Contact Lens & Anterior Eye最新文献

{"title":"Effect of publication bias on the evidence supporting the use of myopia control interventions.","authors":"Giulia Carlotta Rizzo, Lorenza Scotti, Alberto Recchioni, Erika Ponzini, Fabrizio Zeri, Silvia Tavazzi, Jonathan Denniss, Riccardo Cheloni","doi":"10.1016/j.clae.2025.102463","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102463","url":null,"abstract":"<p><strong>Purpose: </strong>Publication bias exists when studies with negative results are less likely to be published, resulting in over-estimation of treatment efficacy. This study aimed to assess the impact of publication bias on current evidence supporting myopia control interventions.</p><p><strong>Methods: </strong>A systematic literature search was conducted to retrieve systematic-reviews (SRs) and meta-analyses (MAs) assessing myopia control interventions. From eligible SRs & MAs randomised controlled trials (RCTs) evaluating myopia control treatments (spectacle-based, contact lenses (CL), pharmacological) were included. Outcomes were mean changes in axial-length and refractive error. Pooled estimates of efficacy were computed with random effects meta-analysis. Publication bias was evaluated with funnel plots and Egger's test.</p><p><strong>Results: </strong>This study included 27 SRs and MAs, reporting on 49 eligible RCTs. Considering axial length outcomes, there were 41 RCTs, assessing CL (n = 16, 39 %), spectacles (n = 13, 31.7 %), and pharmacological treatments (n = 12, 29.3 %). Egger's test was significant only for pharmacological treatments (p = 0.045), but trim and fill analysis indicated that that treatment efficacy was not over-estimated. Of 46 RCTs considering refractive error outcomes, 13 (28.3 %), 14 (30.4 %), and 19 (41.3 %) examined CL, pharmacological and spectacle treatments, respectively. Egger's test showed significant asymmetry only for CL (p = 0.006), but there was not over-estimate of treatment efficacy. Among specific treatments, only atropine (refractive outcomes) and multifocal CL (axial length and refractive outcomes) had sufficient RCTs for analysis, and all Egger's test were not significant (all p > 0.05).</p><p><strong>Conclusions: </strong>This study did not find evidence of publication bias affecting the current literature supporting myopia control treatments, suggesting that the effect of different interventions is unlikely to be overestimated.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102463"},"PeriodicalIF":4.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving multifocal contact lens fitting by replicating their fitting guides using the SimVis Gekko visual simulator.","authors":"Eduardo Esteban-Ibañez, Ainhoa Molina-Martín, Elena Martínez-Plaza, Carlos Dorronsoro, Enrique Gambra, David P Piñero","doi":"10.1016/j.clae.2025.102468","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102468","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of implementing fitting guides for multifocal contact lenses (MCLs) using the SimVis Gekko visual simulator and, through a preliminary assessment with a novel metric (3D-VA, which integrates visual acuity at multiple distances and patient visual needs), determine whether this combined approach can optimise initial MCL selection.</p><p><strong>Methods: </strong>Twenty presbyopic subjects participated in this study using two methods to select on-eye MCLs from 4 manufacturers: (1) using the first step of the fitting guide, according to the patient's addition need, to provide the MCLs recommended by the manufacturer and, (2) using SimVis Gekko simulations to obtain MCLs providing better 3D-VA, between the first and the first-alternative step of the fitting guides. Clinical measurements and metric calculations (3D-VA, perceptual score module, and direct preference) were conducted to compare the visual performance of the on-eye MCLsselected by both methods when differences existed.</p><p><strong>Results: </strong>SimVis Gekko selected the same combination of MCLs as the fitting guides in 59 % of the cases. In 28 %, SimVis Gekko chose the alternative step with differences greater than 0.05 in 3D-VA. In these latter cases, the 3D-VAsobtained with the on-eye MCLs indicated that SimVis Gekko selections were better in 62 % of cases, equal in 14 %, and worse in 24 %. The perceptual score module showed that SimVis Gekko selections were better in 62 % of cases, equal in 9 %, and worse in 29 %. The direct preference indicated that SimVis Gekko selections were better in 61 % of cases. Clinical measurements revealed that MCLsselected by SimVis Gekko had better Near Activity Visual Questionnaire scoresthan the fitting guide selection acrossall manufacturers (p = 0.02), indicating greater comfort and independence for near activities.