Method and trial lens set for fitting scleral contact lenses

Abstract

The present invention relates to a method and a trial lens set for fitting a scleral contact lens for a subject, wherein the scleral contact lens comprises an optical zone arranged in the center of the lens, a transition zone surrounding the optical zone, and a landing zone arranged at the periphery of the lens, wherein the optical zone has a base curve curvature radius BCR, the transition zone has a transition zone curvature radius TZR, and the landing zone has a landing zone curvature radius LZR, wherein TZR depends on BCR, but LZR is independent of BCR. The method comprises: measuring the corneal morphology of the subject to obtain a flat K (FK) value of the cornea of ​​the subject and a corneal eccentricity e value corresponding to the FK value; and selecting a first trial lens of the scleral contact lens for the subject based on the FK value and the e value. The trial lens set comprises at least two subgroups with different LZRs, and each subgroup contains a plurality of trial lenses with different BCRs. The method and trial lens set of the present invention are simple and easy to operate, and can greatly shorten the time for fitting scleral contact lenses.

Description

Technical Field

[0001] The invention relates to the field of contact lenses, and in particular to a method for fitting scleral contact lenses and a trial lens set. Background Art

[0002] Scleral contact lenses are large-diameter rigid gas-permeable contact lenses that are usually worn during the day. Compared with conventional rigid gas-permeable corneal contact lenses (RGPs), scleral contact lenses land on the sclera and arch over the entire cornea and the cornea / sclera junction called the limbus, so that a gap can be formed between the back surface of the lens and the front surface of the cornea and limbus, namely the posterior lens clearance. The posterior tear space includes the corneal space and the limbus space. This gap is used as a liquid reservoir, which can be filled with tears, saline or functional solutions such as medicine, etc., which can create an ideal ocular surface environment. It has unparalleled advantages over contact lenses in protecting the cornea and limbus tissues, improving dry eyes, correcting irregular corneal astigmatism, and reducing high-order phase differences.

[0003] Scleral contact lenses usually include an optical zone, a transition zone, and a landing zone. The optical zone is located in the center of the lens and is mainly used for vision correction. The landing zone is the outermost area of ​​the scleral contact lens and is also the load-bearing area of ​​the entire lens. The transition zone connects the optical zone and the landing zone and is usually arched above the corneoscleral limbus.

[0004] There are many factors to consider when fitting scleral contact lenses, including ensuring that the lens has an appropriate tear gap behind the lens when worn on the human eye, does not contact the cornea and limbus, does not have large bubbles, does not compress blood vessels, and is comfortable to wear. In order to improve comfort, the fitting of most scleral contact lenses requires the measurement of multiple ocular surface parameters, and its design usually involves multiple lens parameters, so as to adjust the posterior surface of the scleral contact lens according to the ocular surface morphology of the subject, especially the shape of the posterior surface of the landing zone, in order to make the lens fit the eye as closely as possible. Therefore, the fitting steps of most scleral contact lenses are cumbersome and complicated, and usually need to be evaluated after wearing the lenses for 20 to 30 minutes, 2 hours, and 4 hours, which is time-consuming.

[0005] Therefore, there is still a need for a scleral contact lens that is simple in design, simple in fitting and easy to wear. Summary of the invention

[0006] The present invention relates to a method for fitting a scleral contact lens for a subject, wherein the scleral contact lens comprises an optical zone arranged in the center of the lens, a transition zone surrounding the optical zone, and a landing zone arranged at the periphery of the lens, wherein the optical zone has a base curve curvature radius BCR, the transition zone has a transition zone curvature radius TZR, and the landing zone has a landing zone curvature radius LZR, wherein TZR depends on BCR but LZR is independent of BCR, and the method comprises: measuring the corneal morphology of the subject to obtain a flat K (FK) value of the cornea of ​​the subject and a corneal eccentricity e value corresponding to the FK value; and selecting a first trial lens of the scleral contact lens for the subject based on the FK value and the e value, wherein the optical zone of the first trial lens has a first base curve curvature radius BCR1 and the landing zone thereof has a first landing zone curvature radius LZR1.

[0007] In some embodiments, the step of selecting a first trial lens includes: calculating the lens sagitta according to the FK value, the e value and the target initial vertex gap; calculating the theoretical base curve curvature radius according to the lens sagitta and the base curve eccentricity; and obtaining the first base curve curvature radius BCR1 by subtracting the correction parameter C from the calculated theoretical base curve curvature radius, wherein the target initial vertex gap is selected from 40 to 200 μm, the base curve eccentricity is selected from 0.30 to 1.10, and the correction parameter C is selected from 0.2 to 0.5.

[0008] In some embodiments, the BCR is selected from 5.0 to 14.0 mm; and / or the TZR is 0.0 to 2.0 mm larger than the BCR; and / or the LZR is larger than the BCR and is independently selected from 8.5 to 15.0 mm.

[0009] In some embodiments, the method further includes: performing a fitting assessment on the first trial lens after the subject wears the first trial lens for 20 to 30 minutes, wherein if the first trial lens fits well, a scleral contact lens having the BCR1 and LZR1 is customized for the subject; if the first trial lens does not fit well, a second trial lens having a second base curve curvature radius BCR2 and / or a second landing zone curvature radius LZR2 is selected for the subject, and performing a fitting assessment again after the subject wears the second trial lens for 20 to 30 minutes, wherein BCR2 is different from BCR1, and LZR2 is different from LZR1.

[0010] In some embodiments, the fit assessment comprises measuring the vertex gap and / or the limbal gap.

[0011] In some embodiments, measuring the subject's corneal morphology is by corneal topography, and preferably, the method comprises performing multiple corneal topography measurements.

