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Muriel Schornack, Michael Helland, Cherie B Nau; Change in Fluid Reservoir Turbidity at 20-Minute Intervals Over 2 Hours of Small Diameter Scleral Lens Wear. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6071.
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© ARVO (1962-2015); The Authors (2016-present)
Accumulation of debris in the post-lens fluid reservoir is frequently observed during scleral lens wear, but changes in fluid reservoir turbidity have not yet been quantified. This study describes a method of quantifying changes in turbidity of the fluid reservoir by measuring its optical density, and compares values of the optical density of the reservoir at 20 minute intervals during the first two hours of 15-mm scleral lens wear.
Twelve participants, seven men and five women age 21-43 years (29 ± 7 years, mean ± SD) with healthy eyes (no history of eye disease or surgery and no previous scleral lens wear), were fitted on one eye with a 15-mm diameter Jupiter scleral lens (Visionary Optics, Front Royal, VA). Lenses were selected from a diagnostic fitting set to provide 200-300 μm clearance between the lens and central cornea. Within 5 minutes after placement, slit images of the lens and cornea were recorded by Scheimpflug photography (Pentacam, Oculus, Inc.). The optical density of the fluid reservoir was assessed midway between the back surface of the lens and the anterior surface of the cornea in center of the vertical Scheimpflug image using the Pentacam’s densitometry analysis software in two images. Scheimpflug photography was repeated every 20 minutes for two hours, and densitometry was recorded in the same manner at each interval. Its value for each measurement was compared to the original value and to the value at the previous time interval by using a paired t-test.
Densitometry analysis of the fluid reservoir after initial placement of the lens was 5.4 ± 1. 6% (range: 4.1-10.4%). After two hours of lens wear, optical density had increased to 10.7± 4.0% (range: 6.1-20.5%), a 97% increase. This change was statistically significant (p<0.001). Statistically significant changes were noted between application and 20 minutes (p=0.003) and between 20 and 40 minutes (p=0.01), but changes in density were not statistically significant between any other consecutive intervals.
Optical density of the post-lens fluid reservoir increases most rapidly during the first 40 minutes of 15-mm scleral lens wear. Fluid reservoir optical density continues to increase during two hours of continuous wear. Quantification of fluid reservoir turbidity will be necessary as we seek solutions to this common clinical phenomenon.
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