Myopia and its management are without question one of the hottest topics in our field today. There are still many clinical and research questions to be answered, and we look forward to the Global Specialty Lens Symposium (GSLS) in 2020 where we will dedicate significant coverage to these topics.
As always, if you attended GSLS 2019, we’d love to hear your feedback on our program as we look forward to GSLS 2020.
Jason J. Nichols, OD, MPH, PhD
B+L Receives 510(k) Clearance for Use of Tangible Hydra-PEG on Some Boston Materials and Zenlens Lenses
Bausch + Lomb (B+L) has received 510(k) clearance for use of the Tangible Hydra-PEG contact lens coating technology with GP lenses manufactured in the Boston XO, Boston XO2, Boston EO, and Boston ES materials, including those utilized in the Zenlens scleral lens family.
AccuLens Announces New DAC Lathe with Laser Marking Capabilities
AccuLens announced the purchase of a new CNC computerized lathe with a high-performance laser with graphic and alpha-alpha-numeric software for engraving of logos, identification, and/or diagnostic marks on contact lenses. The markings will help practitioners with precise diagnostic evaluation and identification, according to AccuLens.
Eyenovia Announces FDA Acceptance of IND Application for MicroPine
Eyenovia, Inc. announced that the U.S. Food and Drug Administration (FDA) has accepted the company’s Investigational New Drug (IND) application for MicroPine, a topical treatment for progressive myopia. MicroPine is the company’s proprietary microdose formulation of atropine.
ABB Optical Offers Free Webinar Series
ABB Optical Group is offering a free webinar series focused on specialty contact lenses and practice development. Hosted by Craig W. Norman, the live webinar series will offer eyecare practitioners (ECPs) an opportunity to hear from renowned industry experts focused on training and topics that support successful treatment options and outcomes.
The series is free for all ECPs. Each class is from 9:00 p.m. to 10:00 p.m. The series includes:
March 7 – Scleral Lens Design and Fitting: The Basics, with Maria Walker, OD
June 13 – Getting the Most Out of Presbyopic Contact Lens Options, with Thomas Quinn, OD, MS
Sept. 17 – Strategies for Solving Contact Lens Complications, with Clark Chang, OD
Dec. 12 – Practice Management Tips for Billing and Coding to Build Your Specialty Contact Lens Practice, with Stephanie Woo, OD
Corey Crawford Named VP of Operations for RevolutionEHR
Rev360 has named Corey Crawford as its vice president of Operations for RevolutionEHR. Mr. Crawford was formerly the director of Product Management. Previously, he worked in product management for a variety of companies including AOL, MapQuest, and Gogo (in-flight internet).
Positive Impact (Sales) Ltd. to Distribute VTI’s NaturalVue Multifocal Lenses in the United Kingdom
Visioneering Technologies, Inc. (VTI) has selected Positive Impact (PI) as the company’s latest Authorized Distributor partner for the NaturalVue (etafilcon A) Brand 1 Day Contact Lenses. PI, based in Hastings, is a distributor of leading eyecare products and contact lenses throughout the United Kingdom.
Robert Warner Joins Euclid Board of Directors
Euclid Systems Corporation (Euclid) has announced the election of Robert Warner to its Board of Directors. Mr. Warner has 20 years of pharmaceutical and medical device experience. He most recently served as the Global Head for Alcon’s Vision Care Franchise, a cross-functional team responsible for strategy, innovation, pipeline, manufacturing strategy, and BD&L. He holds a Management M.B.A with a concentration in finance and a Bachelor of Science degree in chemistry. He currently sits on the ASCRS Foundation Board and was previously involved with The Glaucoma Foundation (2008 – 2010) and the Pan American Association of Ophthalmology (2010 – 2012).
Are scleral contact lenses impacting the rate of corneal transplants in your practice?
I prefer fitting large-diameter scleral lenses for ocular surface disease. But for this patient who was suffering from severe dry eyes secondary to Sjögren’s syndrome, I needed to fit a smaller lens to accommodate a large salivary gland transplant. This patient wears her lens comfortably for 12+ hours a day.
We thank Dr. Sotomayor 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.
S. Barry Eiden, OD
It’s a Dirty World Out There!
Contact lens wear remains a highly effective and safe means of vision correction worldwide. Yet, we realize that the ocular surface is a literal petri dish for microbes. It never ceases to amaze me that we don’t see many more cases of microbial keratitis and other forms of ocular infectious disease in patients who wear contact lenses (CLs). The ocular protective mechanisms are fantastic biological systems.
A recent study was published that assessed the microbiome adherent to contact lenses and defined the bacterial communities associated with the use of lens care solutions.1 In the study, 84 contact lenses were screened for an adherent ocular surface bacterial microbiome. Data were stratified by solution use (peroxide versus polyhexamethylene biguanide [PHMB]-preserved multipurpose solution [MPS]). Diversity of the lens-adherent microbiome was characterized using the Shannon diversity index and the richness index. Data were analyzed using principal components analysis and Kruskal-Wallis tests.
