4.5 Article

Central-to-peripheral corneal edema during wear of embedded-component contact lenses

Journal

CONTACT LENS & ANTERIOR EYE
Volume 45, Issue 1, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.clae.2021.101443

Keywords

Contact lens; Corneal edema; Hypoxia; Corneal metabolism; Contact-lens embedment; Oxygen; Finite-element modeling; Limbal metabolic support; Smart contact lens; Scleral lens; Soft contact lens

Categories

Funding

  1. Verily Life Sciences, United States

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This study evaluates the central-to-peripheral corneal edema caused by scleral lenses and soft contact lenses with embedded components. By adjusting the design parameters of the lenses, corneal swelling can be reduced.
Purpose: With active investigation underway for embedded-circuit contact lenses, safe oxygen supply of these novel lenses remains a question. Central-to-peripheral corneal edema for healthy eyes during wear of soft contact (SCL) and scleral lenses (SL) with embedding components is assessed. Methods: Various 2-dimensional (2D) designs of SL and SCL with embedded components are constructed on Comsol Multiphysics 5.5. Local corneal swelling associated with the designed lenses is determined by a recently developed 2D metabolic-swelling model. Settled central post-lens tear-film thicknesses (PoLTFs) are set at 400 mu m and 3 mu m for SL and SCL designs, respectively. Each lens design has an axisymmetric central and an axisymmetric peripheral embedment. Oxygen permeability (Dk) of the lens and the embedments ranges from 0 to 200 Barrer. Dimensions and location of the embedments are varied to assess optimal-design configurations to minimize central-to-peripheral corneal edema. Results: By adjusting oxygen Dk of the central embedment, the peripheral embedment, or the lens matrix polymer, corneal swelling is reduced by up to 2.5 %, 1.5 %, or 1.4 % of the baseline corneal thickness, respectively, while keeping all other parameters constant. A decrease in PoLTF thickness from 400 mu m to 3 mu m decreases corneal edema by up to 1.8 % of the baseline corneal thickness. Shifting the peripheral embedment farther out towards the periphery and towards the anterior lens surface reduces peak edema by up to 1.3 % and 0.6 % of the baseline corneal thickness, respectively. Conclusions: To minimize central-to-peripheral corneal edema, embedments should be placed anteriorly and far into the periphery to allow maximal limbal metabolic support and oxygen transport in the polar direction (i.e., the.-direction in spherical coordinates). High-oxygen transmissibility for all components and thinner PoLTF thickness are recommended to minimize corneal edema. Depending on design specifications, less than 1 % swelling over the entire cornea is achievable even with oxygen-impermeable embedments.

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