[0012] The present invention also relates to a trial lens set for fitting scleral contact lenses, wherein the trial lens is a scleral contact lens and comprises an optical zone arranged in the center of the lens, a transition zone surrounding the optical zone, and a landing zone arranged at the periphery of the lens, wherein the optical zone has a base curve curvature radius BCR, the transition zone has a transition zone curvature radius TZR, and the landing zone has a landing zone curvature radius LZR, wherein TZR depends on BCR, but LZR is independent of BCR, and the trial lens set comprises: a high edge lift subgroup containing a plurality of first trial lenses and a low edge lift subgroup containing a plurality of second trial lenses, wherein the landing zone curvature radii of the plurality of first trial lenses are all the first landing zones. The landing zone curvature radius LZR1, the landing zone curvature radii of the multiple second trial lenses are all the second landing zone curvature radius LZR2, wherein LZR1 is greater than LZR2, and LZR1 and LZR2 are each independently selected from 8.5 to 15.0 mm; and wherein the multiple first trial lenses have different base curve curvature radii, the multiple second trial lenses have different base curve curvature radii, the base curve curvature radii of the first trial lenses and the second trial lenses are both selected from the same base curve curvature radius set, and the base curve curvature radius set includes a plurality of preset base curve curvature radii with equal step distribution and selected from 5.0 to 14.0 mm.

[0013] In some embodiments, the number of the first trial fitting lenses is the same as the number of the second trial fitting lenses.

[0014] In some embodiments, the number of the preset base curve curvature radii is the same as the number of the first trial fitting lenses and / or the number of the second trial fitting lenses.

[0015] In some embodiments, the trial lens set further comprises other subgroups having LZRs different from LZR1 and LZR2. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Figure 1 A cross-sectional view schematically shows a scleral contact lens according to the present invention placed on a human eye.

[0017] Figure 2 1 is a schematic diagram of the structure of a scleral contact lens according to an embodiment of the present invention. The left figure is a bottom view of the scleral contact lens; the right figure is a cross-sectional view along line AA of the left figure.

[0018] Figure 3 Fluorescein images are obtained by evaluating diffuse light under cobalt blue light from a slit lamp.

[0019] Figure 4 It is a schematic diagram of landing area edge warping assessment.

[0020] Figure 5 is a flow chart of a scleral contact lens fitting method according to the present invention.

[0021] Reference numerals:

[0022] OZ: optical zone; TZ: transition zone; LZ: landing zone; TD: total lens diameter; AC: vertex clearance; LSH: lens sagittal height; ESH: eye sagittal height; EL: edge lift; J1: junction of the posterior surfaces of the optical zone and transition zone; J2: junction of the posterior surfaces of the transition zone and landing zone; 1: cornea; 2: bulbar conjunctiva. DETAILED DESCRIPTION

[0023] The specific embodiments of the present invention will be described in detail below in conjunction with the accompanying drawings. Many specific details are set forth in the following description, just to make the disclosure of this application thorough and complete, and to fully convey the concept of the present invention to those skilled in the art. With respect to the accompanying drawings, for the sake of clarity and convenience, the relative proportions and proportions of the features in the accompanying drawings may be exaggerated or reduced in size. Such arbitrary proportions are merely illustrative and do not limit the present invention in any way. Unless otherwise defined, the terms used in this application have the meanings commonly understood by those skilled in the art.

[0024] When describing in conjunction with contact lenses in this application, the "front surface" refers to the side close to the inner surface of the eyelid when worn, or the convex surface of the lens; the "back surface" refers to the side of the lens facing the cornea when worn, or the concave surface of the lens.

[0025] 1. Scleral contact lenses

[0026] The present invention relates to a scleral contact lens with a simple design, such as Figure 1 As shown, the scleral contact lens includes an optical zone (OZ), a transition zone (TZ) and a landing zone (LZ), wherein the optical zone has a base curve curvature radius BCR, the transition zone has a transition zone curvature radius TZR, and the landing zone has a landing zone curvature radius LZR, wherein TZR depends on BCR, but LZR is independent of BCR. The optical zone is located in the center of the lens, and its diameter is usually larger than the horizontal visible iris diameter, and is mainly used for vision correction. The landing zone is the outermost area of ​​the scleral contact lens, and is the area where the scleral contact lens contacts or lands on the ocular surface. The transition zone connects the optical zone and the landing zone, and is usually arched above the corneoscleral limbus. In the scleral contact lens of the present invention, the transition zone curvature radius is linked to the base curve curvature radius. By measuring the corneal morphology of the subject, the target base curve curvature radius can be selected and the corresponding transition zone curvature radius can be determined at the same time. Then, the landing zone curvature radius is adjusted according to the landing zone fitting situation, and the appropriate lens parameters can be selected.

[0027] The scleral contact lens of the present invention is an open or non-closed scleral contact lens. When used in the present invention, a "non-closed" or "open" scleral contact lens refers to a scleral contact lens whose rear surface of the landing zone is not designed or customized to fully or as closely complement or fit the corresponding ocular surface topography of its wearer, as opposed to a traditional closed or semi-closed scleral contact lens.

[0028] Because perfect fit with the ocular surface (conjunctival part) is not pursued, the scleral contact lens of the present invention, especially its landing zone, is simple in design, wherein the rear surface of the scleral contact lens is rotationally symmetrical. In some embodiments, the rear surface of the landing zone is a rotationally symmetrical aspheric surface. In some embodiments, the eccentricity of the aspheric surface is between 0.05 and 1.00, preferably between 0.05 and 0.60.

[0029] Other features of the scleral contact lens of the present invention include: higher ocular surface mobility, thin tear gap behind the lens, etc., which will be described in detail below.

