Contact Lens & Anterior Eye最新文献

{"title":"Microplastic contamination in artificial tears in South Korea: Potential for direct ocular exposure","authors":"Yun-Hee Choi ,&nbsp;Nayoon Park ,&nbsp;Juyang Kim ,&nbsp;Seul-Ah Park ,&nbsp;Jaehak Jung ,&nbsp;Jong Suk Song ,&nbsp;Yoon-Hyeong Choi ,&nbsp;Dong Hyun Kim","doi":"10.1016/j.clae.2024.102325","DOIUrl":"10.1016/j.clae.2024.102325","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate microplastics (MP) contamination in artificial tear (AT) products.</div></div><div><h3>Method</h3><div>Five hyaluronic acid ATs (two multi-use and three disposable ATs) were used to gauge MP levels in three scenarios: 1) initial drop and remaining liquid after opening the lid upward; 2) remaining liquid after opening the lid downward and discarding two drops; and 3) remaining liquid after opening the lid downward and discarding half of it. Raman spectroscopy was used to identify the quantity, morphological characteristics, and composition of MPs. Scanning electron microscopy/energy dispersive spectroscopy was used to examine the surface traits and elements of MPs and ATs.</div></div><div><h3>Results</h3><div>MPs were detected in 4 out of 5 ATs in the initial drops, containing 0.50 ± 0.65 particles/30 mL, whereas the remaining solution had 0.75 ± 0.72 particles/30 mL. After discarding two drops, 0.14 ± 0.35 particles/30 mL were present in the remaining solution. No MPs were detected after discarding half drops. Most MPs were transparent (95 %), irregular fragments (55 %) sized 10–20 μm (35 %), and made of polyethylene (95 %). If patients use the first drops of ATs four times a day for a year, individuals can be exposed to 730.0 particles. This exposure can be reduced to 204.4 particles by discarding the first two drops before use.</div></div><div><h3>Conclusion</h3><div>MPs are observed in commercially available ATs, and human eyes may be directly exposed to MPs through the use of ATs.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102325"},"PeriodicalIF":4.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630376","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":"Efficacy of different disinfecting methods for contact lenses against Acanthamoeba castellanii","authors":"Cristina Pastrana ,&nbsp;Fernando Huete-Toral ,&nbsp;Ana Privado-Aroco ,&nbsp;Gonzalo Carracedo","doi":"10.1016/j.clae.2024.102326","DOIUrl":"10.1016/j.clae.2024.102326","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the efficacy of different disinfecting methods for contact lenses (CL) against <em>Acanthamoeba castellanii</em> (AC) using quantitative PCR (qPCR) based on RNA detection.</div></div><div><h3>Methods</h3><div>Three CL materials: rigid gas permeable (RGP), hydrogel (Hy), and silicone hydrogel (SiHy), were contaminated with 1x10⁵ amoebae/ml and incubated for 24 h at 30 °C. After contamination, pre-cleaning steps were performed before using four maintenance solutions based on hydrogen peroxide (HP), sodium hypochlorite (SH), povidone-iodine (PI), and a multipurpose solution (MS). The pre-cleaning steps involved using a cleaner (20 % isopropyl alcohol) and rinsing the CL. Disinfection systems 1 and 2 involved no cleaner and rinsed the CL with tap water or saline solution, respectively. Systems 3 and 4 included a cleaner and rinsed with tap water or saline, respectively. After cleaning, <em>A. castellanii</em> was extracted and stored for qPCR analysis, using Hsp70 and TPBF genes to detect RNA <em>A. castellanii</em>. Results were presented as the percentage of positives or negatives (presence or absence of amoebae), with a p-value &lt; 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Disinfection system 1 with MS resulted in 56 % positives for RGP lenses and 100 % positives for both hydrogel materials. When MS was combined with a cleaner, 12.5 % positives were found for SiHy and 100 % negatives for Hy and RGP lenses (p &lt; 0.05). PI solution alone yielded 38 % and 12 % positives for hydrogel and silicone hydrogel lenses, respectively, but was 100 % effective when combined with a cleaner. HP and SH, whether combined with a cleaner or not, were effective against AC for all CL materials, except HP without a cleaner for Hy lenses.</div></div><div><h3>Conclusion</h3><div>All disinfection methods showed some efficacy against <em>Acanthamoeba</em> on any CL material. The most effective solutions were those based on hydrogen peroxide and sodium hypochlorite. Using a cleaner enhanced the final disinfecting efficacy, especially with the multipurpose solution.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102326"},"PeriodicalIF":4.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The repeatability of tests for dry eye signs and symptoms in the dry eye assessment and management (DREAM) study","authors":"Anna Chen ,&nbsp;Patrick Augello ,&nbsp;Penny Asbell ,&nbsp;Gui-Shuang Ying ,&nbsp;the DREAM Research Group","doi":"10.1016/j.clae.2024.102322","DOIUrl":"10.1016/j.clae.2024.102322","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the repeatability of measures for dry eye disease (DED) symptoms and signs in the DREAM study.