Hydrogel contact lens-corneal interactions: a new mechanism for deposit formation and corneal injury.

PURPOSE: In this study, we examined the interactions between hydrogel contact lenses and the cornea, and the role of these interactions in the pathogenesis of interfacial debris formation and the complications of contact lens use. METHODS: We used a corneal abrasion device to simulate the motion of contact lenses on the cornea and the ensuing abrasive interactions. We examined lens and corneal surfaces by Atomic Force Microscopy (AFM), Low Voltage Scanning Electron Microscopy (LVSEM), and optical microscopy (with vital staining of corneas) for unused hydrogel contact lenses, lenses tested in the corneal abrasion device, and worn contact lenses. Young's modulus of hydrogel contact lenses was also measured and compared with the modulus of the human cornea, as reported in the literature. RESULTS: We observed patterns of abrasive damage to the rabbit cornea in vitro caused by corneal interaction with hydrogel contact lenses. Comparison of AFM and SEM of unused lens surfaces with the surfaces of lenses tested in the abrasion device showed dramatic alterations of the contact lens surfaces. Damage to the lenses was also evident by AFM for lenses worn by volunteers. The modulus of hydrogel contact lenses was lower than the modulus of the human cornea. CONCLUSIONS: The surface morphology of hydrogel contact lenses is significantly altered during use. The Young's modulus of the cornea is higher than the modulus of hydrogel contact lenses. These observations suggest a new mechanism for contact lens complications; namely, damage to the contact lens by the cornea as an initial event that produces lens particles and deposits at the lens-cornea interface, followed by corneal abrasion and the onset of other complications.

Examination of contact lens surfaces by Atomic Force Microscope (AFM).

PURPOSE: We evaluated the use of Atomic Force Microscopy (AFM) in examining the surfaces of unused and worn hydrogel contact lenses under natural, fully hydrated conditions. METHODS: Using the AFM contact mode, we examined hydrogel lenses (Acuvue, Surevue, NewVues, CSI Clarity, SeeQuence) that were hydrated. RESULTS: Surface morphologies characteristics of each lens type and wear history were readily observed. The surfaces of worn lenses showed evidence of abrasion and altered morphology. These changes varied with type of contact lens and conditions of use and by site on the lens. CONCLUSIONS: AFM is a very powerful tool for high resolution examination of hydrated contact lens surface structure. The method avoids artifacts due to dehydration and coating which can occur even with low voltage Scanning Electron Microscopy. Significant differences in contact lens surface morphology were observed before and after wear. These observations may be of importance in helping develop improved new lens polymers and ocular solutions.

Humidity-conditioned gravimetric method to measure the water content of hydrogel contact lens materials.

A method to determine the humidity-conditioned gravimetric water content of hydrogel contact lens materials has been developed, in which errors due to blotting have been eliminated by conditioning the lens in a series of relative humidity (RH) environments before measuring the water content gravimetrically, and then extrapolating the water content to 100% RH. This method has been used to determine the water contents of representative materials from each of the four FDA lens groups, which were compared with their labeled values, as well as with values obtained from refractive index measurements. The deviation of the water content of soft contact lenses as measured by refractive index from that obtained gravimetrically increased as the water content decreased. The humidity-conditioned gravimetric method to determine water content of hydrophilic contact lenses is being proposed as an International Organization for Standardization (ISO) standard, as an improvement over the gravimetric and refractive index methods.