Eye & Contact Lens-Science and Clinical Practice最新文献

{"title":"Acquired Corneal Subepithelial Hypertrophy: First Ultrastructural Characterization by Transmission Electron Microscopy.","authors":"Matilde Buzzi, Mirko Manetti, Alfonso Strianese, Alberto Carnicci, Daniele Guasti, Mirca Marini, Rita Mencucci","doi":"10.1097/ICL.0000000000001316","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001316","url":null,"abstract":"<p><strong>Abstract: </strong>Acquired corneal subepithelial hypertrophy (ACSH) is a rare corneal condition whose ultrastructural features have not previously been characterized. We report the first detailed ultrastructural analysis of ACSH in a 57-year-old man with a history of penetrating keratoplasty for corneal trauma followed by Descemet stripping automated endothelial keratoplasty who presented with progressive visual decline due to a superficial corneal opacity. Clinical evaluation included slitlamp biomicroscopy, anterior segment optical coherence tomography, corneal topography, and pachymetry, which localized the lesion to the subepithelial compartment. The lesion was managed with selective surgical peeling, and the excised tissue was examined by light microscopy and transmission electron microscopy. Surgical removal led to restoration of best-corrected visual acuity with no recurrence at 1-year follow-up. Histopathological analysis demonstrated irregular epithelial thickening, complete absence of Bowman layer, and subepithelial fibrosis with myofibroblast proliferation, without evidence of inflammation or neovascularization. Ultrastructural examination revealed epithelial mitochondrial damage with mitophagy, disruption of intercellular junctions, and subepithelial myofibroblasts containing abundant rough endoplasmic reticulum, consistent with active fibrotic remodeling. These findings support ACSH as an acquired corneal fibrotic process driven by wound healing mechanisms, with clinical, epidemiological, and histopathological features distinct from other corneal degenerations and confirmed that surgical peeling of the thickened epithelial and subepithelial tissue can be curative.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Poorly Fitted Scleral Lenses and Approaches to Continued Wear.","authors":"Cherie B Nau, Amy C Nau, Jennifer S Fogt, Ellen S Shorter, Jennifer S Harthan, Muriel M Schornack","doi":"10.1097/ICL.0000000000001306","DOIUrl":"10.1097/ICL.0000000000001306","url":null,"abstract":"<p><strong>Abstract: </strong>Scleral lenses (SLs) are increasingly considered a mainstream option for optical correction in patients with corneal irregularity and for protection of the ocular surface in patients with ocular surface disease. However, there can be complications with SL if the fit and disease is not regularly monitored. This case series reviews complications from poorly fitted SLs. Changes in SL design may allow a patient to resume successful lens wear. Regardless, SL fit and underlying disease states should be assessed at regularly scheduled intervals for new concerns in all patients and for recurrence of problems despite modification of fit in those who suffer complications.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"432-435"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time of Day Effects of Contact Lens-Induced Full-Field and Peripheral-Field Defocus on Choroidal Thickness: A Pilot Study in Adults.","authors":"Varsha Venkata Srinivasan, Ayeswarya Ravikumar, Lisa A Ostrin","doi":"10.1097/ICL.0000000000001292","DOIUrl":"10.1097/ICL.0000000000001292","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effects of contact lens-induced full-field and peripheral-field myopic defocus on choroid thickness and variation with time of day in young adults.</p><p><strong>Methods: </strong>In this prospective, randomized, crossover study, 16 adults (age 28.2±6.3 years) participated in four experimental sessions (two morning and two evening). At each session, optical coherence tomography (OCT) was performed before and 60 min after distance viewing with either full-field or peripheral-field +2.50 D contact lens-induced defocus in the left experimental eye and distance correction in the right eye. Recovery was assessed after 20 min with distance correction in both eyes. Choroidal thickness was analyzed using a custom MATLAB program and two-factor repeated-measures ANOVAs.</p><p><strong>Results: </strong>Mean spherical equivalent refraction was -1.7±1.7 D in right eyes and -1.9±2.0 D in left eyes ( P =0.20). Baseline choroidal thickness was greater in the morning (326±71 μm) than evening (316±72 μm, P =0.006). No significant changes occurred after 60 min for either full field or peripheral-field in the morning or evening ( P >0.05 for all).