[0030] (I) Lens movement

[0031] The landing zone is the outermost area of ​​the scleral contact lens and is also the load-bearing area of ​​the entire lens. In order to improve comfort, avoid conjunctival compression and disperse the weight of the lens as much as possible, it is usually required that the rear surface of the landing zone fits the corresponding ocular surface shape as closely as possible to have a larger contact area. Studies have shown that the shape of the anterior surface of the sclera (diameter between 15.0 mm and 20.0 mm) is tangential in most subjects, convex in less than one-third of the subjects, and concave in a very small number of subjects. Moreover, it is known in the art that the shape of the anterior surface of the sclera gradually increases in asymmetry in areas outside the diameter of 13.0 mm. Therefore, in order to achieve good fit and lens stability, the rear surface of the landing zone of most scleral contact lenses is designed to be tangential, with no or only a small amount of curvature, and many people have tried to divide the scleral contact lens into multiple zones or quadrants to adjust the parameters and design of each zone of the scleral contact lens according to the ocular surface morphology of the subject.

[0032] Because of this, most scleral contact lenses are closed or semi-closed, with no or very little tear exchange and lens mobility. In most cases, without mechanical operation, a well-fitting traditional scleral contact lens will not show any clinically significant tear exchange. Complications that are prone to occur with closed scleral contact lenses include (but are not limited to) daytime fogging caused by tear pool debris, visual fluctuations caused by lens sedimentation, higher-order aberrations caused by eccentricity, high lipid concentrations, accumulation of inflammatory factors, corneal hypoxic stress, etc. In addition, because traditional scleral contact lenses have no or very little tear exchange, the reservoir behind the lens cannot be filled after wearing, resulting in bubble formation, etc. Therefore, when wearing, the wearer needs to add appropriate liquid to the concave surface of the lens in advance, lower his head to keep it basically parallel to the ground, and then put the scleral contact lens filled with liquid into the eye with one hand. If the amount of liquid added is insufficient or the wearer is not skilled, bubbles may form between the lens and the ocular surface, and the lens will need to be removed and re-worn. This is because bubbles can cause eye discomfort, blurred vision and corneal staining, which are things that need to be avoided during and during the wearing of scleral contact lenses.

[0033] Therefore, in an embodiment of the present invention, the inventor solves the problems of conventional closed / semi-closed scleral contact lenses by providing a non-closed or open scleral contact lens. As used in the present invention, a "non-closed" or "open" scleral contact lens means that the rear surface of the landing zone of the scleral contact lens is not designed or customized to fully or as much as possible complement or fit the corresponding ocular surface morphology of the wearer.

[0034] Because it does not pursue perfect fit with the ocular surface morphology, the scleral contact lens of the present invention has a higher ocular surface mobility compared with similar products. The higher the lens mobility, the higher the tear exchange rate. It has been demonstrated that the scleral contact lens of the present invention can provide continuous dynamic tear exchange, which is manifested, for example, by the fact that after fluorescein is dripped onto the outside of the lens, it can be observed that the fluorescein fills the back of the lens after 5 to 10 blinks. However, too high or too low mobility will reduce comfort, so in some embodiments, the scleral contact lens of the present invention is configured to move on the surface of the eyeball during use between 0.4 mm and 1.2 mm, preferably between 0.5 mm and 1.0 mm, such as about 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.1 mm and any value therebetween, preferably less than 1.0 mm, more preferably about equal to 0.5 mm (e.g., 0.5±0.05 mm). The movement is assessed using the direct focus method with slit lamp illumination (0.5-2.0 mm width) and slit lamp graduations of known length or slit lamp illumination beam width.

[0035] In some embodiments, the rear surface of the landing zone of the scleral contact lens of the present invention is rotationally symmetric about the optical axis of the scleral contact lens, so when the lens is placed on the sclera with an asymmetric front surface morphology, it will not fit perfectly with it, but will likely have only a few contact points or contact positions, so that the mobility is higher, which is more conducive to the exchange of tears under the lens. In some other embodiments, the rear surface of the landing zone is a rotationally symmetric aspherical surface.

[0036] In some other embodiments, the vertical distance between the connection point of the posterior surface of the landing zone and the posterior surface of the transition zone (i.e., the starting point of the landing zone, J2) and the lens axis of the scleral contact lens is between 6.0 mm and 7.0 mm, preferably between 6.0 mm and 6.8 mm, for example 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7 mm and any value therebetween, so as to make full use of the asymmetry of the anterior surface of the sclera with a diameter outside 13.0 mm.

[0037] Without wishing to be bound by any theory, the inventors believe that the scleral contact lens of the present invention solves the problems existing in the prior art by achieving sufficient exchange of tears beneath the scleral contact lens with tears outside the lens, thereby effectively avoiding the accumulation of proteins, lipids, mucins and inflammatory factors in the tear layer between the cornea and the back surface of the lens.

[0038] As mentioned above, conventional scleral contact lenses are usually designed as closed or semi-closed reservoirs, and are therefore particularly suitable for patients with dry eyes. However, the biggest problem with closed or semi-closed scleral contact lenses is the accumulation of various chemicals and debris in the tear layer under the lens, and midday fogging is one of the most representative manifestations, which forces the subjects to remove the lenses for cleaning during the day to maintain good vision. The scleral contact lenses of the present invention do not fit perfectly with the ocular surface in the landing area and have a relatively high degree of mobility. With the help of the subject's blinking action, the tear pool behind the lens can be filled and the tears can be continuously exchanged and renewed, which is beneficial to corneal health and allows the lenses to be worn comfortably all day without any problems.

[0039] Therefore, the scleral contact lens according to the present invention not only does not need to be instilled with physiological saline before wearing, is easy to wear, but also does not fog during the day, and is safe and convenient to remove.

