The role of fenestrations and channels on the transverse motion of a soft contact lens

Abstract

Purpose: Ineffectual removal of potentially harmful species from the postlens tear film (POLTF) may lead to adverse responses among extended wearers of soft contact lenses. It is apparently important to remove bacteria, cell debris, and metabolic products from the postlens tear film to the outer tear lake; the flushing or dispersion rate of these species is enhanced by increasing fluid movement in the tear film driven by periodic lens motion. The contact lens moves laterally (up-down) and transversally (in-out) due to the action of the eyelid forces during blinking. Viscous drag in the POLTF resists lens motion. Consequently, any design change in the lens that reduces viscous drag increases motion and improves flushing of unwanted species from the POLTF. We investigate quantitatively the effect of channels cut on the back surface of the lens and fenestrations (holes) drilled through the lens on transverse lens motion.

Methods: We model the lens as a curved solid body with a periodic arrangement of channels/holes. The cornea is treated as a flat surface, and the hydrodynamic equations of motion are solved for Newtonian fluid transport in the POLTF assuming lubrication and creeping flow. POLTF pressure profiles, obtained by solving these equations, are integrated to determine the lens settling velocity in the transverse direction for a given amount of applied lid force. Lens settling velocity is then compared with the same velocity in the absence of channels/fenestrations. Further, we calculate the total transverse motion in a blink for lenses with and without channels/fenestrations to estimate the possible enhancement in transverse motion due to the channels/fenestrations.

Results: Variables that affect the fluid mixing in the POLTF are the postlens tear film thickness, lens thickness, channel length, depth and spacing, and the hole diameter, location, and spacing. We study the effect of each of these variables on the enhancement of transverse motion for channels and holes of diameters varying from 0.1 to 2 mm with spacing varying from 1 to 5 mm.

Conclusions: We demonstrate that incorporation of channels and holes reduces viscous resistance and increases transverse lens motion, and thus increases fluid mixing and dispersive flushing from the POLTF. The increase in transverse motion depends strongly on the postlens tear film thickness. Enhancement of the transverse motion varies from a factor of about 2 to 20 depending on the particular lens design and the postlens tear film thickness. Because fluid mixing increases up to the square of the transverse motion, channels/holes are expected to render flushing of the POLTF considerably more effective. We find that channels and/or fenestrations, when appropriately designed, can provide significant improvement in flushing from the POLTF. This work provides a new quantitative tool for the efficient design of channels/holes in soft contact lenses.