</div></div><div><h3>Methods</h3><div>At screening and baseline visits approximately 2 weeks apart, participants were assessed for symptoms by Ocular Surface Disease Index (OSDI) and Brief Ocular Discomfort Index (BODI), and signs by the same physician in the same order: tear break-up time (TBUT), corneal staining, conjunctival staining, Meibomian gland evaluation, and the Schirmer test. The repeatability of DED symptoms and signs was assessed by interclass correlation coefficient (ICC), 95 % limits of agreement, and the percent of eyes with inter-visit difference above the clinically significant threshold.</div></div><div><h3>Results</h3><div>Among 1046 eyes (523 participants), ICC for signs ranged from 0.53 (TBUT) to 0.73 (corneal staining). A substantial percentage of eyes showed clinically significant inter-visit differences: ≥2 points in 17.8 % of eyes for conjunctival staining; ≥3 points in 18.8 % for corneal staining; &gt;2 s in 14.1 % for TBUT; ≥5 mm/5 min in 29.9 % for the Schirmer test, and ≥ 2 points in 27.5 % for Meibomian gland plugging and lid secretion. The OSDI and BODI had ICC of 0.64 and 0.63 respectively, and nearly 40 % of participants had inter-visit score differences ≥ 10 points.</div></div><div><h3>Conclusion</h3><div>In DREAM participants with moderate-to-severe DED, DED signs and symptoms had moderate repeatability, with ocular surface staining scores being the most repeatable and TBUT the least repeatable. A notable percentage of participants had inter-visit differences above the clinically meaningful threshold. These test–retest variabilities in DED signs and symptoms should be considered for designing clinical trials and monitoring disease progression.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102322"},"PeriodicalIF":4.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548492","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":"Richard M. Pearson, MPhil, D.Orth, DCLP","authors":"Simon Barnard ,&nbsp;Jan P.G. Bergmanson ,&nbsp;Judith Morris","doi":"10.1016/j.clae.2024.102323","DOIUrl":"10.1016/j.clae.2024.102323","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"47 6","pages":"Article 102323"},"PeriodicalIF":4.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723104","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":"Standing on the shoulders of giants: The evolution of dry eye disease","authors":"Sarah Farrant (British Contact Lens Association (BCLA) President; Managing Director and Optometrist)","doi":"10.1016/j.clae.2024.102318","DOIUrl":"10.1016/j.clae.2024.102318","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"47 6","pages":"Article 102318"},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478639","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":"Tear levels of apoptotic, matrix-degrading and antioxidant biomarkers in patients with and without keratoconus: A cross sectional study","authors":"Anna Maria Roszkowska ,&nbsp;Umberto Camellin ,&nbsp;Francesco Franchina ,&nbsp;Danilo Alunni-Fegatelli ,&nbsp;Giuseppe Lombardo ,&nbsp;Sebastiano Serrao ,&nbsp;Rita Mencucci ,&nbsp;Annarita Vestri ,&nbsp;Marco Lombardo","doi":"10.1016/j.clae.2024.102315","DOIUrl":"10.1016/j.clae.2024.102315","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the tear levels of a set of apoptotic, matrix-degrading and antioxidant biomarkers, including Metalloproteinase 9 (MMP9), High Mobility Group Box 1 (HMGB1) and Superoxide Dismutase 3-Extracellular (SOD3).</div></div><div><h3>Methods</h3><div>Sandwich-ELISA commercial kits were used to test the expression of the three tear biomarkers in the lacrimal fluid of eligible participants. Linear logistic regression analysis was performed to<!--> <!-->determine whether the set of tear biomarkers could be associated with clinically manifest keratoconus. ROC curve analysis using 10-fold cross-validation was performed<!--> <!-->to evaluate the prediction accuracy of the model.</div></div><div><h3>Results</h3><div>Eighty-one participants aged 30–48 years old were enrolled in this study; 48 were patients with keratoconus and 33 were age-matched healthy subjects. The linear combination of the three tear biomarkers levels (AUC = 0.811; CI 95 %: 0.712–0.911) accurately indicated the existence of keratoconus; higher levels of MMP9 (Odd Ratio: 1.069; CI 95 %: 1.029–1.130) and HMGB1 (OR: 1.011; CI 95 %: 1.003–1.022) and lower levels of SOD3 (OR: 0.994; CI 95 %: 0.989–0.997) were significantly associated with a higher probability of keratoconus.</div></div><div><h3>Conclusion</h3><div>Multivariable analysis of the set of tear levels of MMP9, HMGB1 and SOD3 biomarkers confirmed a chronic state of inflammation in the ocular surface of patients with keratoconus.