[0040] (II) Corneal space

[0041] When the scleral contact lens of the present invention is placed on the eyeball, the rear surfaces of the optical zone and the transition zone do not contact the front surface of the subject's eyeball, thereby forming a liquid storage space. The gap between the rear surface of the optical zone and the front surface of the cornea is called the corneal gap, and the gap between the rear surface of the transition zone and the front surface of the corneoscleral limbus is called the corneoscleral limbus gap. The corneal gap can be characterized by a central gap or an apical gap (AC (apical clearance)). The central gap refers to the distance between the center of the rear surface of the scleral contact lens and the front surface of the cornea; the apical gap refers to the distance between the highest point of the front surface of the cornea and the rear surface of the scleral contact lens. Since the morphology of the front surface of the cornea is usually irregular, especially for patients with keratoconus, corneal trauma or corneal surgery, the apical gap is used in the present invention to determine whether the arch of the scleral contact lens above the cornea is appropriate. The apical gap is related to the lens sagittal height (LSH) (i.e., the vertical distance between the geometric center of the rear surface of the lens and the lens edge plane).

[0042] The corneal space should not be too large or too small. When the corneal space is too large, the thickness of the tear layer increases, which affects the transmission of oxygen from the outer surface of the lens to the cornea, easily leading to corneal hypoxia and the accumulation of various ocular debris (such as mucus debris, meibomian debris, and lacrimal sac debris). When the corneal space is insufficient, due to the sedimentation effect of the scleral contact lens, the back surface of the scleral contact lens may come into contact with the front surface of the cornea after the subject wears the lens for several hours, causing damage to the corneal epithelium. In addition, some scholars believe that even if the cornea does not bear weight, a thinner tear layer (less than 100 microns) is not favorable, because the film adhesion generated in the closed space will increase the adsorption between the scleral contact lens and the ocular surface, making it difficult to remove the lens, especially after wearing the lens for a long time, when the ocular surface secretions, metabolites, etc. make the tears in it more viscous. Of course, there is no consensus in this field as to what is the ideal corneal clearance, but it is generally believed that at the time of initial lens fitting, a corneal clearance of at least 250 microns should be maintained.

[0043] The inventors have found that in the closed scleral contact lens of the present invention, the vertex gap is set to no more than 200 microns when the scleral contact lens is properly fitted. Not only does it not cause the problem of difficulty in removing the lens, but it also unexpectedly reduces the degree of lens sedimentation. Even when the vertex gap is as low as 40 microns, there is no corneal load and damage after the subject wears the lens for a long time. When used in this article, the term "initial vertex gap" refers to the distance between the highest point of the anterior surface of the cornea and the rear surface of the scleral contact lens measured by optical coherence tomography (OCT) or fluorescein staining after the subject wears the lens for 20 to 30 minutes. The initial vertex gap as described in the present invention is also one of the important parameters used by the optician to determine whether the selected trial lens is suitable when fitting the scleral contact lens of the present invention.

[0044] Therefore, the initial vertex gap between the rear surface of the optical zone of the scleral contact lens according to the present invention and the vertex of the eyeball is below 200 μm, such as less than 200 μm, less than 190 μm, less than 180 μm, less than 170 μm, less than 160 μm, less than 150 μm, less than 140 μm, less than 130 μm, less than 120 μm, less than 110 μm, less than 100 μm, less than 90 μm, less than 80 μm, less than 70 μm. Vertex gaps higher than 200 μm are not ideal, because in the non-sealed scleral contact lens of the present invention, excessively high vertex gaps easily lead to bubbles entering the space behind the lens from the place where the landing zone does not fit the ocular surface during wearing along with the movement of the lens and tears.

[0045] In a preferred embodiment, the initial vertex gap is above 40 microns, for example, greater than 40 μm, greater than 50 μm, greater than 60 μm, greater than 70 μm, for example, the initial vertex gap is 55, 65, 75, 80, 85, 90, 95, 100, 105, 110, 115, 120, 125, 130, 135, 140, 145, 160, 165, 170, 175, 180, 185, 190, 195 μm or any value therebetween. A vertex gap below 40 microns is disadvantageous because the irregular shape of the sclera and the rotation of the eyeball in different gaze directions may cause the lens to be close to the cornea during movement, which may cause potential damage.

[0046] Since the scleral contact lens according to the present invention has a thinner tear gap behind the lens under ideal fitting conditions, wherein the tear lens thickness formed by tears is thin, even if the lens movement is high, the change in tear lens thickness caused thereby is almost negligible and will not cause fluctuations in the subject's vision.

[0047] In some embodiments of the present invention, the transition zone of the scleral contact lens is configured to be located above the limbus of the eyeball when the scleral contact lens is placed on the eyeball. The limbus is the cornea-sclera junction, and this area contains stem cells that play a key role in eye health. If the scleral contact lens contacts the limbus, it will cause damage to the stem cells therein; similarly, if the scleral contact lens is arched too high in this area, it may affect the oxygen supply of the limbus stem cells. Therefore, in some embodiments of the present invention, the scleral contact lens is also configured to provide a limbus gap between 75 and 150 microns.

[0048] Vertex and limbal clearance after lens wearing can be quantitatively measured by optical coherence tomography (OCT) or assessed using fluorescein staining in both static and dynamic states.

[0049] (III) Edge Warping

[0050] In some embodiments, the end of the landing zone is provided with an edge lift. When used in the present invention, "edge lift" means that the end of the landing zone does not contact the ocular surface, and edge lift is sometimes also called edge lift or edge lift, and "edge lift height" refers to the distance from the end of the landing zone to the bulbar conjunctiva of the portion of the eyeball chord length equal to the diameter of the scleral contact lens ( Figure 1 ).

[0051] Generally speaking, due to the large size of scleral lenses, the edge warping is not liked by the subjects, because the edge warping makes it easier for the subjects to feel the presence of the lens (foreign body sensation), and the upper edge warping may also aggravate giant papillary conjunctivitis (GPC). In the process of fitting scleral lenses, the ideal situation generally accepted in this field is that the landing area fits the sclera (bulbar conjunctiva) perfectly, without edge warping, no pressure, and no conjunctival blanching.

