School of Optometry and Vision Science, University of Waterloo, Ontario, Canada.
Optom Vis Sci. 2021 Feb 1;98(2):143-149. doi: 10.1097/OPX.0000000000001645.
Cytokine and protease analysis revealed relative changes in the post-lens tear film of scleral lenses with low and high limbal clearances. Results from this study indicate that midperipheral lens fit is an important fitting feature that can impact the inflammatory response of a keratoconic eye.
The purpose of this study was to investigate changes in levels of inflammatory mediators in the post-lens tear film of keratoconic scleral lens wearers with varying limbal clearance designs.
Twenty-two keratoconic eyes were fitted with two sets of scleral lenses that were consistent in lens diameter and central sagittal depth but varied in limbal clearance by approximately 50 μm. Lenses were worn in a randomly assigned order for a 2-week period each. At each follow-up visit, immediately after lens removal, tear samples were collected with a microcapillary tube (10 μL, 0.5 mm in diameter) from the bowl of the inverted scleral lens. Tear cytokine and protease analysis was performed using a multiplex electrochemiluminescent array (Meso Scale Discovery, Rockville, MD) instrument. Levels of interleukins 1, 6, and 8; tumor necrosis factor α; and matrix metalloproteinases 1 and 9 were compared and analyzed.
Levels of interleukin 1β, tumor necrosis factor α, and matrix metalloproteinase 1 increased with high limbal clearance (P = .01, .006, and .02, respectively). No change in interleukins 6 and 8 levels was found (P > .05). A decrease in matrix metalloproteinase 9 was noted in post-lens tear film of scleral lenses with high limbal clearance (P = .10).
Relative changes in the cytokine and protease levels were found when comparing low and high limbal clearance, indicating that the midperipheral lens fit is an important feature that can impact the inflammatory response of the keratoconic eye.
细胞因子和蛋白酶分析显示，低和高周边角膜透明带的巩膜隐形眼镜后泪膜有相对变化。本研究结果表明，周边中部镜片拟合是一个重要的拟合特征，可影响圆锥角膜眼的炎症反应。
本研究旨在探讨不同周边角膜透明带设计的圆锥角膜患者佩戴巩膜隐形眼镜后泪膜中炎症介质水平的变化。
22 只圆锥角膜眼分别佩戴了两组直径和中央矢状深度一致但周边角膜透明带相差约 50μm 的巩膜隐形眼镜。每两周更换一副镜片，每种镜片各佩戴两周。每次随访时，立即在倒置巩膜镜片的碗状处用微毛细管管（直径 10μL，0.5mm）收集泪液样本。使用 Meso Scale Discovery（马里兰州罗克维尔）仪器的多功能电化学发光阵列（Multiplex Electrochemiluminescent Array）进行泪液细胞因子和蛋白酶分析。比较和分析白细胞介素 1、6 和 8；肿瘤坏死因子-α；以及基质金属蛋白酶 1 和 9 的水平。
白细胞介素 1β、肿瘤坏死因子-α和基质金属蛋白酶 1 的水平随高周边角膜透明带而增加（P =.01，.006 和.02，分别）。白细胞介素 6 和 8 的水平没有变化（P >.05）。高周边角膜透明带的巩膜隐形眼镜后泪膜中的基质金属蛋白酶 9 减少（P =.10）。
当比较低和高周边角膜透明带时，发现细胞因子和蛋白酶水平发生了相对变化，这表明周边中部镜片拟合是一个重要特征，可影响圆锥角膜眼的炎症反应。
