disposable contact lenses are an increasingly attractive option for
patients. Wearers of these lenses don't have to worry about buying
(or the efficacy of) solutions or about replacement schedules. The
newer offerings also address a previous complaint of daily
disposable lens wearers - all-day comfort.
1?Day Acuvue Moist (Vistakon) was designed to combat previous
end-of-day comfort and dryness issues. Here we'll look at the
technology and talk to practitioners who have been dispensing the
lens since its launch in July 2006. They'll also discuss why they're
excited about the future of daily disposables.
Designing for Moisture
M. Schnider, OD, MSc, MBA, FAAO, Director, Medical Affairs, Vistakon,
said that Vistakon's Hydraclear technology taught them several
things that were important about creating a comfortable lens.
Lubricity, flexibility and moisture are the three things that we
optimized with our Hydraclear technology, Dr. Schnider said. With
that technology, all the components of the lens are combined at the
beginning of the process. The technology starts with the very
genesis of the material to create physical flexibility, smoothness,
lubricity and moisture retention.
Lacreon process Vistakon uses to create 1?Day Acuvue Moist is
different because the wetting agent is added at the end of the
process, after the lens is polymerized. 1?Day Acuvue Moist
incorporates a high molecular weight polymer that is hydrophilic,
binding water molecules in the lens matrix. This polymer is not
present in 1?Day Acuvue.
with the etafilcon lens and add the moisture, Dr. Schnider said. By
using the wetting agent, we've been able to change the nature of the
lens. The process is really as important as the ingredients.
designed 1?Day Acuvue Moist to simulate the mucin layer of the
natural tears, to reduce friction and lysozyme absorption and to
enhance moisture retention. The lens has a 58 percent water content.
Acuvue Moist has a visibility tint and provides ultraviolet
radiation blocking. UV blocking averages 97 percent in the UVB range
of 280nm to 315nm and 82 percent in the UVA range of 316nm to 380nm.
Potential Daily Wear Patients
disposables, best-sellers in Japan and Europe, haven't been as
popular in the United States. Addressing comfort problems and
stressing the health benefits of daily disposable lens wear can
encourage more patients to wear them.
Ripps, OD, who is in private practice in Lake Hopatcong, NJ, is a
strong proponent of single-use lenses, especially for patients
younger than 18. You can solve 80 percent of contact lens problems
that occur by using a one-day lens, Dr. Ripps said. These patients
are by far the most compliant. There's no confusion about what needs
to be done. It's so convenient.
they came out, we prescribe a daily use lens for any patient under
18, Dr. Ripps said. He cites ease of compliance, UV blocking and
health benefits. He added that if a patient's first introduction to
contact lenses is with a single-use lens, it's difficult for them to
switch to a planned replacement lens and lose the convenience of a
Breeden, OD, also agrees that single-use lenses are a good choice
for young patients. In his Eatontown, NJ, practice many student
athletes choose them because of UV blocking. It's also convenient
for them to have an extra supply of lenses on-hand for games.
explain to students and parents the convenience and safety, Dr.
Breeden said. The parents appreciate that.
who travel often during the year, for business or for pleasure, are
also prime candidates for daily disposables, Dr. Breeden said.
Especially keeping in mind new airline restrictions on liquids,
daily disposable travelers don't have to worry about trying to get
solution bottles through security.
patients when offered the convenience really opt for it, Dr. Breeden
Weintraub, OD, who practices in Santa Monica, Calif., concurs. Daily
disposables are my lens of choice for all patients who have little
or no cylindrical correction, he said. I find that patients wearing
one-day lenses experience fewer problems with allergies and
infections. Compliance with cleaning and disinfection regimens,
which is a more pervasive problem than we like to admit, becomes a
prescribing 1?Day Acuvue Moist last summer, and was part of the
1?Day launch in 1995. He cites moistness as one advantage of the new
absence of dry eye symptoms, I've continued to fit patients under 30
years of age with the regular 1?Day (Acuvue) lens. I generally fit
patients over 30 years of age with 1?Day Acuvue Moist because
they're more likely to have dry eye symptoms and be able to
appreciate a difference, Dr. Weintraub said. I wear 1?Day Acuvue
Moist as well.
Breeden said that with discomfort being the No. 1 reason for
patients dropping out of lens wear, 1?Day Acuvue Moist has been
successful with many of these patients because the lenses stay wet
on the eye, reducing irritation. His practice also has had success
fitting the lens on allergy patients who suffer in the fall with hay
Universally, dropouts will describe contact lens problems as dry,
Dr. Schnider said. That's what makes the moist, cool, soothing
feeling relevant to existing wearers. Even just touching a new lens
that's moist, there's the anticipation that you believe it's going
to be comfortable.