</p><p><strong>Conclusion: </strong>One-hour exposure to full-field or peripheral myopic defocus did not alter choroidal thickness, irrespective of time of day, in young adults with a range of refractive errors. Studies in children, particularly with longer durations of imposed defocus, are needed to determine whether short-term structural responses may serve as clinically meaningful biomarkers.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"395-402"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous Longitudinal Changes in Corneal Epithelial and Stromal Thicknesses in Patients With Very Asymmetric Ectasia: A Case Series.","authors":"Shizuka Koh, Ryota Inoue, Renato Ambrósio, Dan Z Reinstein, Timothy J Archer, Kohji Nishida","doi":"10.1097/ICL.0000000000001288","DOIUrl":"10.1097/ICL.0000000000001288","url":null,"abstract":"<p><strong>Abstract: </strong>This study aimed to investigate the longitudinal changes in corneal epithelial and stromal thicknesses in eyes with very asymmetric ectasia that appeared clinically and topographically normal at baseline. Fourteen eyes from 14 patients underwent serial evaluation using corneal topography, corneal tomography, and corneal biomechanical assessment. Based on baseline tomographic and biomechanical parameters, eyes were classified into two groups. Over a mean follow-up of 54 months, eyes with normal baseline parameters showed minimal changes in stromal thickness, whereas a subset of eyes with abnormal baseline indices demonstrated measurable stromal thinning exceeding physiological variability. By contrast, epithelial thickness changes were small and inconsistent across all patients. These findings indicate that eyes with very asymmetric ectasia represent a heterogeneous population and that the longitudinal assessment of corneal layer-specific changes may provide additional insights beyond that derived from cross-sectional evaluation alone.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"440-444"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Variation in Extended Depth-Of-Focus Design on Myopia Control and Visual Function in Japanese Children.","authors":"Sayuri Ninomiya, Shizuka Koh, Sachiyo Ueshima, Kohji Nishida","doi":"10.1097/ICL.0000000000001294","DOIUrl":"10.1097/ICL.0000000000001294","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of extended depth-of-focus (EDOF) soft contact lenses with different optical profiles in controlling myopia progression and their effect on visual function in Japanese children.</p><p><strong>Methods: </strong>In this 12-month multicenter, double-masked, randomized controlled trial, 60 Japanese children aged 6 to 12 years were assigned to wear two types of EDOF soft contact lenses with different depths of focus (Mid-EDOF [+1.50 D] or Low-EDOF [+0.75 D]) or single-vision daily disposable contact lenses (control). Axial length and cycloplegic spherical equivalent (SE) were measured at 6 and 12 months. Visual function, including contrast sensitivity, higher-order aberrations (HOAs), and subjective visual quality, was assessed at baseline and follow-up.</p><p><strong>Results: </strong>Mid-EDOF lenses significantly suppressed axial elongation and SE progression by 49% and 59%, respectively, compared with single-vision lenses ( P <0.01). Low-EDOF lenses exerted no significant effect on axial elongation or SE progression. Visual function assessments revealed reduced contrast sensitivity and increased HOAs in the Mid-EDOF group; subjective visual quality remained comparable across groups. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Mid-EDOF lenses significantly suppress myopia progression, with tolerable visual function changes, potentially providing effective myopia control. Low-EDOF lenses showed no significant benefit over single-vision lenses. EDOF lenses' optical profile critically affects treatment efficacy.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"403-409"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of a Novel Customized Multifocal Corneo-Scleral Contact Lens With Spherical Aberration Control.","authors":"Olalla Rica-Molinero, Juan Carlos Nieto, Daniel Monsálvez-Romín, David P Piñero","doi":"10.1097/ICL.0000000000001305","DOIUrl":"10.1097/ICL.0000000000001305","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the objective and subjective clinical outcomes of a customized multifocal corneo-scleral contact lens (CLs) with spherical aberration (SA) control in presbyopic patients.