Enzyme-orthokeratology

A method of correcting refractive errors in an eye of a subject mammal, comprising the steps of:

• administering to said subject a corneal softening amount of an agent that softens the cornea in said eye of said subject so that said cornea can be reshaped from a first configuration to a desired second configuration, wherein said agent is an activator of an endogenous enzyme which breaks down the structural components of said cornea;
• fitting said cornea with a rigid contact lens having a concave curvature of said desired second configuration;
• permitting said cornea to reshape to said desired second configuration under the influence of said lens;
• and
• removing said lens when said cornea is capable of maintaining said desired second configuration without the support of said lens.

A method of correcting refractive errors in an eye of a subject mammal, comprising the steps of:

• administering to said subject a corneal softening amount of an agent that softens the cornea in said eye of said subject so that said cornea can be reshaped from a first configuration to a desired second configuration, wherein said agent is an inactivator which inactivates an inhibitor of an endogenous enzyme;
• fitting said cornea with a rigid contact lens having a concave curvature of said desired second configuration;
• permitting said cornea to reshape to said desired second configuration under the influence of said lens;
• and
• removing said lens when said cornea is capable of maintaining said desired second configuration without the support of said lens.

A method of correcting refractive errors in an eye of a subject mammal, comprising the steps of:

• administering to said subject a corneal softening amount of an agent that softens the cornea in said eye of said subject so that said cornea can be reshaped from a first configuration to a desired second configuration;
• fitting said cornea with a rigid contact lens having a concave curvature of said desired second configuration;
• permitting said cornea to reshape to said desired second configuration under the influence of said lens;
• administering to said cornea an amount of an inhibitor of said agent sufficient to slow or stop the softening activity of said agent, wherein said inhibitor is added after said cornea has softened and reshaped to said desired second configuration;
• and
• removing said lens when said cornea is capable of maintaining said desired second configuration without the support of said lens.

A method of reshaping a cornea from a first configuration to a second desired configuration in order to correct refractive errors in an eye of a subject mammal, comprising the steps of:

• providing a soft contact lens;
• loading said soft contact lens with an amount of a corneal softening agent sufficient to soften the cornea in said eye, wherein said agent is an enzyme which breaks down proteoglycans in said cornea;
• fitting said soft contact lens to said cornea, said corneal softening agent in said soft contact lens thereafter causing said cornea to become softer and more pliable;
• removing said soft contact lens;
• and
• fitting at least one rigid contact lens to said cornea while said cornea is in the softened condition, thereby causing said cornea to reshape to the configuration of the concave curvature of said rigid contact lens.

A method of reshaping a cornea from a first configuration to a second desired configuration in order to correct refractive errors in an eye of a subject mammal, comprising the steps of:

• providing a soft contact lens;
• loading said soft contact lens with an amount of a corneal softening agent sufficient to soften the cornea in said eye;
• fitting said soft contact lens to said cornea, said corneal softening agent in said soft contact lens thereafter causing said cornea to become softer and more pliable;
• removing said soft contact lens;
• fitting at least one rigid contact lens to said cornea while said cornea is in the softened condition, thereby causing said cornea to reshape to the configuration of the concave curvature of said rigid contact lens;
• and
• administering to said eye an amount of an inhibitor of said agent sufficient to slow or stop the softening activity of said agent, wherein said inhibitor is added after said cornea has softened and reshaped to said desired second configuration.

A method of correcting refractive errors in an eye of a subject mammal, comprising the steps of:

• (a) providing a contact lens for delivering agents to said eye, said contact lens comprising:
• a rigid anterior layer;
• a rigid posterior layer having a convex side and a concave side, wherein the convex side of said posterior layer has a flatter curvature than the concave side of said anterior layer over a center portion of said posterior layer;
• and
• a channel in said center portion of said poster layer, wherein said channel passes from the convex side of said posterior layer to the concave side of said posterior layer,
• wherein the concave side of said anterior layer and the convex side of said posterior layer are joined, thereby forming a center chamber between said layers in communication with the concave side of said posterior layer by means of said channel;
• (b) loading said center chamber of said contact lens portion with an amount of a corneal softening agent sufficient to soften the cornea of said eye, wherein said agent is an enzyme which breaks down proteoglycans in said cornea;
• and
• (c) releasing said corneal softening agent into said cornea from said central chamber, thereby softening said cornea and making it more pliable, said cornea then reshaping to the inside central curvature of said posterior layer of said contact lens.

A method of correcting refractive errors in an eye of a subject mammal, comprising the steps of:

• (a) providing a contact lens for delivering agents to said eye, said contact lens comprising:
• a rigid anterior layer having a posterior surface with an intermediate portion;
• a rigid posterior layer having an interior surface with an intermediate portion, wherein the intermediate portion of the posterior surface of said anterior layer has a steeper radius of curvature than the anterior surface of the intermediate portion of said posterior layer;
• and
• a channel in said intermediate portion of said posterior layer wherein said channel passes from the convex side of said posterior layer to the concave side of said posterior layer, wherein the concave side of said anterior layer and the convex side of said posterior layer are joined, thereby forming a peripheral chamber between said layers in said intermediate portions, and wherein said channel is in communication with both said peripheral chamber and the posterior surface of said posterior layer of said contact lens;
• (b) loading said peripheral chamber of said contact lens with an amount of a corneal softening agent sufficient to soften the cornea of said eye, wherein said agent is an enzyme which breaks down proteoglycans in said cornea;
• and
• (c) releasing said corneal softening agent into said cornea from said central chamber, thereby softening said cornea and making it more pliable, said cornea then reshaping to the inside central curvature of said posterior layer.

A method of rehabilitating corneal irregularity and correcting refractive error in an eye of a subject mammal with irregular corneal shape, comprising the steps of:

• identifying a subject with irregular corneal shape;
• administering to said subject a corneal softening amount of an agent that softens the cornea of said eye of said subject so that said cornea can be reshaped from a first configuration to a desired second configuration, wherein said agent is an enzyme which breaks down proteoglycans in said cornea;
• fitting said cornea with a contact lens having a concave curvature of said desired second configuration;
• permitting said cornea to reshape to said desired second configuration under the influence of said lens;
• and
• removing said lens when said cornea is capable of maintaining said desired second configuration without the support of said lens.

A method of improving the clinical success of surgery to the eye involving the manipulation of a cornea of a subject mammal, comprising the steps of:

• identifying a subject who has undergone a corneal manipulation;
• administering to said subject a corneal softening amount of an agent that softens a manipulated cornea of said subject so that said cornea can be reshaped from a first configuration to a desired second configuration, wherein said agent is an enzyme which breaks down proteoglycans in said cornea;
• fitting said cornea with a contact lens having a concave curvature of said desired second configuration;
• permitting said cornea to reshape to said desired second configuration under the influence of said lens;
• and
• removing said lens when said cornea is capable of maintaining said desired second configuration without the support of said lens.