[0052] However, the present invention utilizes the tear exchange promoting effect brought by the edge warping. The edge warping at the end of the landing zone makes the tear exchange effect behind the lens of the scleral contact lens of the present invention more outstanding.

[0053] In addition, the inventors have also found that by setting the curvature radius r1 at the connection point (J2) between the rear surface of the landing zone and the rear surface of the transition zone of the scleral contact lens of the present invention and the curvature radius r2 at the end of the rear surface of the landing zone ( Figure 2), and the radius of curvature of the portion of the rear surface of the landing zone between the above two points is set to gradually (continuously or in stages) increase radially outward, so that the rear surface shape of the landing zone can be individually controlled to construct a gently raised edge warp and reduce the foreign body sensation of the subject. The radius of curvature r1 at the connection point J2 is also the radius of curvature LZR of the landing zone. In some embodiments, the radius of curvature r1 at the connection point (J2) between the rear surface of the landing zone and the rear surface of the transition zone is between 8.5 and 15.0 mm, for example, 9.0, 10.0, 11.0, 12.0, 13.0, 14.0, 15.0 mm or any value therebetween. The radius of curvature r2 at the end of the rear surface of the landing zone is between 8.65 and 20.0 mm, preferably between 10.0 and 15.0 mm. Changing r1 (LZR) can lead to changes in the position where the lens lands on the conjunctiva, and overall changes in the sagittal height of the lens and its fit with the anterior surface of the cornea. Figure 2 Part B shows the change in the landing zone caused by the change in r1.

[0054] In some embodiments, the sagittal height S at J2 is set according to the curvature radius r1 at J2, where S represents the vertical distance between the connection point J2 and the lens edge plane; the larger r1 is, the smaller S is, and the higher the edge warping is. Where S(r1)=(A+B×r1+C×r1 2 +D×r1 3 ) -1 , and A is selected from -2 to -150, B is selected from 0.5 to 5, C is selected from -0.06 to -0.6, and D is selected from 0.003 to 0.03. For example, A is -10, B is 2.5, C is -0.28, and D is 0.017. As an example, a suitable vector height S is selected from 0.6 to 3.2 mm, preferably 1.0 to 2.2 mm, and more preferably 1.2 to 1.7 mm. The inventors have found that the landing area of ​​a scleral contact lens that varies within this range can provide an edge warp with a suitable height, thereby establishing a balance between tear exchange and the subjective comfort felt by the subject.

[0055] (IV) Other lens features

[0056] In some embodiments, the scleral contact lens of the present invention further comprises a through hole (fenestration) and / or a concave pocket (pocket), wherein the through hole and / or the concave pocket are arranged in the optical zone and / or the transition zone ( Figure 2). A through hole is a small hole drilled on a scleral lens that helps improve tear exchange under the lens and / or provide more available oxygen through the lens. The horizontal cross-section of the through hole has a maximum size selected from 0.2 to 1.0 mm. Unlike a through hole, a concave pocket is a non-through structure with an opening on the rear surface of the lens. The concave pockets suitable for the present invention can have various profiles. The concave pockets can reduce the average thickness of the lens and increase the oxygen permeability of the lens. Therefore, in some embodiments, the scleral contact lens of the present invention is provided with a plurality of concave pockets on the rear surface. In some embodiments, the concave pockets are configured to capture and limit bubbles that may enter the gap behind the lens through the through hole, such as described in CN112666723A. The patent document is incorporated herein by reference in its entirety.

[0057] In yet other embodiments, the optic zone diameter φ of the scleral contact lens of the present invention is a0 Between 5.00 and 12.00 mm. The central thickness of the optical zone is between 0.15 and 0.55 mm to provide sufficient lens strength while taking into account good lens oxygen permeability. In various embodiments, the rear surface of the optical zone may be spherical, aspherical or complex. In various embodiments, the rear surface of the optical zone may have a radius of curvature that is larger or smaller than the radius of curvature of the cornea. In some embodiments, the radius of curvature r0 of the rear surface of the optical zone (that is, the base curve curvature radius (BCR) of the scleral contact lens) is between 5.0 and 14.0 mm, for example, between 5.5 and 12.0 mm, for example, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, 10.0, 10.5, 11.0, 11.5 and any value therebetween.

[0058] In various embodiments, the width of the transition zone (i.e., φ) of the scleral contact lenses of the present invention is a1 With φ a0 The curvature radius of the posterior surface of the transition zone and the posterior surface of the optical zone (i.e., the starting point of the transition zone) is greater than or equal to the base curve curvature radius, for example, 0.1 to 2.0 mm greater than the base curve curvature radius, for example, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9 mm and any value therebetween. Therefore, in various embodiments of the present invention, the curvature radii of the posterior surface of the optical zone and the posterior surface of the transition zone are linked.

[0059] In various embodiments, the radius of curvature of the landing zone of the scleral contact lenses of the present invention is independent of the BCR setting, but rather depends on the desired edge lift height, as long as it is greater than the BCR.

[0060] In various embodiments, the diameter of the scleral contact lens of the present invention is 14.0 to 25.0 mm, preferably 14.0 to 18.0 mm.

[0061] Table 1. Exemplary scleral contact lenses of the present invention

[0062]

[0063] 2. Fitting of scleral contact lenses

[0064] The fitting of scleral contact lenses includes pre-fitting examination, fitting assessment, parameter adjustment and ordering of customized lenses.

[0065] Pre-fitting examination includes medical history collection, eye health examination, eye parameter measurement and subjective and objective optometry. Eye parameter measurement includes corneal curvature, corneal morphological parameters, corneal diameter, pupil diameter measurement, etc. Understanding corneal morphology is the basis for selecting trial lens base curve. Corneal curvature can be measured using a keratometer and corneal topography. Since corneal topography can more completely reflect the overall picture of the cornea, it is more widely used in practice.