</p><p><strong>Conclusions: </strong>SimVis Gekko can effectively replicate fitting guide steps and, in combinationwith the3D-VA metric, has the potential to become a tool that helps practitioners enhance MCL wearer satisfaction. This approach could improve the adoption and visual performance of MCLs among the presbyopic population,streamlining the fitting process.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102468"},"PeriodicalIF":4.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-level light therapy alone versus combination therapy with intense pulsed light in the treatment of dry eye disease with meibomian gland dysfunction: A randomised paired-eye and mechanism of action trial.","authors":"Jeremy Chung Bo Chiang, Viktor Dremin, David A Semp, Hiu Yan Lam, Patrick Wk Ting, Moonisah Ayaz, James S Wolffsohn","doi":"10.1016/j.clae.2025.102456","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102456","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate ocular surface changes following intense pulsed light therapy (IPL) combined with low level light therapy (LLLT) versus LLLT alone for the treatment of meibomian gland dysfunction (MGD) in patients with dry eye disease (DED).</p><p><strong>Methods: </strong>Twenty-four participants with MGD and DED were recruited into a double-masked, paired-eye clinical trial, with one eye randomised to being treated with combined therapy and the other eye with LLLT alone across 4 treatment sessions, each 2 to 3 weeks apart. Follow-up assessments were also conducted at 2 weeks and then 3 months after the final treatment. Outcome measures included change in DED signs, symptomatology and in-vivo confocal microscopy parameters at final follow-up from baseline. Mechanism of action was explored with laser doppler flowmetry and fluorescence measures of the central lower eyelid.</p><p><strong>Results: </strong>Symptom frequency rated with the Symptom Assessment Questionnaire in Dry Eye improved from baseline to final follow-up with combined therapy (mean difference - 21.6; 95 % CI - 38.5, -4.8; p = 0.005) and LLLT alone (-20.5; 95 % CI - 37.9, -3.1; p = 0.01), while symptom severity improved only with combined therapy (-18.5; 95 % CI - 34.5, -2.6; p = 0.01). Both modalities improved meibum expressibility following 3 treatment sessions, although improvement remained at final follow-up only with LLLT alone (-0.5, 95 % CI - 0.8, -0.2; p < 0.001). Tissue flavin fluorescence decreased after the fifth visit only with combined therapy (-12.7; 95 % CI - 4.9, 20.6; p = 0.001).</p><p><strong>Conclusions: </strong>Combined therapy may have further mechanistic changes in increasing cellular metabolism, in addition to improvements in symptoms and meibum expressibility compared to LLLT alone. LLLT alone could be considered an adjunctive therapy for MGD if IPL is contraindicated.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102456"},"PeriodicalIF":4.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International reporting guidelines for tear fluid research: A Delphi consensus.","authors":"Jente Schmeetz, Nienke van de Sande, William Rojas-Carabali, Burak Mergen, Clémence Bonnet, Nikolay Boychev, Carlos Cifuentes-González, Karima Kessal, Françoise Brignole-Baudouin, Penny Asbell, Necati Alp Kilicaslan, Imre Lengyel, Inmaculada Cuchillo Ibanez, Rupesh Agrawal, Marlies Gijs","doi":"10.1016/j.clae.2025.102448","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102448","url":null,"abstract":"<p><strong>Purpose: </strong>Tear fluid is a valuable biomarker source for diagnostics, monitoring, and screening thanks to its minimally invasive, inexpensive, and rapid collection. However, the lack of standardized reporting has hindered reproducibility in the field. To address these challenges, this study aimed to establish international consensus-based reporting guidelines tailored to tear fluid research.</p><p><strong>Methods: </strong>Using the Delphi methodology, the Tear Research Network engaged 74 international professionals to evaluate 35 proposed reporting statements. These statements covered essential aspects of tear fluid research, including terminology, collection, storage, pre-analytical processing, analysis, and data normalization. Professionals ranked their agreement on the need to include each of the statements based on a 5-point Likert scale (very unimportant - very important). Consensus was defined as ≥70 % agreement, and all ratings were collected and analyzed anonymously.