From year to year, we often try to accumulate a top 10 list of the items that we feel are the most significant and deserving of attention in the contact lens field. And, each year, we solicit your input for items on this list. Please send the contact lens items or issues that you think should go on the 2019 top 10 contact lens list to firstname.lastname@example.org.
Jason J. Nichols, OD, MPH, PhD
Valley Contax Updates Warranty Policy
Valley Contax announced a new Total Cost Guaranteed warranty policy. According to the company, every lens that it sells will have a single standard price and include free two-day and ground shipping to practitioners’ offices, free add-on services, free upgrades like edge vault and quadrant-specific options, a choice of any material, eligibility for spare lens pricing, unlimited remakes for 120 days (including shipping), 120-day cancellations, risk-free 100% credit on patient cancellations, and the need to only return lenses upon cancellation or defect. The new warranty policy will take effect Aug. 19, 2019.
In unrelated news, Valley Contax recently held the Custom Stable Cup Challenge at Optometry’s Meeting 2019 in St. Louis, June 19 to 22. Current optometry students and alumni were encouraged to participate by visiting the Valley Contax booth, where they partnered up and applied the Custom Stable lens with sodium fluorescein and then evaluated the lens’ central clearance. First place was awarded to Southern College of Optometry, which received two $500 scholarships and the Custom Stable Cup. The second-place winner was University of Missouri, which was awarded a $500 scholarship. Along with Valley Contax, contributing sponsors included Menicon, Contamac, Optovue, and TelScreen along with special support from the American Optometric Student Association.
Glaukos and Avedro Announce Definitive Acquisition Agreement
Glaukos Corporation and Avedro Inc. announced that the companies have entered into a definitive merger agreement under which Glaukos will acquire Avedro in an all-stock transaction. The transaction, which is subject to Avedro stockholder approval along with other customary closing conditions and regulatory approvals, has been approved by the board of directors of both companies and is expected to be completed in the fourth quarter of 2019.
According to the companies, Glaukos plans to leverage its proven market-building expertise, global commercial scale and extensive clinical and regulatory infrastructure to maximize Avedro’s disruptive bio-activated pharmaceuticals and pipeline. The companies also say that the transaction will expand Glaukos’ R&D capabilities and is expected to strengthen multiple corneal health and vision correction development initiatives now underway across both organizations.
Perella Weinberg Partners LP is serving as financial advisor to Glaukos, and O’Melveny & Myers LLP is serving as its legal advisor. Guggenheim Securities is serving as financial advisor to Avedro, and Cooley LLP is serving as its legal advisor.
Sight Sciences Hires Leading Industry Executives
Sight Sciences Inc. announced that Jessica Holmes, Brian Regan, and Jim Sluck have joined the company as vice president of Health Policy & Reimbursement, vice president of Strategy & Professional Relations, and vice president of Dry Eye Marketing, respectively. The three industry veterans will bring a wide range of leadership experience to the management team in directly relevant products and end markets.
Previously, Ms. Holmes directed the prominent medical device reimbursement and market access practice at Navigant Consulting as director of Life Sciences and served as vice president of Reimbursement for Argenta Advisors, Inc. She will be leading the reimbursement and health policy strategy for all of the company's surgical and dry eye portfolio.
Prior to joining Sight Sciences, Mr. Regan was vice president of Marketing & Development at Johnson & Johnson Vision following its acquisition of TearScience, Inc. He will lead strategy across both the surgical and dry eye businesses, with a focus on the company's interactions with key opinion leaders within the ophthalmology and optometry specialties.
Prior to joining Sight Sciences, Mr. Sluck was part of the market development team at Shire that led the launch and acceleration of Xiidra in the dry eye pharmaceutical market. He will lead the marketing strategy and execution for the launch of TearCare.
Harrow Health Forms Stowe Pharmaceuticals Subsidiary
Harrow Health Inc.’s newly formed subsidiary, Stowe Pharmaceuticals Inc., has entered into an agreement with TGV Health to acquire worldwide rights to the Zian anti-microbial molecule for ophthalmic and otic uses. Zian is a patented small molecule that is water soluble, colorless, and odorless to treat various complex bacterial, fungal, and viral infections. The initial primary indication for Stowe’s initial drug candidates is expected to be adenoviral conjunctivitis, with secondary indications for mixed bacterial-viral infections, keratitis, endophthalmitis, and corneal ulcers.
Dr. Kester Nahen joins Notal Vision as Chief Commercial Officer
Notal Vision Inc. announce the appointment of Kester Nahen, PhD, to chief commercial officer. Dr. Nahen is a medical device industry expert and brings more than 18 years of international business experience in product management, medical science, clinical research, marketing, sales, professional education, and business development to the company.
Prior to joining Notal Vision, Dr. Nahen was managing director of ophthalmic diagnostic device manufacturer Heidelberg Engineering GmbH and served on the board of Heidelberg Engineering Inc.
Kyriakos Telamitsi, Limassol, Cyprus
This image shows a scleral lens edge digging into a small cyst during fitting.
We thank Kyriakos Telamitsi for this image and welcome photo submissions from our other readers! It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit http://www.cltoday.com/upload/upload.aspx to upload your image. Please include a detailed explanation of the photo and your full name, degree or title, and city/state/country.