</p><p><strong>Methods: </strong>A pilot observational clinical study was conducted in 27 presbyopic subjects (54 eyes). All participants were fitted with a customized multifocal corneo-scleral rigid gas-permeable (RGP) CLs designed to induce controlled SA. Binocular visual acuity (VA) was assessed under photopic conditions for distance, intermediate (67 cm), and near (40 cm) vision after a minimum wear period of 2 months and binocular defocus profile was constructed by plotting mean visual acuity (logMAR) as a function of induced defocus from +2.00 to -2.50 D. Ocular aberrations with the lens in situ were measured using a Hartmann-Shack aberrometer. Subjective visual quality and comfort were evaluated using the Quality of Vision (QoV) questionnaire and the eight-item Contact Lens Dry Eye Questionnaire (eCLDEQ-8). Spearman correlation analyses were performed to explore relationships between visual outcomes and optical parameters.</p><p><strong>Results: </strong>Mean binocular VA was 0.03±0.06 for distance vision, 0.10±0.12 for intermediate vision, and 0.32±0.17 for near vision. The binocular defocus profile showed preserved visual performance from distance to intermediate defocus levels, with a marked reduction at-2.50 D. A weak but statistically significant positive correlation was found between the sign of induced SA and distance VA (ρ=0.303, P =0.026), indicating poorer distance vision with positive SA induction. Near VA was weakly and positively correlated with mean pupil diameter (ρ=0.301, P =0.027). No significant associations were observed between VA and total higher-order aberration (HOAs) magnitude. Subjective symptoms were generally mild, with difficulty focusing being the most frequently reported complaint.</p><p><strong>Conclusions: </strong>The customized multifocal corneo-scleral CLs with SA control evaluated can provide good distance and intermediate visual performance in presbyopic patients, but limited near visual performance and symptom tolerance. The sign of induced SA and pupil size seem to influence visual outcomes, supporting the value of individualized optical design. Further controlled studies with larger samples and extended follow-up are warranted.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"425-431"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Improvement with Red-Tinted Contact Lens in Pediatric Achromatopsia: A Case Report.","authors":"İbrahim Talyurt, Mehmet O Kiristioglu, Mehmet Baykara","doi":"10.1097/ICL.0000000000001310","DOIUrl":"10.1097/ICL.0000000000001310","url":null,"abstract":"<p><strong>Abstract: </strong>Achromatopsia is a rare inherited cone dysfunction characterized by reduced visual acuity, photophobia, nystagmus, impaired color discrimination, and decreased contrast sensitivity (CS). This case report describes the clinical and patient-reported outcomes of red-tinted contact lens use in a child with achromatopsia. Baseline and postlens assessments included cycloplegic refraction, visual acuity, CS, and vision-related quality of life using a Turkish questionnaire adapted from the 25-Item National Eye Institute Visual Function Questionnaire for low vision and photophobia. After lens fitting, the patient reported reduced glare, improved comfort in bright environments, and better performance in daily visual activities. Questionnaire findings also suggested improvement in distance-related tasks, outdoor functioning, reading/writing comfort, and overall visual comfort. However, CS testing showed deterioration after lens use. These findings suggest that red-tinted contact lenses may provide meaningful symptomatic and functional benefit in pediatric achromatopsia, particularly by alleviating photophobia, even when objective CS does not improve.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"436-439"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of HEV-Filtering in a Soft Contact Lens on Contrast Sensitivity With and Without Veiling Glare.","authors":"Billy R Hammond, John R Buch, Patricia Martin, Jie Xu, Lisa M Renzi-Hammond","doi":"10.1097/ICL.0000000000001296","DOIUrl":"10.1097/ICL.0000000000001296","url":null,"abstract":"<p><strong>Purpose: </strong>The contrast sensitivity function (CSF) can be used to assess even subtle changes in visual function. These changes are likely amplified in the presence of a stressor such as glare. In this study, we tested mesopic and photopic CSF in the absence/presence of an ecologically valid glare source. CSF was tested within subjects, comparing a high energy visible (HEV)-filtering contact lens against a clear comparator lens of similar material and design.