Highlights
- •Corneal topography measurements are affected by in the insertion of fluorescein sodium (NaFl) ocular dye.
- •A single (not double) dose of NaFl resulted in increased reliability and consistency in corneal topography measurements.
- •Tear film surface regularity changes significantly with NaFl, although this is not clinically significant in healthy corneas.
Abstract
Purpose
During image acquisition, certain topographers require the addition of sodium fluorescein
(NaFl) dye to the tear film. This study investigates the effect of NaFl dye on corneal
topography and tear surface quality.
Method
The E300 corneal topographer (Medmont International Pty Ltd., Victoria, Australia)
was used to measure ocular surface topography and quality of 57 eyes of 57 healthy
individuals without dry eye symptoms, age 35.1 ± 15.2 years (mean ± standard deviation)
ranging between 19 and 65 years. The mean of three simulated keratometry values, a
variety of corneal shape descriptors, and Tear Film Surface Quality (TFSQ) were measured
under three different conditions; without NaFl (baseline), with the addition of a
single dose NaFl, and using a double dose of NaFl.
Results
Compared to baseline, the Inferior-Superior (IS) index decreased significantly after
a single dose (P = 0.034) or double dose of NaFl (P = 0.030). The corneal surface
was significantly more regular without NaFl (P = 0.003) or one insertion of NaFl (P
= 0.024) when compared to two doses of NaFl. There was no association with age, or
dry eye signs or symptoms on the variance observed in any of the indices between baseline,
intervention I, and intervention II (P > 0.05). Agreement between corneal surface
indices reduced following the addition of NaFl.
Conclusion
In comparison to measurements taken without an ocular dye, one dose of NaFl resulted
in increased reliability and consistency in corneal topography measurements using
the E300 topographer, but 2 doses decreased reliability and consistency. Practitioners
ought to be aware that tear film surface regularity and inferior-superior corneal
power changed significantly following the addition of NaFl in those with healthy corneas.
Its effect in diseased corneas is unknown.
Keywords
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Article info
Publication history
Published online: March 04, 2020
Accepted:
February 25,
2020
Received in revised form:
February 25,
2020
Received:
July 23,
2019
Identification
Copyright
© 2020 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
