Abstract
To evaluate the performance of precorneal and prelens non-invasive tear break-up time (NIBUT) measurements to determine tear instability in contact lens (CL) wearers. In this study, 50 eyes of 25CL wearers were evaluated. Precorneal first and average NIBUTs and fluorescein tear break-up time (FBUT) were measured before wearing CLs in the morning. Those with FBUT less than 10s were considered to have tear instability. After wearing CL, first and average prelens NIBUTs were measured at the 30th minute. The receiver operating characteristic (ROC) curve was analyzed to evaluate the performance of NIBUT measurements in the diagnosis of tear instability. The FBUT value had a significant correlation with first and average precorneal NIBUT values (p < 0.001, r = 0.653 and p < 0.001, r = 0.628, respectively). The FBUT value had no correlation with the prelens first and average NIBUT values (p = 0.542 and p = 0.263, respectively). To understand the relationship between the precorneal and prelens NIBUT values measured by the automated method, their correlation was evaluated. There was no significant correlation between the precorneal and prelens NIBUTs (for all; p > 0.05). The area under curve (AUC) in ROC curve for the first and average precorneal NIBUTs were 0.842 (p < 0.001) and 0.810 (p < 0.001), respectively. The AUC values for the first and average prelens NIBUTs at the 30th minute of CL wear were 0.586 and 0.619, respectively (p = 0.317 and p = 0.166, respectively). Precorneal NIBUT measurements may be useful in diagnosing tear instability. Prelens NIBUT values are not yet capable of adequately defining the tear film dynamicsin CL wearers.
Highlights
Since some changes occur in the ocular surface and tear functions due to the use of contact lens (CL), it is necessary to evaluate the ocular surface and tear stability to prevent CL-related complications [1, 2]
The fluorescein tear break-up time (FBUT) value had no correlation with the prelens first and average non-invasive tear break-up time (NIBUT) values (p = 0.542 and p = 0.263,respectively)
Precorneal NIBUT measurements may be useful in diagnosing tear instability in CL wearers
Summary
Since some changes occur in the ocular surface and tear functions due to the use of contact lens (CL), it is necessary to evaluate the ocular surface and tear stability to prevent CL-related complications [1, 2]. Being simple and requiring no expensive equipment, FBUT measurements are widely used in clinical practice; this method cannot be used in CL users while they are wearing CLs on their eye since fluorescein needs to be applied Another way to measure tear instability is non-invasive tear break-up time (NIBUT), which is an automated method based on the principle of evaluating irregularities in the tear by projecting Placido rings onto the precorneal tear film. The advantage of this method is that it can measure tear instability without the need for a foreign substance, such as fluorescein drops or strips; it provides a practical solution for the evaluation of prelens tear instability in people wearing CLs [11, 12]. The NIBUT method is used by eye care practitioners, there is not yet sufficient evidence of its ability to assess tear instability in CL wearers [11, 13]
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