Changes of Visual Function, Ocular Surface Structures and Physiology After Long-Termed Contact Lens Wear

Study Overview
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Brief Summary
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Our study is aimed to observe the long termed effect of contact lens wear on ocular surface, especially focused on visual function and ocular inflammation mediators.

Detailed Description
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Contact lens fitting are important treatments for many ocular diseases as they provide three main therapeutic applications: visual correction, protection of ocular surface, and cosmetic or sport purposes. The ophthalmology department of NTUH has set up contact lens special clinic as one of our comprehensive refractive services. The investigators provided corneal lenses or Rose K lenses for optical correction of keratoconus patients; the investigators also fitted large scleral lenses for the correction of irregular astigmatism for post-penetrating keratoplasty and post-refractive surgery patients. In addition, contact lenses can be an adjuvant therapy for ocular surface disorders as severe dry eye and limbal insufficiency. There were researches that proved the inflammatory mediators and neutrophils increased after long-termed wear of silicon hydrogel soft lenses or over night orthokeratology lenses. They also concluded that lens wear affected corneal epithelial proliferation. However, the physiological changes after long-termed wear of large diameter scleral lenses are still pending. In addition, we still do not understand the lens effects on high order aberration and ocular surface structures. The purpose of our study is to analyze the epidemiologic data and treatment results of the patients fitted with specialty lenses in our contact lens clinic from Aug 2016 to Aug 2018. Patients will be categorized into different groups by the diagnoses and the type of lens wear. After 6 months of follow up, the change of visual acuity, visual function related quality of life, the changes of ocular surface structures and physiology will be analyzed. The investigators hope to share the experiences of specialty contact lens fitting and understand the effects of long-term contact lens wear on ocular surface.

Official Title
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Changes of Visual Function, Ocular Surface Structures and Physiology After Long-Termed Contact Lens Wear

Conditions
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Ocular Surface Disease, Keratoconus, Irregular Astigmatism

Intervention / Treatment
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* Device: corneal lenses
* Device: large diameter lenses


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 20 to 65 contact lens wear willing to be followed for at least 6 months Exclusion Criteria: active ocular infection active corneal melting inability to follow lens cleaning instructions pregnancy

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: corneal lenses<br>patients that wear corneal lenses ( Hiclear Rigid Gas Permeable Lenses) | Device: corneal lenses<br>* wear corneal lenses on daily basis<br>|
| Experimental: large diameter lenses<br>patients that wear scleral lenses (Paragon Normaleyes) | Device: large diameter lenses<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ocular inflammatory mediators | to monitor the change of tear inflammatory mediators 6 months after lens wear | 6 months |