ANNIVERSARY SECTION - 20th
20 Years of Pursuing Comfort, Vision and Health with CLs
BY JEROME A. LEGERTON, OD, MS, MBA, FAAO
The year 1986 marked a time when the number of new soft lens fits surpassed GP lens fits, GPC was the leading complication with daily wear soft lenses and the last nail in the extended wear coffin was about to be hammered home because of hypoxia-related infectious keratitis. It was also defined by the vertical integration with DPAs and TPAs in optometry that coincided with changes in the way practitioners managed lens wearers.
The late '80s framed the trend to reduce the length of follow up for new fits and to reduce or eliminate the inspection visit after dispensing a replacement lens. This paved the way for reduced contact lens fees and for the advent of fulfillment businesses that mail or dispense contact lenses. These events further coincided with high U.S. inflation rates that altogether impacted the average profit per contact lens patient.
The next milestone was the advancement of low-cost cast molding and subsequent launch of disposable lenses. While providing greater convenience and preventive health benefits, disposable lenses took the inspection visit to extinction and reinforced alternative delivery systems.
The 1990s were an exciting time in product development. The industry directed tremendous resources to material science to improve the oxygen permeability and surface wetting of hydrogel materials. At the same time, care product researchers focused attention on multipurpose systems to simplify handling and enhance convenience. The fruit of this research was the commercialization of surface-treated silicone hydrogel lenses as well as one-step and no-rub care products.
Corneal reshaping gained regulatory approval in the late 1990s for daily wear. The FDA approved Paragon's Corneal Refractive Therapy in June 2002 for overnight wear, paving the way for providing good vision without surgery, glasses or waking-hour contact lens wear.
Material science advancement facilitated the development of SynergEyes high-Dk hybrid lenses that received FDA market clearance in 2005. The GP center/soft skirt platform is designed for a broad range of refractive errors and indications.
The final, most recent trend is a new emphasis on vision. Technology advances in adaptive optics and precision manufacturing are ushering in an era of "super-vision" and the promise of realizing effective contact lens correction of presbyopia and contact lens control of myopia.
Sharpen Up for the Future
In business it's difficult to separate stimulus from response; in fact, they dance together. In 1986 lenses were inseparable from prescribers. The industry took a big swing during the last 20 years to high brand awareness and direct-to-consumer advertising. Consumers now view lenses as a commodity, pulled through the practitioner by manufacturer-sponsored advertising.
But the technology milestones appear to be taking the industry full cycle. The focus on vision is forecast to reunite practitioners with patients. Vision-enhancing products aren't one-size-fits-all they're more dependent on practitioner skill and competency.
The line of tension that will define the next 20 years passes through practitioners. We must sustain age old case history and consultation and endeavor to connect patients' needs to vision-enhancing products. At the same time, manufacturers will attempt to mass produce and mass merchandise super-vision. But in the end, super-vision entails mass-customization, which requires the laying on of hands by skilled practitioners.
Dr. Legerton practiced in San Diego for 26 years. He is the Chief Technology Officer for SynergEyes and inventor for eight refractive surgery and contact lens patents.