</p><p><strong>Methods: </strong>This was a randomized, controlled, and double-masked study. Forty participants (19-65 years) provided photopic (n=20) or mesopic (n=20) CSF (1.6, 3.2, 8, 16, and 24 cpd) both with and without veiling glare. CSF was measured using a customized optical system. Two separate light channels were combined with a beam splitter that allowed contrast modulation using sine-wave gratings on glass. Glare was interposed between the grating and the subject's eye using an ancillary xenon-based optics channel.</p><p><strong>Results: </strong>The mean area under the CSF curve derived for both photopic and mesopic CSF (with and without glare) was significantly improved by use of the HEV-absorbing lens compared with the control. With a glare source, the least-squares mean differences (95% confidence interval) were 0.3 (0.24-0.36) and 0.14 (0.10-0.18) under photopic and mesopic conditions, respectively. In the absence of a glare source, the least-squares mean differences (95% confidence interval) were 0.26 (0.21-0.31) and 0.28 (0.20-0.37) for photopic and mesopic conditions, respectively.</p><p><strong>Conclusion: </strong>The HEV-absorbing lens significantly improved CSF when tested under mesopic and photopic conditions and both with and without veiling glare.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"417-424"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Eye Rubbing: Mechanical Ocular Stimulation Is Highly Prevalent in Keratoconus.","authors":"Shizuka Koh, Ryota Inoue, Damien Gatinel, Kohji Nishida","doi":"10.1097/ICL.0000000000001311","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001311","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate current and previous mechanical ocular stimulation behaviors beyond conventional eye rubbing in patients with keratoconus.</p><p><strong>Methods: </strong>This prospective study included Japanese outpatients with a clinical diagnosis of keratoconus in at least one eye. All participants completed a structured investigator-developed questionnaire assessing current and past mechanical ocular stimulation behaviors, followed by face-to-face physician interviews. Questionnaire items included history, reasons, duration, frequency, techniques, and anatomical sites of stimulation.</p><p><strong>Results: </strong>A total of 304 patients were included, with 91.4% reporting mechanical ocular stimulation. These behaviors were typically long-standing (75.9% >10 years) and varied widely in motivation, frequency, methods, and anatomical sites. Ocular itching was the most common trigger (75.9%), although many behaviors were unrelated to itching. Finger pulp (56.1%) and knuckles (48.6%) were commonly used, and the medial canthus was the most commonly involved site (70.1%) (P<0.05). Pressure-related behaviors, such as eye pressing or massage during fatigue, were reported by approximately one third of patients.</p><p><strong>Conclusions: </strong>The concept of mechanical ocular stimulation provides a more comprehensive framework than eye rubbing for characterizing pressure-related behaviors in patients with keratoconus. Broader assessment of current and past behaviors may improve clinical assessment and patient counseling.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Scleral Lens Wear on Intraocular Pressure, Retinal Structure, and Choroidal Vascularity.","authors":"Rabia Eroğlu, Gamze Ozkan, Semra Akkaya Turhan","doi":"10.1097/ICL.0000000000001314","DOIUrl":"https://doi.org/10.1097/ICL.0000000000001314","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of scleral lens (SL) wear on intraocular pressure (IOP), retinal parameters, and choroidal metrics in habitual SL wearers with keratoconus.</p><p><strong>Methods: </strong>This cross-sectional study included 25 eyes of 25 habitual SL wearers with keratoconus and 25 eyes of 25 healthy controls. Measurements were obtained before SL wear and immediately after lens removal after 4 hr of wear. IOP, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) were evaluated.</p><p><strong>Results: </strong>Mean SL wear duration was 3.9±3.8 years. Mean IOP was 12.16±3.00 mm Hg before wear and 12.14±2.90 mm Hg after 4 hr, with a paired mean difference of 0.01 mm Hg (95% CI, -0.76 to 0.78; P=0.678). No statistically significant changes were observed in RNFL, GCC, SFCT, or CVI after 4 hr (P=0.929, 0.094, 0.098, and 0.424, respectively). CVI did not differ between groups before or after SL wear (P=0.114 and 0.358, respectively).</p><p><strong>Conclusions: </strong>Four hours of SL wear was not associated with statistically significant changes in IOP, RNFL, GCC, SFCT, or CVI in habitual SL wearers with keratoconus.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}