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• W2074565730 abstract "The availability of gas permeable flexible and rigid materials while widening the scope of contact lens practice has also brought about a dramatic improvement in the management of those patients who present adaptation problems. For twenty years the fitting of hard corneal lenses has been bedevilled by corneal oedema and its associated effects. Since first fitting the microlens in 1956 I have tried all the permutations including mini diameters and lenses which resemble a vegetable strainer in an attempt to achieve a balance between acceptable vision and minimum tissue disturbance. In many cases small diameters less than 8.5mm present location problems resulting in flare, increased lid insult which encourages excessive tearing, are more prone to loss and are less easy to handle. When they require a tighter fitting to reduce the visual impairment oedema of some degree is almost inevitable. Fenestrations have been a time honoured device for the relief of oedema but they are not without their drawbacks, particularly when introduced to longer term wearers. Over 50% experience intolerable visual problems from disruption of the tear film after blinking. Surveys reported in the literature over this period indicated at least a 3(F~ failure rate for PMMA wearers after six months and this figure would be close to our experience in New Zealand. The contour of the ocular lens surface has been the subject of intensive investigation with claims for superiority of one design over the other. Claim for superiority for example of aspheric over multi-curve back surface is tenable in my view only in respect to the ease of prescribing aspherics and the precision reproduction of any parameter; they have no inherent advantage over well blended multicurve back surfaces in respect to corneal respiration. The advent of gas permeable hard materials though long overdue held considerable promise for improved management of patients both new and in the longer term. The question was would these materials of rather marginal oxygen permeability come up to our expectations'? The paper by Stone (1978) on lathe manufactured CAB lenses indicated a disturbing dimensional instability of this material and others questioned its surface resistance to wear and tear and chemical purity. The report by Sarver et al (1977) on refitting some PMMA wearers with silafocon A (Polycon) was very favourable to this particular gas permeable material and it was decided to use this material in our practice." @default.
• W2074565730 created "2016-06-24" @default.
• W2074565730 creator A5073182167 @default.
• W2074565730 date "1979-09-01" @default.
• W2074565730 modified "2023-09-27" @default.
• W2074565730 title "Experience with silicone— PMMA material" @default.
• W2074565730 cites W1965199931 @default.
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• W2074565730 doi "https://doi.org/10.1016/s0141-7037(79)80007-5" @default.
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