Daily Disposable Discussions
thoroughly educate my patients on visual health and hygiene. After
recently seeing a referred case of
Acanthamoeba keratitis in a teen from tap water rinsing and
contact lens abuse, I'm more convinced that daily disposables are
the healthiest option for most patients.
Atlantic Eye Institute, I provide patients with the opportunity to
experience this new technology whenever I fit a spherical disposable
soft contact lens. I fit one eye with a two-week disposable and the
other with a 1?Day Acuvue Moist. I give them an extra two-week
disposable diagnostic lens for the other eye and a small supply of
diagnostic 1?Day Acuvue Moist lenses for both eyes. Upon follow-up,
most patients elect to purchase the 1?Day Acuvue Moist after
experiencing the benefits of this lens. Many patients purchase
supplies of both lenses.
a big part of the approach, Dr. Breeden said. Nothing replaces
putting a new clean, sterile lens on the eye. It's the healthiest
Throughout the course of a contact lens exam, Dr. Ripps asks
questions about lens wear, hobbies, etc. He asks if the patient's
eyes feel dry at the end of the day. Simple questions such as, Do
you take your lenses out as soon as you get home from work? offer
clues to comfort. These are obvious patients to inform about 1?Day
end of the exam, if the patient is doing fine with his current
lenses, Dr. Ripps asks if he'd like to hear about new technology
that will make his eyes feel better and less dry throughout the day.
I put a
pair on them in the office and instantly they feel the difference,
Dr. Ripps said. In a small percentage of the population for whom it
made no difference, they still wanted the new technology.
generally tell my patients, 'It's not magic, it's not the miracle
cure for contact lens-related dry eyes, but I personally can wear
these lenses an hour or two longer than other lenses before
experiencing dry eye symptoms,' Dr. Weintraub said. He added that
the feedback from his patients has been consistent with his personal
also are savvier than ever. They're interested in new technology,
and that your practice is offering the latest in contact lenses.
contact lens technology had languished. But just as computers have
ramped up, contact lenses have increased dramatically in the past
four years, Dr. Breeden said. Offer the new technology aggressively.
Breeden's approach is to tell patients that he believes this
technology is better. With existing contact lens wearers, he fits
them with the new lens and tells patients that if they disagree,
they can return to their former lenses. They know I'm not trying to
take away their lenses. I'm trying to offer them something better,
question of the cost of daily disposables arises, Dr. Ripps points
out that contact lenses are really the cheapest medical devices.
Single-use lenses at 70 cents to $1 a day are incredibly
inexpensive, he said. He usually dispenses a six-month supply,
although rarely patients will ask for a smaller supply.
patients don't have to buy solutions or lens cases, or worry about
sterile lens cases or solutions, Dr. Breeden said. I usually
dispense a six-month supply. We do offer tier pricing for our
Positive Patient Response
began dispensing 1?Day Acuvue Moist, Dr. Ripps said the response has
been positive. I ask patients if the lens has made a difference.
More than 90 percent were very happy. I had three patients who
decided to go back to 1?Day Acuvue.
did have a few patients who said they felt their vision wasn't as
sharp, but he's found few have had that experience. Patients he's
fit have also commented about comfort upon initial dispensing.
Initial comfort is dramatically better, he said.
Breeden had similar results. We're getting good wettability at the
end of the day, but we're also finding it enhances initial comfort.
Patients say the lenses feel wet, fresh and moist.
reporting an increase in comfort to Dr. Breeden are allergy patients
who have moderate symptoms. These patients experienced reduced
irritation and were able to wear their lenses longer during the
autumn allergy season. With daily disposable lenses, allergy
sufferers don't experience the allergen build-up associated with
planned replacement lenses.
personally have found a dramatic increase in comfort level at the
end of the day when wearing the 1?Day Acuvue Moist. My wearing time
has been increased and my dry eye symptoms have significantly
decreased since I switched to this lens.
points out that sometimes eyecare practitioners are concerned with a
patient's ability or willingness to pay for daily disposable lenses,
so they never mention the option to the patient. People can afford
what they see value in, Dr. Ripps said. It's our job to provide the
patient what's best for them.
patients, what's best increasingly may be single-use lenses. With
initial and all-day comfort - along with the health benefits of
putting in a new lens each day - daily disposable lenses may soon
find increased success with patients everywhere.