SPECIALTY LENS SPACE
Karen DeLoss, OD
GP Basic Reminders
I still use corneal GP lenses for many reasons. In my clinical setting, patients don’t necessarily need or want scleral lenses, and alternatives to corneal GP lenses can be cost prohibitive. Plus, care and handling of corneal GPs is relatively simple and straightforward. That said, I feel like I can never remember the basics off the top of my head. So, here are some basic reminders for those of us who forget.
First, where does the lens naturally tend to travel? In any case, manually moving the lens back to the center of the eye can help determine the basic central pattern such as steep, flat, or adequate.
Next, where is that lens headed? For lenses that drop inferiorly, flatten the base curve or go to a larger diameter. If the lens travels laterally or superiorly, steepen the base curve (BC). A minimum of 0.5D (or 0.1mm BC change) is recommended to see a change.1 Diameter changes need to be at least 0.2mm but can go up to 0.5mm (depending on your preference or who taught you). If switching to a larger diameter, remember that this will change the “chord,” so you will need to adjust your BC to maintain the fit. Remember to use your lab consultants and that the GP Lens Institute’s website has some wonderful fitting resources.
1. Bennett E, Scheid, T, Moran B. Gas-permeable lens problem solving. In: Clinical Manual of Contact Lenses. Fourth Edition, Bennett ES, Henry VA, eds. Lippincott. pp. 206-207.
MATERIALS & DESIGNS
David L. Kading, OD
Hi, My Name Is GP-T
You are probably not using me as often as you should, but I am an important part of your patient’s success. I am a GP toric lens. You know me because I correct astigmatism, but not the way that you think. Unlike my soft lens counterpart that you use for patients who have refractive cylinder, you chose to use me because of the way that I fit on the cornea first, and then the way that I correct the total cylinder second.
When the cornea is toric way out at the limbus, you need to use me so that I can lock in place; my spherical little buddy would move all over. If there is toricity only centrally that doesn’t reach out to the limbus, then the spherical lens can take care of that.
When you use me, you create a toric curve on the back surface that works to nearly match the toricity of the cornea. If you put a toric curve on the back of me and a spherical surface on the front of me, I would end up inducing cylinder. It’s for that reason that you put toricity on my front surface: so that it compensates for my backside. Usually, if the refractive and corneal power are close, you can use the same amount of toricity on the front and back surfaces. These then align just right, and I create a spherical power effect (SPE). When I am an SPE GP toric, I can spin like a merry-go-round on the eye, and a patient’s visual outcome will be stable.
However, if the refractive and corneal power are not the same (think lenticular cylinder), you will need to create a cylindrical power effect (CPE). In a CPE situation, I have a back surface that matches the corneal curve, but my front surface has more or less power to match or compensate for the total residual cylinder created by the optical system. When I am a CPE GP toric, you will need to be more diligent at locking me in so that I don’t rotate as much.
Fitting me tends to be something that is often thought of as over complicated, but I am a basic optics system and am really a lot of fun. I create great outcomes for patients and am generally well liked. My friends at your GP laboratory would love to chat with you more and would be happy to introduce us so that we can work more together in the future to change some patients’ lives. I hope to work with you again soon. – GP-T
Sensory Adaptation to Silicone Hydrogel Contact Lens Wear Is Not Associated With Alterations in the Corneal Subbasal Nerve Plexus
The purpose of this study was to evaluate corneal subbasal nerve alterations in contact lens (CL)-naive silicone hydrogel CL wearers and to investigate the relationship between structural subbasal nerve changes with corneal sensitivity.
Twenty eyes of 20 neophyte daily silicone hydrogel CL wearers and 20 eyes of age-matched control subjects were recruited for this prospective longitudinal study. Corneal subbasal nerve densities were evaluated using in vivo confocal microscopy. Central corneal tactile sensitivity was measured using Cochet-Bonnet esthesiometers. In vivo confocal microscopy and Cochet-Bonnet esthesiometry were performed before and at the six-month time point after the initiation of CL wear. Two-way repeated measures analysis of variance, χ, and Wilcoxon signed-rank tests were used for statistical analyses.
The mean ages of CL users and control subjects were 21.8 years ± 1.8 years (range = 19 to 24 years) and 21.5 years ± 2.3 years (range = 20 to 24 years), respectively (P = 0.58). Compared with their baseline values, there were no significant changes at the six-month follow-up period in the mean total subbasal nerve fiber length (2266.6 ± 414.6μm/frame versus 2277.9 ± 405.0μm/frame; P = 0.43), mean total subbasal nerve branch density (10.4 ± 1.5 nerves/frame versus 10.5 ± 1.3 nerves/frame; P = 0.66), or the mean long nerve fiber density (4.7 ± 0.7 nerves/frame versus 4.8 ± 0.7 nerves/frame; P = 0.56) of CL users. Mechanical corneal sensitivity remained unaltered during the six-month period in CL users (11.2 ± 0.5 versus 11.2 ± 0.5; P = 1.00). No significant changes were observed in the subbasal nerve plexus or corneal tactile sensitivity of the control subjects during the study interval.
The researchers concluded that sensory adaptation to CL wear is not mediated through attenuation of the subbasal nerve or reduction of corneal tactile sensitivity in CL-naive users.
Kocabeyoglu S, Colak D, Mocan MC, Irkec M. Sensory Adaptation to Silicone Hydrogel Contact Lens Wear Is Not Associated With Alterations in the Corneal Subbasal Nerve Plexus. Cornea. 2019 Jun 19. [Epub ahead of print]