the trend was not
statistically significant (p=0.51). The average Onefit P&A
clearance after six hours of wear was 159 ± 64 microns. The average
Onefit P&A settling after six hours of wear was 91.71 microns.
Corneal epithelial staining was present following six hours of wear
in 4/14 (29%) eyes wearing Air Optix lenses and 13/14 (93%) of eyes
wearing Onefit P&A lenses. The Onefit P&A rigid lenses do
not appear to reduce aberrations in a population of normal eyes,
consistent with previous studies.1,3 In addition, there was no
detectable difference between the Onefit P&A and Air Optix
lenses in tests of visual performance including high contrast
visual acuity, low contrast…
Advisors/Committee Members: VanNasdale, Dean (Advisor).
Subjects/Keywords: Biomedical Research; Medicine; Ophthalmology; Optics; Scleral contact lens; higher-order aberrations; contact lens; wavefront aberrations; settling; epithelial staining; epithelial bullae; vision performance; optical coherence tomography; OCT
…56
viii
List of Figures
Figure 1: Scleral lens demonstrating complete clearance of the… …12
Figure 3: OCT cross-sectional image of a scleral lens fit with a bubble trapped beneath… …sclera. This improves lens centration and stability by
resting on the more regular scleral… …Although scleral lenses offer good comfort,
early scleral lens designs fell out of favor because… …astigmatic eyes. Leading contact lens trade publications recognize the trend in greater
scleral…
Record Details
Similar Records
Cite
Share »
Record Details
Similar Records
Cite
« Share
❌
APA ·
Chicago ·
MLA ·
Vancouver ·
CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Nixon, A. D. (2014). Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes. (Masters Thesis). The Ohio State University. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=osu1397498763
Chicago Manual of Style (16th Edition):
Nixon, Alex D. “Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes.” 2014. Masters Thesis, The Ohio State University. Accessed March 01, 2021.
http://rave.ohiolink.edu/etdc/view?acc_num=osu1397498763.
MLA Handbook (7th Edition):
Nixon, Alex D. “Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes.” 2014. Web. 01 Mar 2021.
Vancouver:
Nixon AD. Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes. [Internet] [Masters thesis]. The Ohio State University; 2014. [cited 2021 Mar 01].
Available from: http://rave.ohiolink.edu/etdc/view?acc_num=osu1397498763.
Council of Science Editors:
Nixon AD. Visual Performance of Scleral and Soft Contact Lenses in
Normal Eyes. [Masters Thesis]. The Ohio State University; 2014. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=osu1397498763
. 
Open Access Theses and Dissertations