The researchers identified 19 phyla and 167 genera of bacteria adherent to the lenses. Proteobacteria was the most abundant phyla, followed by Firmicutes and Actinobacteria. The most abundant bacterial genera (> 1% abundance) were Ralstonia, Enterococcus, Streptococcus, Halomonas, Corynebacterium, Staphylococcus, Acinetobacter, Shewanella, Rhodococcus, and Cobetia. Of lenses that were negative for bacterial DNA, 80% were worn by participants using peroxide solutions, while only 20% were MPS-treated lenses (P = 0.004). Genera diversity of the lens-adherent microbiome showed a significant increase in MPS-treated lenses compared with peroxide (P = 0.038). Abundance of Corynebacterium, Haemophilus, and Streptococcus were increased 4.3-, 12.3-, and 2.7-fold, respectively, in the MPS group compared with peroxide (P = 0.014, 0.006, and 0.047, respectively).
The researchers concluded that although most contact lenses worn by asymptomatic wearers harbor bacterial DNA, lenses stored in a PHMB-preserved MPS have more quantifiable, abundant, and diverse bacterial communities adherent to them compared with peroxide.
This study reinforces thoughts that many of us in clinical contact lens practice share. First, there are just loads of microbes hanging out on or around our eyes. Contact lenses are somewhat like fly paper and have many of these bugs adhering to their surface. Second, peroxide-based care systems employed for reusable CLs significantly reduce the bioburden when compared to multipurpose care systems (even when both are properly utilized). Finally, given this "dirty world" contact lens environment, the reality is that the incidence of any serious or significant contact lens-associated infections is very low.
1. Retuerto MA, Szczotka-Flynn L, Mukherjee PK, et al. Diversity of Ocular Surface Bacterial Microbiome Adherent to Worn Contact Lenses and Bacterial Communities Associated With Care Solution Use. Eye Contact Lens. 2019 Feb 1. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
New Year, New Look
In light of the report of the Dry Eye Assessment and Management (DREAM) study, here is more data regarding omega-3 acid supplementation for dry eye disease. The purpose of a recent meta-analysis was to assess whether omega-3 fatty acid (FA) supplementation is more efficacious compared to placebo in amelioration of signs and symptoms of dry eye disease.
In a systematic literature search in PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, randomized clinical trials comparing omega-3 FA supplementation with placebo in patients who have dry eye disease were evaluated. The outcome measures were dry eye symptoms, tear breakup time (TBUT), Schirmer’s test, and corneal fluorescein staining.
Seventeen randomized clinical trials involving 3,363 patients were included. Compared with placebo, omega-3 FA supplementation decreased dry eye symptoms and corneal fluorescein staining, whereas it increased the TBUT (standardized difference in mean value [SDM] = 0.905; 95% confidence interval [CI], 0.564-1.246; P < 0.001) and Schirmer’s test values.
This meta-analysis provides evidence that omega-3 FA supplementation significantly improves dry eye symptoms and signs in patients who have dry eye disease. Therefore, these findings indicate that omega-3 FA supplementation may be an effective treatment for dry eye disease.
1. Giannaccare G, Pellegrini M, Sebastiani S, et al. Efficacy of Omega-3 Fatty Acid Supplementation for Treatment of Dry Eye Disease: A Meta-Analysis of Randomized Clinical Trials. Cornea. 2019 Jan 29. [Epub ahead of print]
Prevention and Management of Myopia and Myopic Pathology
Myopia is fast becoming a global public health burden with its increasing prevalence, particularly in developed countries. Globally, the prevalence of myopia and high myopia (HM) is 28.3% and 4.0%, respectively, and these numbers are estimated to increase to 49.8% for myopia and to 9.8% for HM by 2050 (Note: Myopia is defined as –0.50D or less, and HM defined as –5.00D or less). The burden of myopia is tremendous, as adults who have HM are more likely to develop pathologic myopia (PM) changes that can lead to blindness.
Accordingly, preventive measures are necessary for each step of myopia progression toward vision loss. Approaches to prevent myopia-related blindness should therefore attempt to prevent or delay the onset of myopia among children by increased outdoor time; retard progression from low/mild myopia to HM through optical (e.g., defocus incorporated soft contact lens, orthokeratology, and progressive-addition spectacle lenses) and pharmacological (e.g., low dose of atropine) interventions; and/or retard progression from HM to PM through medical/surgical treatments (e.g., anti-VEGF therapies, macula buckling, and scleral cross-linking). Recent clinical trials aiming for retarding myopia progression have shown encouraging results.
In this research, the authors highlighted recent findings on preventive and early interventional measures to retard myopia and current and novel treatments for PM.
Saw SM, Matsumura S, Hoang QV. Prevention and Management of Myopia and Myopic Pathology. Invest Ophthalmol Vis Sci. 2019 Feb 1;60(2):488-499.