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102315"},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contact lens-tear film interface: Investigating the tear envelope","authors":"Aisling M. Mann ,&nbsp;James S. Wolffsohn ,&nbsp;Graeme Young ,&nbsp;Brian J. Tighe","doi":"10.1016/j.clae.2024.102319","DOIUrl":"10.1016/j.clae.2024.102319","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the complex interface between the tear film, a unique mucosal fluid which is fundamental to ocular homeostasis and optimal vision, and an in-situ contact lens. This study exploits the use of a unique tear envelope (TE) extraction technique, which harvests the material-influenced layer of tear film that is in intimate contact with the lens during wear, to specifically investigate the influence of contact lens wear on tear film protein dynamics.</div></div><div><h3>Methods</h3><div>TEs were collected from freshly removed worn lens using a novel microcentrifuge ‘piggyback’ technique. Two distinct ex vivo studies were performed to investigate the key influencing factors involved. Non lens-wearing tear samples were also collected from all wearers. A compositional protein profile for each TE and tear film (TF) sample was obtained using an Agilent 2100 Bioanalyzer lab-on-a-chip microfluidic assay which detected proteins in a 14–230 kDa range.</div></div><div><h3>Results</h3><div>The data demonstrated that the TE protein compositional profile was quite distinct from either that of tear components deposited on the lens or those held in the tear menisci. For example, for one of the participant subgroups the tear protein average values in tears (n = 39) were determined at 35.2 ± 2.5 % lysozyme, 17.2 ± 0.6 % lipocalin, 7.3 ± 1.6 % IgA, 20.3 ± 1.3 % lactoferrin and 0.4 ± 0.4 % albumin as a function of total protein detected. In contrast, the average TE values were measured at 49.2 ± 3.7 %, 21.3 ± 3.9 %, 7.8 ± 1.6 % and 10.2 ± 1.7 % and 1.3 ± 2.8 % respectively with omafilcon A wear. In addition, 63 % of all TE samples (n = 180) (wearing lotrafilcon B and omafilcon A lenses) were albumin positive compared with only 19 % of all pre-lens insertion tear film samples (n = 237).</div></div><div><h3>Conclusions</h3><div>The TE approach not only allows material differentiation, but it can determine changes in the ocular host response that may otherwise be missed by sole non lens-wearing tear film sample analysis.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102319"},"PeriodicalIF":4.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of eyelid pressure on corneal tomography and biomechanics: Quantitative analysis using a novel blepharo-tensiometer","authors":"Meng Lin ,&nbsp;Jian Zhao ,&nbsp;Xueli Shao ,&nbsp;Hongqing Ma ,&nbsp;Yadong Huang ,&nbsp;Zhengqian Fang ,&nbsp;Zhiqiang Xu ,&nbsp;Kan Lin ,&nbsp;Kechun Liu ,&nbsp;Jia Qu ,&nbsp;Fan Lu ,&nbsp;Liang Hu","doi":"10.1016/j.clae.2024.102313","DOIUrl":"10.1016/j.clae.2024.102313","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to validate a blepharo-tensiometer, and investigate the relationship between eyelid pressure (ELP) and corneal tomography/biomechanics.</div></div><div><h3>Methods</h3><div>Repeatability of the blepharo-tensiometer was evaluated at different inclination angles: 10°, 15°, and 20° for the upper eyelid (U10, U15, and U20) and 45°, 50°, and 55° for the lower eyelid (L45, L50, and L55). Reproducibility was evaluated in terms of different operators and inclination angles. Both the maximum and average ELP were evaluated. Best-corrected visual acuity, manifest refraction spherical equivalent, eyelid types, palpebral fissure height, exophthalmometry, axial length, and corneal tomographic/biomechanical parameters were measured. Spearman analysis and generalized estimating equations were used to explore potential correlations.</div></div><div><h3>Results</h3><div>This study included 36 eyes from 36 subjects. The ICCs for repeatability were comparable between different inclination angles, so U15 and L50 were selected for further analysis. The ICCs for reproducibility in terms of different operator or inclination angle also achieved good to excellent outcomes. Certain associations have been revealed between the ELP and corneal tomographic/biomechanical parameters. Tomographically, ELP influences corneal front J0, front asphericity, and the index of surface variance; whereas biomechanically, ELP affects the time at first applanation, deformation amplitude at highest concavity, and biomechanically corrected intraocular pressure.</div></div><div><h3>Conclusions</h3><div>The tensiometer showed good precision. The study also showed that ELP causes a flattening effect on the peripheral cornea, with greater ELP linked to better corneal biomechanical properties in healthy subjects. These findings may potentially illuminate new avenues in the field of corneal disorders and beyond.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"47 6","pages":"Article 102313"},"PeriodicalIF":4.