The annular tinted contact lens syndrome: corneal topographic analysis of ring-shaped irregular astigmatism caused by annular tinted contact lenses.

PURPOSE: Irregular corneal astigmatism has been reported in association with annular tinted hydrogel contact lenses. We report the abnormal videokeratographic findings of five patients wearing annular tinted contact lenses, who presented with bilateral blurred vision and revealed a loss of best corrected visual acuity. METHODS/RESULTS: The corneal topographic analysis revealed a previously unreported distinct ring-shaped pattern of irregular astigmatism. The topographic circular band of irregular astigmatism was further characterized by concentric areas of relative steepening, flattening, and steepening with a diameter of approximately 4 mm. This pattern suggests that forces acting at the junctional zone between the tinted area and the clear pupillary area are inducing structural abnormalities of the corneal surface. At the time of presentation, the mean surface regularity index (SRI) was 2.06 (range: 0.61-5.88). The topography and best-corrected visual acuity returned to normal within days of discontinuing annular tinted lens use, and the mean SRI decreased to 0.44 (range: 0.21-1.16). Digital imaging of lenses obtained from our patients and of identical control lenses was performed. A masked analysis suggested that the study lenses contain greater amounts of pigment compared to the control lenses. CONCLUSIONS: We present ten characteristic signs and symptoms of this condition, which we have named "the annular tinted contact lens syndrome." Corneal topographic analysis is a powerful tool for detecting specific reversible irregularities of the corneal surface associated with the use of annular tinted contact lenses.

Development of Chronomers tm for narcotic antagonists.

The object of this program is to prepare a bioerodable naltrexone delivery system which can be implanted subcutaneously in humans and which can relieve the narcotic antagonist over 1-6 months at relatively constant and sufficient rates to block the euphoric effect of morphine based drugs. The system is composed of naltrexone uniformly dispered in a solid hydropholic CHRONOMER TM matrix which undergoes predictable surface erosion when exposed to an aqueous medium. Kinetic studies in vitro have been carried out during the course of the program to determine the best composition for the system. Toxilogical studies conducted at ALZA during the past 2 years have not revealed limiting adverse effects of either the CHRONOMER TM materials or their hydrolysis products. The tail-flick test procedure was used to measure the effectiveness of naltrexone to antagonize the analgesis of morphine in rats. Naltrexone infused intravenously at doses of 4 and 16 ug/kg/hr resulted in, after 6 hours, 54 and 89% antagonism, respectively, against a 63.5% effective dose of morphine. Perliminary sterilization studies showed that no adverse effects to CHRONOMER TM/naltrexone systems occurred after exposure to 2.5 or 5.0 mrads of 60CO irradiation.

Development of Chronomers for narcotic antagonists.

The object of this program is to prepare a bioerodable naltrexone delivery system which can be implanted subcataneously in human and which can relieve the narcotic antagonist over 1-6 months at relatively constant and sufficient rates to block the euphoric effect of morphine based drugs. The system is composed of naltrexone uniformly dispersed in a solid hydropholic CHRONOMER matrix which undergoes predictable surface erosion when exposed to an aqueous medium. Kinetic studies in vitro have been carried out during the course of the program to determine the best composition for the system. Toxilogical studies conducted at ALZA during the past 2 years have not revealed limiting adverse effects of either the CHRONOMER materials or their hydrolysis products. The tail-flick test procedure was used to measure the effectiveness of naltrexone to antagonize the analgesis of morphine in rats. Naltrexone infused intravenously at doses of 4 and 16 ug/kg/hr resulted in, after 6 hours, 54 and 89 per cent antagonism, respectively, against a 63.5 per cent effective dose of morphine. Preliminary sterilization studies showed that no adverse effects to CHRONOMER/naltrexone systems occurred after exposure to 2.5 or 5.0 mrads of 60Co irradiation.