Using optical coherence tomography to assess corneoscleral morphology after soft contact lens wear

摘要

PURPOSE: To evaluate the use of optical coherence tomography (OCT) for assessing the effect of different soft contact lenses on corneoscleral morphology. METHODS: Ten subjects had anterior segment OCT B-scans taken in the morning and again after 6 h of soft contact lens wear. For each subject, three different contact lenses were used in the right eye on non-consecutive days, including a hydrogel sphere, a silicone hydrogel sphere, and a silicone hydrogel toric. After image registration and layer segmentation, analyses were performed of the first hyper-reflective layer (HRL), the epithelial basement membrane (EBL), and the epithelial thickness (HRL to EBL). A root mean square difference (RMSD) of the layer profiles and the thickness change between the morning and afternoon measurements were used to assess the effect of the contact lens on the corneoscleral morphology. RESULTS: The soft contact lenses had a statistically significant effect on the morphology of the anterior segment layers (p < 0.001). The average amounts of change for the three lenses (average RMSD values) for the corneal region were lower (3.93 ± 1.95 μm for the HRL and 4.02 ± 2.14 μm for the EBL) than those measured in the limbal/scleral region (11.24 ± 6.21 μm for the HRL and 12.61 ± 6.42 μm for the EBL). Similarly, averaged across the three lenses, the RMSD in epithelial thickness was lower in the cornea (2.84 ± 0.84 μm) than the limbal/scleral (5.47 ± 1.71 μm) region. Post hoc analysis showed that ocular surface changes were significantly smaller with the silicone hydrogel sphere lens than both the silicone hydrogel toric (p < 0.005) and hydrogel sphere (p < 0.02) for the combined HRL and EBL data. CONCLUSIONS: In this preliminary study, we have shown that soft contact lenses can produce small but significant changes in the morphology of the limbal/scleral region and that OCT technology is useful in assessing these changes. The clinical significance of these changes is yet to be determined.