[0066] According to the results of the pre-fitting examination, the optician will select the first trial lens for the subject to conduct a fitting assessment. A good scleral contact lens fitting includes three basic aspects: appropriate corneal clearance, corneal scleral limbal clearance and scleral fit. Therefore, the fitting assessment includes the evaluation and inspection of the optical zone, transition zone and landing zone. For example, after wearing for 5 minutes, a pen light or slit lamp is used to roughly assess whether there is corneal contact or bubbles in the central zone, whether there is lifting or vascular compression in the landing zone, etc., and the subject is asked about comfort. If the first lens is positioned in the center, there is no contact, no large bubbles, and no obvious discomfort, the slit lamp fluorescein is used to evaluate after continuing to wear it for 20 minutes; otherwise, the trial lens is replaced and re-evaluated. The fitting of traditional scleral contact lenses usually requires evaluation after wearing the lenses for 20 to 30 minutes, 2 hours and 4 hours, which is time-consuming. The criteria for successful scleral contact lens fitting include good dynamic and static evaluation (no bubbles, no contact, including no contact of the cornea and corneal scleral limbus), improved visual acuity corrected by on-lens optometry, and good comfort of the subject.

[0067] If the trial lenses do not fit well, the optician needs to select trial lenses with other parameters for the subject according to the situation until a good fit is achieved. The optician can then order the corresponding product for the subject based on the parameters of the trial lenses. Scleral contact lenses designed by different manufacturers usually require opticians to adjust different lens parameters and provide corresponding fitting guidelines. Some scleral contact lenses have complex designs, many adjustable parameters, and are complex to fit.

[0068] The scleral contact lens according to the present invention is simple in design, so fitting is relatively simple. Therefore, in some embodiments, the present invention also provides a method for fitting a scleral contact lens. Figure 5 As shown, the method includes, for example, measuring the corneal morphology of the subject using corneal topography to obtain the flat K value (FK) of the cornea of ​​the subject and the corneal eccentricity e value corresponding to FK (step 110); based on the FK value and the e value, selecting a first trial lens of a scleral contact lens for the subject, the optical zone of the first trial lens having a first base curve curvature radius BCR1 and its landing zone having a first landing zone curvature radius LZR1 (step 120).

[0069] The step of selecting the first trial lens includes: calculating the appropriate lens sagitta according to FK, e value and target initial vertex gap (40-200 μm), and calculating the base curve curvature radius according to the lens sagitta and base curve eccentricity (0.30-1.10, preferably 0.5-0.99); subtracting a correction parameter C in the range of 0.2-0.5 from the calculated base curve curvature radius to obtain the base curve curvature radius of the first trial lens. The calculation formulas required for each step are common knowledge in the art, for example, see those described in Contact lens optics and lens design, ISBN 978-0-7506-8879-6, Chapter 4 Aspherical surfaces. In a preferred embodiment, the correction parameter is 0.3.

[0070] The method of the present invention also includes performing a fitting assessment (step 130) 20 to 30 minutes after wearing the glasses, for example, by dripping sodium fluorescein to perform the assessment, and the assessment content includes: whether the lens is centered and the degree of mobility; whether there are large bubbles in the center and whether there is contact; whether there are bubbles or pressure in the mid-circumference (transition zone) of the lens; whether there are bubbles or pressure at the periphery (landing zone) of the lens. Figure 3Several situations that may occur in lens fitting are shown, among which flat fitting is manifested as too thin a gap behind the lens or contact in the center; steep fitting is manifested as a large bubble in the center; and perfect fitting shows that the fluorescent layer behind the lens is evenly distributed. In the case of flat fitting and steep fitting, it is necessary to adjust the parameters of the trial lens, such as the BC curvature radius or edge warping. In the field of contact lens fitting, especially hard lenses (such as RGP, orthokeratology lenses and scleral contact lenses), adjusting the corresponding lens parameters according to the fitting evaluation results of the trial lens belongs to conventional technical means in this field. As a simple example, for example, in the method of the present invention, if compression is observed in the optical zone, or the vertex gap is less than 40μm, the BC can be steepened (smaller BCR), the lens sagittal height can be increased, and it is away from the cornea; if there are large bubbles in the optical zone or the vertex gap is greater than 200μm, and / or the limbal gap is too large or there are bubbles, it is replaced with a trial lens with a larger BCR. If there is compression in the landing area, you can relax the edge warping and choose a larger r1 (ie LZR); if there are bubbles in the landing area, choose a smaller r1 to reduce the edge warping. Figure 4 Several situations where the lens edge warping does not fit well are shown.

[0071] In some embodiments, the methods of the invention further comprise measuring the apex gap and / or the limbal gap, for example by OCT.

[0072] Further, the method of the present invention also includes customizing or ordering a scleral contact lens with the parameters for the subject according to the ideal BCR and edge warping height (characterized by LZR) obtained from the fitting assessment and the subject's diopter (step 140). Those skilled in the art will appreciate that the order parameters may also include other special instructions, such as adjusting the lens diameter, polishing the lens well, etc. However, in various embodiments, the method does not include the step of measuring the scleral surface morphology of the subject, and the order parameters do not include scleral morphology-related parameters.

[0073] In yet other embodiments, the method of the present invention further comprises performing multiple corneal topography measurements to ensure the consistency and accuracy of the data.

[0074] Since the scleral contact lens of the present invention has dynamic tear exchange and has no or only slight sedimentation, there is no need to wait for up to 4 hours for evaluation when fitting the lens. Instead, the ideal fitting lens can be found simply by adjusting the BC and edge warping of the lens, which greatly shortens and simplifies the lens fitting process.