</p><p><strong>Results: </strong>Consensus was achieved for 34 of the 35 proposed statements in the first Delphi round, reflecting a high level of agreement among professionals, with 26 of these statements reaching strong consensus at agreement levels of 90% or higher. The resulting guidelines provide detailed recommendations to standardize reporting, improve transparency, and enhance reproducibility in tear fluid studies.</p><p><strong>Conclusions: </strong>The TEAR-reporting guidelines (TEAR-RG) represent a significant step toward standardizing research practices in tear fluid studies. By addressing key methodological and reporting issues, these guidelines aim to improve the reproducibility and transparency of research in this rapidly evolving field. This work underscores the importance of standardized frameworks for advancing biomarker discovery and clinical applications in tear fluid research.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102448"},"PeriodicalIF":4.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing power profiles of a concentric ring multifocal contact lens for myopia management: a novel approach.","authors":"Annabelle J Mawhinney, Phillip J Buckhurst, Craig McNeile, Stephen D Hall, Hetal D Buckhurst","doi":"10.1016/j.clae.2025.102454","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102454","url":null,"abstract":"<p><p>This study presents a systematic method for characterizing power profiles of concentric ring multifocal contact lenses (MFCL), specifically the MiSight® lens used in myopia management, and evaluates the potential of Multivariate Adaptive Regression Spline (MARS) modelling to extrapolate profiles across a full dioptric range. Power profiles of eleven MiSight® lenses (-0.25D, then -1.00D to -10.00D in 1.00D steps) were measured using the NIMOevo® system. MiSight® lenses comprise four concentric zones, with zones 2 and 4 providing additional plus power. Centre thickness (CT) was measured using an immersive spectral-domain Optical Coherence Tomographer. Zonal boundaries were determined as asymptotes of a four-parameter sigmoidal function fitted to junctions between zones, average power within each zone was calculated between these boundaries. MARS was trained on the measured power profiles and used to generate theoretical power profiles for intermediate powers. These were validated against independently measured lenses with matching labelled powers (-1.50D, -3.50D and -6.50D). The proposed method identified consistent zonal boundaries across labelled powers, with minor power-dependent variations. CT correlated significantly with labelled power (r = 0.78). Zone 2 addition powers were consistent, while zone 4 demonstrated a decreasing trend with increasing negative power. The MARS accurately modeled boundary locations and addition powers. This framework offers a systematic approach for analyzing zonal MFCL power profiles, addressing the method for determining zonal boundaries. Additional plus power provided by MiSight® lenses varies across the two zones, with a pronounced effect of reducing addition power in zone 4. MARS modelling allowed extrapolation of power profiles and warrants further investigation.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102454"},"PeriodicalIF":4.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From evidence to action: why does it take so long for clinical practice to adapt?","authors":"Raquel Gil-Cazorla","doi":"10.1016/j.clae.2025.102455","DOIUrl":"10.1016/j.clae.2025.102455","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 4","pages":"Article 102455"},"PeriodicalIF":4.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical characteristics of Keratoconus amongst school children in Mumbai.","authors":"Neha Chaurasia, Vanessa Raquel Moodley, Khathutshelo Percy Mashige","doi":"10.1016/j.clae.2025.102444","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102444","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the prevalence and characterize the clinical profile of keratoconus [KC] among Mumbai schoolchildren.</p><p><strong>Methods: </strong>A sample of 2 042 students aged 9-17 years was selected from schools in Mumbai through stratified random sampling. Selected participants underwent ocular assessments of visual acuity [VA], auto keratorefractometry [ARK], retinoscopy, ophthalmoscopy, and corneal topography. Descriptive and inferential statistical analyses were conducted utilizing SPSS software version 25.