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394593","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":"Potential pro-inflammatory impact of scleral lens midday fogging on human corneal epithelial cells: An in vitro study.","authors":"Maria K Walker, Carolina Lema, Rachel Redfern","doi":"10.1016/j.clae.2024.102187","DOIUrl":"10.1016/j.clae.2024.102187","url":null,"abstract":"<p><strong>Purpose: </strong>Midday fogging (MDF) occurs when particulate material accumulates in the fluid reservoir (FR) beneath scleral lenses (SL), and its impact on epithelial cells is unknown. This study examines the in vitro pro-inflammatory effect of the FR on human corneal epithelial cells in varying degrees of MDF.</p><p><strong>Methods: </strong>Normal SL neophytes were recruited to wear SL 8 h daily for 4 days. Following 8 h on days 1 and 4, optical coherence tomography (OCT) images were acquired for MDF quantification using ImageJ, and the FR was collected. FR samples from the same eye were later pooled, diluted 2-fold and applied on human telomerase-immortalized corneal epithelial (hTCEpi) cells cultured on Terasaki microwell plates. Tumor necrosis factor (TNF)-α and culture media were used as positive and negative controls, respectively. After a 30-minute treatment, the nuclear factor-kappa B (NF-κB) pathway was measured by NF-κB-p65 immunofluorescence and images were analyzed with ImageJ. Pearson's correlation was conducted to determine the association between median nuclear fluorescence and MDF.</p><p><strong>Results: </strong>Fourteen FR samples with a mean volume of 22 ± 16 µl were tested. Mean MDF severity following 8 h of SL wear was 25 ± 17 units (range 7 - 64). The median nuclear fluorescence (NF-κB-p65 translocation) in cultured hTCEpi cells ranged from 31.43 to 45.16 while the negative and positive controls were 44.71 ± 1.72 and 108.77 ± 68.38, respectively. Although a potential positive trend between MDF and median nuclear fluorescence was observed, Pearson's correlation analysis revealed no significant association (r = +0.48, P = 0.09).</p><p><strong>Conclusions: </strong>The results suggest that the FR can trigger NF-κB-p65 translocation in hTCEpi cells, which may be associated with MDF severity. This study introduces the use of Terasaki microwell plates for immunofluorescence studies of the FR. The technique is simple, minimizes sample usage, and does not require expensive instrumentation.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102187"},"PeriodicalIF":4.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960586","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":"Lid wiper epitheliopathy: Topical review of current identification strategies and future perspectives","authors":"Anitha Arvind ,&nbsp;Rakesh Nanjappa ,&nbsp;Krishna Kumar Gupta ,&nbsp;Rute J. Macedo-de-Araújo ,&nbsp;Daddi Fadel","doi":"10.1016/j.clae.2024.102312","DOIUrl":"10.1016/j.clae.2024.102312","url":null,"abstract":"<div><div>Lid Wiper Epitheliopathy (LWE) is a recognized ocular condition affecting visual quality and ocular comfort, characterized by the damage of the marginal conjunctiva of the upper eyelid. This review critically examines the current strategies for LWE identification and explores the multifactorial etiology of LWE and its association with various ocular surface diseases. A literature review conducted on PubMed identified 67 relevant studies, which were analyzed to enhance understanding of LWE’s diagnostic criteria and its clinical implications, offering future perspectives on improving diagnostic accuracy and patient outcomes.</div><div>The association between LWE and contact lens-related discomfort is examined, with studies reporting conflicting findings regarding its prevalence and severity among soft contact lens wearers. Moreover, LWE has been linked to tear film abnormalities, altered tear composition, and eyelid margin abnormalities in non-contact lens wearers, further complicating diagnosis and management.</div><div>Current LWE grading systems, including subjective methods and semi-objective approaches, are reviewed, highlighting challenges such as subjectivity, complexity, and variability. Recent advances in LWE grading, including semi-automated methods and photographic scales, show promise but face implementation challenges in clinical settings.</div><div>The review concludes by proposing areas for further research, including investigating factors contributing to LWE onset and development, developing more sensitive diagnostic tools, and exploring the impact of LWE on ocular surface health and visual function. Standardization, validation, and innovation in grading systems are emphasized to enhance diagnostic accuracy and improve clinical outcomes for patients with LWE. Ongoing research in LWE grading is essential for addressing diagnostic challenges and optimizing assessment methodologies in clinical practice.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"47 6","pages":"Article 102312"},"PeriodicalIF":4.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330737","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}