[0075] Therefore, according to yet another embodiment, the present invention further provides a trial lens set for scleral contact lens fitting, wherein the trial lens set provides different combinations of lens BCR and LZR for selection by opticians. Specifically, the trial lens group includes: a high-edge-upturned subgroup containing multiple first trial lenses and a low-edge-upturned subgroup containing multiple second trial lenses, the landing area curvature radius of the multiple first trial lenses is all LZR1, and the landing area curvature radius of the multiple second trial lenses is all LZR2, wherein LZR1 is greater than LZR2, and each is independently selected from 8.5 to 15.0 mm; and wherein the multiple first trial lenses each have a different base curve curvature radius, and the multiple second trial lenses each have a different base curve curvature radius, the base curve curvature radii of the first trial lenses and the second trial lenses are both selected from the same base curve curvature radius set, and the base curve curvature radius set includes multiple preset base curve curvature radii distributed in equal steps (for example, steps selected from 0.2 to 1.0 mm, for example, a step of 0.5 mm) and selected from 5.0 to 14.0 mm.

[0076] In some embodiments, the number of the first trial lenses is the same as the number of the second trial lenses. In some further embodiments, the number of the preset base curve curvature radii is the same as the number of the first trial lenses and / or the number of the second trial lenses. In some embodiments, the trial lens group further includes other subgroups having LZRs different from LZR1 and LZR2, and the other subgroups also include multiple trial lenses. For example, the trial lens group further includes a mid-edge warping subgroup containing multiple third trial lenses, and the landing area curvature radius of the multiple third trial lenses is LZR3, and LZR1>LZR3>LZR2.

[0077] By way of example, the present invention provides a scleral contact lens trial lens set, the trial lens set comprising: (1) a high edge lift subgroup comprising 14 first trial lenses, with LZR1 of 13.0 mm, (2) a low edge lift subgroup comprising 14 second trial lenses, with LZR2 of 10.0 mm, and (3) a medium edge lift subgroup comprising 14 third trial lenses, with LZR3 of 11.5 mm, wherein the base curve curvature radius set includes the following 14 preset base curve curvature radii of 6.0, 6.2, 6.4, 6.6, 6.8, 7.0, 7.2, 7.4, 7.6, 7.8, 8.0, 8.2, 8.4, and 8.6 mm.

[0078] 3. Indications of the scleral contact lens of the present invention

[0079] The scleral contact lens according to the present invention is suitable for (1) patients with irregular corneal astigmatism, such as keratoconus, corneal marginal degeneration disease and astigmatism after keratoplasty; (2) the treatment of ocular surface diseases, such as dry eye, corneal neuralgia, GVHD graft-versus-host reaction, severe ocular surface diseases (such as persistent epithelial defect (PED)), and combined treatment with drugs (such as lubricants, rapid, cyclosporine eye drops) and other ophthalmic surgeries (such as amniotic membrane transplantation, eyelid surgery); (3) non-emmetropia, such as refractive error and presbyopia.

[0080] Example

[0081] Example 1

[0082] Patient A: 30 years old, male, vision loss after chemical injury in left eye for 3 years

[0083] Basic eye information: naked eye visual acuity 0.05, subjective optometry OS-0.75 / -2.25*150, best corrected visual acuity 0.4

[0084] The patient's corneal flatness K value was 8.46 and e value was 0.94 measured by corneal topography.

[0085] First trial lens: BC 8.6mm, moderate edge warping (sagittal height at the junction S=1.47mm). Slit lamp examination after wearing the lens for 20 minutes: thin tear layer behind the central cornea lens, thickness of about 20μm; thin tear layer behind the peripheral lens, thickness of about 40μm; nasal conjunctiva whitening, lens well centered, no lens movement under natural blinking.

[0086] Adjusted to high edge tilt (joint sagittal height S = 1.40mm), and selected a trial lens with a steep BC of 8.2mm. After wearing the lens for 20 minutes, the central and peripheral corneas were checked by slit lamp and the tear layer was filled to 100μm, the landing area was well fitted, and the conjunctival blood flow was not blocked by dynamic and static assessments. The lens was well centered and had a small mobility of about 0.5mm in the natural blinking state. The main complaint was no foreign body sensation.

[0087] After one month of wearing the glasses, the patient underwent a follow-up examination and the subjective eye test with the glasses was: -0.75 / -0.50*180, and the visual acuity with the glasses was 0.8.

[0088] Example 2

[0089] Patient B: 22 years old, male, 2 years after corneal cross-linking for keratoconus in the left eye

[0090] Basic eye information: naked eye visual acuity 0.15, subjective optometry OS-4.00 / -3.75*80, best corrected visual acuity 0.3

[0091] The patient's corneal flatness K value was 8.39 and e value was 0.21 measured by corneal topography.

[0092] First trial lens: BC 7.2mm, moderate edge warping (sagittal height at junction S=1.47mm), slit lamp examination after 20 minutes of wearing: central corneal contact; peripheral bubbles behind the lens; good fit in the landing zone, no blockage of conjunctival blood flow in dynamic and static assessments, good centering of the lens, and slight mobility of about 1.0mm in natural blinking.

[0093] Adjusted to a steeper BC 7.0mm trial lens, with moderate edge warping (sagittal height at the junction S = 1.47mm), slit lamp examination after 20 minutes of wearing: no contact with the central cornea, tear layer thickness behind the lens ~100μm; small mobile bubbles behind the peripheral lens; good fit in the landing area, no blockage of conjunctival blood flow in dynamic and static assessments, good centering of the lens, and slight mobility of about 0.5mm in the natural blinking state. The main complaint was no foreign body sensation.

[0094] During the follow-up examination one month after wearing the glasses, the patient's eyesight test result was: -0.50 / -0.50*145, and his visual acuity with the glasses was 0.8.

[0095] Example 3

[0096] Patient C: 31 years old, female, high myopia in both eyes for more than 20 years

[0097] Basic eye information: naked eye visual acuity 0.01, subjective optometry OD-10.75 / -3.25*5, best corrected visual acuity 0.8

[0098] The patient's corneal flatness K value was 8.11 and e value was 0.78 measured by corneal topography.

