Contact Lens and Anterior Eye xxx (xxxx) xxx–xxx

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Contact Lens and Anterior Eye

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An approach for simulating the fitting of rigid gas-permeable contact lenses

using 3D printing technology☆
⁎
Feng Zhao, Jing Wang, Linnong Wang, Lixun Chen
Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China

A R T I C LE I N FO A B S T R A C T

Keywords: Objective: To introduce a new approach to simulatethe fitting process of rigid gas-permeable (RGP) contact
Rigid gas permeable Lens lenses using 3D printing technology.
3D printing Methods: A hemispherical or parabolic 3D model was created using 3D Builder or Tinkercad software. The
Contact lens fitting horizontal and vertical diameters and the hemispherical or ellipsoid height were adjusted to simulate different
morphologies of the corneal anterior surface. After exporting the file in stereo lithography (STL) format, a solid
model was printed using a 3D printer and was used to simulate RGP contact lens fitting.
Results: Limited by the precision of the entry-level 3D printer which was used in this study, the print-outs of the
corneal models were crude, but the models were tested for their ability to simulate common corneal
morphologies with no corneal astigmatism and different axial corneal astigmatism. Compared with some built-in
simulation programs for corneal topography, the solid models generated by 3D printing could well simulate the
positioning of the lens under the influence of gravity and the eyelid, as well as lens eccentricity or the bubbles
under lenses caused by an improper wearing method.
Conclusion: 3D printing technology can be well applied in the simulation of RGP contact lens fitting, which may
become a new teaching method in optometry.

1. Introduction 2. Methods

The rigid gas-permeable (RGP) contact lens is an important means A hemispherical or parabolic 3D model was created using the free
of correcting refractive errors [1–9], and optometry students must learn 3D Builder (built into Windows 10, Microsoft) or Tinkercad (running
and master the technique for this lens in clinical practice. Although it is online, Autodesk) software. The horizontal and vertical diameters, as
not difficult to understand the theoretical knowledge related to RGP well as the hemispherical or ellipsoid height, were adjusted to simulate
lens fitting for simple myopia and regular astigmatism, proficiency in different morphologies of the corneal anterior surface (Figs. 1 and 2) to
the RGP lens fitting technique still requires a long practice time for most create the desired 3D corneal model.
students, even those with a good understanding of the relevant theo- The components for hand-held or slit-lamp installation were added
retical knowledge. The unskilled operation of internship students in the if needed and were assembled with the previously designed corneal
early stage of practice may cause eye discomfort during the actual fit- model (Fig. 3), and the designed 3D model was saved in the format
ting process, which may even lead to some disputes. A method that can supported by the 3D printer being used.
well simulate the fitting process of RGP lenses obviously has practical The designed model was printed by a 3D printer (mini 2, TierTime
teaching and clinical value. Inc, China) and used for the simulation of RGP fitting (Fig. 4).
To solve the above problems, this study tried to introduce a virtual
simulation technology and 3D printing technology to the teaching 3. Results
process of contact lens fitting. A preliminary study of its feasibility and
practicability were conducted. Although the printed corneal models are relatively rough because of
the low precision of the 3D printer being used, the models were tested
for their ability to simulate common corneal morphologies with no

☆
Research projects of medical and health in Nanjing, Project number YKK5091.
⁎
Corresponding author.
E-mail address: njsdyyyyk@[Link] (L. Chen).

[Link]
Received 31 March 2018; Received in revised form 4 June 2018; Accepted 10 October 2018
1367-0484/ © 2018 Published by Elsevier Ltd on behalf of British Contact Lens Association.

Please cite this article as: Zhao, F., Contact Lens and Anterior Eye, [Link]
F. Zhao et al. Contact Lens and Anterior Eye xxx (xxxx) xxx–xxx

Fig. 1. Using Tinkercad software, the corneal astigmatism is simulated by adjusting the diameters of the two perpendicular axes.

Fig. 2. The axis of astigmatism can also be set by Tinkercad software.

Fig. 3. A computer image of the corneal model and handle designed by 3D builder.

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F. Zhao et al. Contact Lens and Anterior Eye xxx (xxxx) xxx–xxx

Fig. 4. Photograph of a 3D-printed corneal model with an

RGP lens. (A corneal model was generated with 3D Builder or
Tinkercad software. Subsequently a 3D printer was used to
create a physical model of the cornea mounted on a handle
which would allow the model to be held in an upright position
for viewing with a slit-lamp biomicroscope.)

Fig. 5. Photograph of a 3D-printed corneal model with an RGP lens demonstrating a fluorescein pattern of a spherical lens on an astigmatic cornea.

corneal astigmatism and different axial corneal astigmatism. Compared [6,10,16]. There are some obvious disadvantages in this approach: the
with some built-in simulation programs for corneal topography, the actual position of the RGP lens on the cornea is also affected by the
solid models generated by 3D printing could better simulate the posi- lens's own weight and the eyelid, and the built-in corneal topography
tioning of the lens under the influence of gravity and the eyelid, as well simulation software can not accurately simulate these impacts; in ad-
as lens eccentricity or the bubbles under lenses caused by an improper dition, the simulation software cannot simulate lens eccentricity and
wearing method as shown (Figs. 5 and 6). the bubbles under lenses caused by an improper wearing method.
Based on preliminary experimental results, the method proposed in
this study has some advantages: Compared with the traditional teaching
4. Discussion
methods, this method of constructing a 3D corneal model using 3D
printing technology for applications in optometry teaching can stimu-
Some manufacturers of corneal topography systems developed
late students' interest, allowing intuitive and multi-angle observation of
software for fitting simulation based on corneal topography data to
the lens position and fluorescence staining and effectively promoting
simplify the fitting process of RGP lenses. The principle is to create a
the understanding and mastering of the relevant knowledge. In addi-
simulated fluorescence evaluation diagram (Fig. 7) based on the data
tion, it is increasingly difficult for Chinese medical students to directly
for the corneal anterior surface obtained from a corneal topography
participate in invasive examinations and treatments during clinical
examination and the lens design parameters of some RGP brands; a try-
practice due to the serious medical-patient relationship in China. This
on lens is chosen on this basis to improve the fitting efficiency

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F. Zhao et al. Contact Lens and Anterior Eye xxx (xxxx) xxx–xxx

Fig. 6. Photograph of a 3D-printed corneal model with an RGP lens demonstrating a fluorescein pattern of eccentric lens positioning.

Fig. 7. Simulation software for contact lens fitting built in to some corneal topography systems.

situation will inevitably lead to a decline in the quality of medical Acknowledgement

education. The application of 3D printing technology in contact lens
fitting simulation may help to alleviate the current predicament in We thank Ms. Na Song for providing the free RGP lenses for this
medical education in China. study. Funding from the Nanjing Medical and Health Foundation is
The actual effect of this method awaits further verification by in- gratefully acknowledged.
stitutions with better experimental conditions, including a 3D printer
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