Thickness of the Pre- and Post–Contact Lens Tear Film Measured In Vivo by Interferometry

PURPOSE: To evaluate an interferometric method for measuring the thickness of the pre- (PLTF) and postlens tear film (POLTF) in subjects wearing hydrogel contact lenses. The precision and accuracy of measuring postlens tear thickness is compared with a previous method based on optical pachymetry and mechanical measurement of contact lens thickness. METHODS: Reflectance spectra (562-1030 nm) from the front of an eye wearing a contact lens were measured at normal incidence. Interference between reflections from four surfaces--the front of the tear film, the front and back of the contact lens, and the front of the cornea--can give rise to as many as six oscillations in the reflectance spectra, three from simple layers (layer A: PLTF; B, POLTF; C, contact lens) and three from composite layers, (layer D, A+C; layer E, C+B; layer F, A+C+B). The thickness of any layer is derived from the frequency of the oscillations. The principle of the method was tested with a rigid contact lens, which was designed to give distinct thicknesses for all six layers. Twenty spectra were then recorded from each of 12 subjects wearing hydrogel contact lenses. RESULTS: The PLTF thickness averaged 2.31 microm. There was good agreement between a direct estimate from layer A and an indirect estimate: layer D minus layer C. For POLTF, an indirect estimate--layer F minus layer D--averaged 2.34 microm and was more satisfactory than the direct estimate from layer B. There was no correlation between PLTF and POLTF thickness, showing that these are independent measurements, despite the similarity of their means. CONCLUSIONS: Prelens tear thickness was in reasonable agreement with prior measurements. Postlens tear thickness was much less than the 11 to 12 microm found by the pachymetric method. It is argued that the current method avoids some of the systematic errors of the pachymetric method and also has much higher precision.