[0099] First trial lens: BC 8.0mm, moderate edge warping (sagittal height at the junction S=1.47mm). Slit lamp examination 20 minutes after wearing the lens: the tear layer behind the central cornea is thin, with a thickness of <20μm; the tear layer behind the peripheral lens is full, with a thickness of about 100μm; the nasal conjunctiva is whitened, the lens is well centered, and the lens movement under natural blinking is <0.5mm.

[0100] Adjusted to a high-edge tilt and steeper BC 7.6mm trial lens, 20 minutes after wearing the lens, slit lamp examination: moderate tear layer behind the central corneal lens, about 50μm; small mobile bubbles behind the peripheral lens; good landing zone fit, dynamic and static assessment of conjunctival blood flow without obstruction, lens centered well, with slight mobility of about 0.5mm in natural blinking state. The main complaint was no foreign body sensation.

[0101] During the follow-up examination one month after wearing the glasses, the patient's eyesight test result was: -0.25 / -0.50*34, and his visual acuity with the glasses was 1.0.

[0102] Although certain features of the present invention have been illustrated and described herein, many modifications, substitutions, changes and equivalents may occur to those skilled in the art. Therefore, it should be understood that the present invention is intended to cover all such modifications and changes that fall within the true spirit of the present invention.

Claims

1. A method for fitting a scleral contact lens for a subject, the scleral contact lens comprising an optical zone disposed in the center of the lens, a transition zone surrounding the optical zone, and a landing zone disposed at the periphery of the lens, the optical zone having a base curve curvature radius BCR, the transition zone having a transition zone curvature radius TZR, and the landing zone having a landing zone curvature radius LZR, wherein TZR depends on BCR, but LZR is independent of BCR, the scleral contact lens is a non-closed or open type, and the scleral contact lens is configured such that during use, the scleral contact lens moves between 0.4 and 1.2 mm on the surface of the eyeball, The method comprises: Measuring the corneal morphology of the subject to obtain a flat K (FK) value of the cornea of ​​the subject and a corneal eccentricity e value corresponding to the FK value; Selecting a first trial lens of the scleral contact lens for the subject based on the FK value and the e value, wherein the optical zone of the first trial lens has a first base curve curvature radius BCR1 and the landing zone thereof has a first landing zone curvature radius LZR1; and After the subject wears the first trial piece for 20 to 30 minutes, a fitting evaluation is performed on the first trial piece.

2. The method according to claim 1, wherein the step of selecting a first trial lens comprises: Calculating the lens sagitta according to the FK value, the e value and the target initial vertex gap; Calculating a theoretical base curve curvature radius according to the lens sagittal height and base curve eccentricity; as well as The first base curve curvature radius BCR1 is obtained by subtracting the correction parameter C from the calculated theoretical base curve curvature radius. The target initial vertex gap is selected from 40 to 200 μm, the base arc eccentricity is selected from 0.30 to 1.10, and the correction parameter C is selected from 0.2 to 0.

5.

3. The method according to claim 1 or 2, wherein the BCR is selected from 5.0 to 14.0 mm; and / or The TZR is 0.0 to 2.0 mm larger than the BCR; and / or The LZR is greater than the BCR and is independently selected from 8.5 to 15.0 mm.

4. The method according to claim 1 or 2, wherein the method further comprises: If the first trial lens is well-fitted, a scleral contact lens having the BCR1 and LZR1 is customized for the subject; If the first trial lens does not fit well, a second trial lens with a second base curve curvature radius BCR2 and / or a second landing zone curvature radius LZR2 is selected for the subject, and the fitting evaluation is performed again after the subject wears the second trial lens for 20 to 30 minutes, wherein BCR2 is different from BCR1, and LZR2 is different from LZR1.

5. The method of claim 4, wherein the fit assessment comprises: Measure the vertex space and / or limbal space.

6. The method according to claim 1 or 2, wherein measuring the corneal morphology of the subject is measured by corneal topography.

7. The method of claim 6, comprising performing multiple corneal topography measurements.

8. A trial lens set for fitting a scleral contact lens, the trial lens being a scleral contact lens and comprising an optical zone disposed in the center of the lens, a transition zone surrounding the optical zone, and a landing zone disposed at the periphery of the lens, the optical zone having a base curve curvature radius BCR, the transition zone having a transition zone curvature radius TZR, and the landing zone having a landing zone curvature radius LZR, wherein TZR depends on BCR, but LZR is independent of BCR, the scleral contact lens is a non-closed type or an open type, and the scleral contact lens is configured such that during use, the scleral contact lens moves on the surface of the eyeball between 0.4 and 1.2 mm, The trial wear lens set comprises: A high edge lift subgroup comprising a plurality of first trial pieces and a low edge lift subgroup comprising a plurality of second trial pieces, wherein the landing area curvature radius of the plurality of first trial pieces is the first landing area curvature radius LZR1, and the landing area curvature radius of the plurality of second trial pieces is the second landing area curvature radius LZR2, wherein LZR1 is greater than LZR2, and LZR1 and LZR2 are each independently selected from 8.5 to 15.0 mm; as well as The multiple first trial lenses have different base curve curvature radii, and the multiple second trial lenses have different base curve curvature radii. The base curve curvature radii of the first trial lenses and the second trial lenses are selected from the same base curve curvature radius set, and the base curve curvature radius set includes multiple preset base curve curvature radii with equal step distribution and selected from 5.0 to 14.0 mm. 9 . The trial fitting lens set according to claim 8 , wherein the number of the first trial fitting lenses is the same as the number of the second trial fitting lenses. 10 . The trial lens set according to claim 8 , wherein the number of the preset base curve curvature radii is the same as the number of the first trial lenses and / or the number of the second trial lenses.

11. The trial lens set according to claim 8 or 9, further comprising another subgroup having LZRs different from LZR1 and LZR2.

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