</p><p><strong>Results: </strong>The prevalence of KC was 3.6% [n = 74], with a mean age of 12.47 ± 1.7 years and 70% being female. Amongst the KC group, 58% were Hindus and 41% Muslims, with consanguinity being significantly associated with KC amongst Muslims (<0.001). In both topography [48.22D vs. 43.58D] and ARK [47.58D vs. 43.16D], K2 [steep keratometry] was higher in the KC as compared to the non-KC group. The I-S index was elevated [2.0D vs. 0.71D], unaided VA worse by 0.35 log units, and myopia [-5.27D vs. -1.89D] and irregular astigmatism [-1.88D vs. -0.68D] more severe in the KC group. Significant asymmetry was noted in the surface asymmetry index, flat and mean K values, myopia, and astigmatic refractive errors [p < 0.001] when comparing better and worse eyes. Retinoscopy showed strong associations with refractive error and topographical findings.</p><p><strong>Conclusion: </strong>This first population-based study among schoolchildren in Mumbai [aged 9-17] found a significant KC prevalence. A more comprehensive screening approach, incorporating key diagnostic indicators such as topographical indices [mean K, I-S index, an asymmetric bow-tie pattern], positive scissors reflex on retinoscopy, myopia [≥ - 5 D], irregular astigmatism [>1.5 D], VA of 0.35 log units or worse and marked asymmetry between better and worse eyes, proved effective in identifying KC cases. Findings highlight the need to integrate KC detection protocols into school vision programs in Mumbai for early diagnosis and intervention, ultimately improving long-term visual and ocular health outcomes of affected children.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102444"},"PeriodicalIF":4.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An in vivo study of cigarette smoke induced meibomian gland deterioration in a murine model.","authors":"Yuting Jiang, Ling Zhang, Jingru Wang, Runhua Lyu, Yingying Gao","doi":"10.1016/j.clae.2025.102452","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102452","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of cigarette smoke (CS) exposure on the histopathological structure of the meibomian gland in a murine model, including the presence of inflammatory mediators and sebocyte apoptosis, and to provide a new experimental basis and theoretical support to further explore the relationship between CS and dry eye.</p><p><strong>Methods: </strong>Forty-eight female C57BL/6 mice aged 6-8 weeks were randomly divided into a normal control group (12 weeks, 24 weeks) and a CS exposure group (12 weeks, 24 weeks). The normal control group received no treatment while the CS exposure group were exposed to CS 2 cigarettes/hour, 3 h/day and 6 days/week for either 12 or 24 weeks. Corneal changes were monitored regularly. Following CS exposure, meibomian gland tissues of mice were processed for H&E staining, CD45 immunohistochemical staining, and immunofluorescence staining for IL-6 and Ki67. The expression of IL-6, Ki67, P63, MMP-3 in meibomian glands were evaluated by RT-PCR. Sebocyte apoptosis was assessed through TUNEL staining.</p><p><strong>Results: </strong>Compared with the normal control group, H&E staining in the CS12 group showed no significant change, while meibomian gland orifices were blocked in the CS24 group. TUNEL staining demonstrated a significant increase in cellular apoptosis in both smoke-exposed groups compared to the normal control group. IL-6 and MMP-3 were significantly up-regulated in meibomian gland tissues after 12 weeks of CS exposure and the expression of cell proliferation-related gene Ki67 and P63 decreased.</p><p><strong>Conclusion: </strong>CS exposure induces meibomian gland inflammation, promotes sebocyte apoptosis, and inhibits sebocyte proliferation in mice.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102452"},"PeriodicalIF":4.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimisation of blinking exercises for dry eye disease.","authors":"James S Wolffsohn, Sònia Travé-Huarte, Ishvinder Bahra, Charis Finch, Uche Anyaegbu, Nery Garcia-Porta, Alec Kingsnorth","doi":"10.1016/j.clae.2025.102453","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102453","url":null,"abstract":"<p><strong>Purpose: </strong>Blinking exercises can reduce the signs and symptoms of dry eye disease, but the optimum technique, repetitions and repeats/day are unclear. Hence, this study used an instructional app to assess the best routine for blinking exercises.</p><p><strong>Method: </strong>In the optimisation stage, dryness symptoms with the Ocular Surface Disease Index (OSDI-6-item), Symptom Assessment Questionnaire iN Dry Eye (SANDE), and the time the eyes were comfortable for after a blink (the Blink Test) were assessed in 98 participants with dry eye before and after 2 weeks of blinking exercises, as well as 2 weeks after completing the blinking exercise routine. Participants were randomised between a squeeze and blink compared to blink only regimen, 2 to 4 repeats per day and 5 to 25 repetitions each time. A second efficacy study with 28 participants with dry eye disease assessed the optimum app parameters based on symptom severity and frequency, blink rate/completeness, tear film stability and volume, along with ocular surface staining over the same time period.</p><p><strong>Results: </strong>Overall, blinking exercises reduced symptomatology (p < 0.01). Including a squeeze step significantly reduced symptom frequency (p < 0.01). Forty repetitions spread over two time a day was more effective than 10 repetitions 4x/day (SANDE frequency p = 0.015). Fifteen repetitions was more effective than 5 repetitions 3x/day (SANDE frequency p = 0.008). Using the optimum blinking exercise routine of 15 repeats, 3x/day for 2 weeks, dry eye symptom severity (p = 0.001), frequency (p = 0.027), incomplete blinks (p < 0.001) and conjunctival staining (p = 0.041) significantly decreased. These readings mostly returned to baseline levels two weeks after finishing the blinking exercises (p > 0.05). However, there was no significant effect on the blink rate, non-invasive tear breakup time, tear meniscus height or corneal staining (p > 0.05).</p><p><strong>Conclusion: </strong>Fifteen repeats of close-squeeze-open cycles, 3x/day was the optimum blinking exercise routine, reducing symptoms, number of incomplete blinks and conjunctival staining.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102453"},"PeriodicalIF":4.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of apical clearance rigid corneal contact lens fitting on keratoconus progression: a controlled longitudinal analysis.","authors":"Tsung-Hsien Tsai, Jui-Hung Hsu, Chi-Chin Sun, Ching-Hsi Hsiao, Jiahn-Shing Lee, Ken-Kuo Lin","doi":"10.1016/j.clae.2025.102449","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102449","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of apical clearance rigid corneal contact lens (RCCL) fitting on keratoconus (KC) progression compared to untreated KC patients over a 12-month period.</p><p><strong>Methods: </strong>This retrospective, controlled longitudinal study included 237 eyes with KC from two centers between 2018 and 2023. Following propensity score matching for baseline age and maximum keratometry (K_max), 31 eyes each were assigned to untreated and RCCL groups. RCCLs were fitted using the apical clearance method. Assessments at baseline, 3, 6, and 12 months included best-corrected visual acuity (BCVA), Scheimpflug corneal tomography and higher-order aberrations (HOAs). KC progression was defined by any of the following: an increase in K_max or anterior steep keratometry (K2) of >1.0 D, a decrease in thinnest corneal thickness (TCT) of > 10 μm, or a loss of >1 line of BCVA. Longitudinal changes were analyzed using generalized estimating equations (GEE).</p><p><strong>Results: </strong>No significant differences in BCVA, tomographic indices, or HOAs were observed between the untreated and RCCL groups at baseline or during follow-up at 3 and 12 months (all p > 0.05). KC progression rates were comparable between the groups, occurring in 12.9 % of untreated eyes and 19.35 % of RCCL treated eyes by 12 months (p = 0.731). GEE analysis revealed a significant reduction in K2 at 3 months within the RCCL group (p = 0.003); however, no other significant longitudinal differences were detected within or between groups at any follow-up period.</p><p><strong>Conclusion: </strong>Apical clearance RCCL fitting did not significantly affect overall KC progression compared with no treatment over 12 months. However, the significant reduction in K2 at 3 months in the RCCL group suggests that one week of contact lens discontinuation may not be sufficient for the cornea to fully return to its natural state.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102449"},"PeriodicalIF":4.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}