Most practitioners are very excited about the opportunities afforded by specialty contact lenses, and there is certainly excitement in the field about the expanding options available in this regard. There is always hope that, by fitting any new contact lens design or material, vision and physiological response will be improved. Unfortunately, there is always the chance for a potential complication that was not expected.
For example, scleral contact lenses have tremendous benefits for many patients who otherwise cannot successfully wear contact lenses. However, scleral contact lenses are not without their own potential complications, albeit somewhat infrequent. The figure below shows the relative frequency of complications as noted by the respondents of our December Quick Poll.
Jason J. Nichols, OD, MPH, PhD
CooperVision Acquires Blanchard Contact Lenses
CooperVision has acquired Blanchard Contact Lenses, Inc. Founded in 1986, Blanchard has operations in Sherbrooke, Canada and in Manchester, NH and employs approximately 70 people. As with CooperVision’s other specialty businesses, it will retain its name and will continue to operate as a separate yet complementary organization. Customers should continue to work with their current representatives. The acquisition includes Blanchard’s U.S. and Canadian entities.
Art Optical Introduces Spare Lens Discount Program
Art Optical introduced a spare lens purchasing program for Ampleye scleral lenses. With the spare lens program, practitioners prescribing Ampleye lenses are eligible to purchase duplicate-parameter lenses at a 25% savings within 45 days of their patients’ final Rx order. The savings may be passed on to the patient, in part or in full, to help defray the cost of maintaining a backup pair of Ampleye lenses.
According to the company, the Ampleye spare purchasing option helps eyecare practitioners and patients avoid the panic of emergency rush orders, and it ensures that patients are not without their necessary devices in the event of accidental lens loss or damage.
ABB Optical Group Manufacturing GP Lenses in Contamac Materials with Tangible Hydra-PEG Coating
ABB Optical Group announced that its specialty lens lab has been approved by Contamac to manufacture GP contact lenses in the Optimum line of GP materials with Tangible Hydra-PEG (Tangible Science)-surfaced coating technology.
ABB Optical is offering customers one pair of Hydra-PEG coatings through Jan. 31, 2019. Costs of lenses still apply. Hydra-PEG is only available for lenses manufactured in Contamac materials.
AccuLens Announces Toric PC Maxim Scleral Lens Sets Now Available
AccuLens announced the availability of Maxim Toric PC trial lens sets as of Jan. 1, 2019. In response to growing demand for scleral lens fittings that have haptic toric design options, AccuLens now offers the Maxim 12-lens set in 15.9mm and 16.4mm diameters with ± 200μm toricity.
Vyzulta Approved in Canada by Nicox’s Partner
Nicox SA announced that its partner (Bausch + Lomb) has received approval in Canada of Vyzulta (latanoprostene bunod ophthalmic solution), 0.024%. Vyzulta is indicated for the reduction of intraocular pressure (IOP) in patients who have open-angle glaucoma or ocular hypertension.
The U.S. Patent and Trademark Office has issued a notice of allowance to complement the 12 patents already issued to Innovega Inc. The recently allowed patent, titled “Contact Lens and Method and Systems for Constructing a Contact Lens,” claims the ability to supply the required oxygen to the cornea when the lens contains components that are not oxygen permeable.
Innovega is currently conducting a round of financing with New York-based SeedInvest for the purpose of completing its Phase III U.S. Food and Drug Administration clinical investigations for the iOptik and eMacula contact lenses.
The family of Innovega patents claim systems and methods for coupling eye-borne optics with display eyewear in pursuit of two goals: eliminating the need to wear a heavy, cumbersome apparatus; and delivering a panoramic field of view rather than the narrow field that’s inherent with conventional waveguided optics. Innovega’s latest patent allowance adds to one allowed in mid-2018 that claimed methods for regulating water vapor transmissibility while maintaining oxygen transmissibility in ultra-high-oxygen-permeable lens materials. Both patents were filed by inventors and scientists Jerome Legerton, William Meyers, and Jay Marsh.
Registration Open for 2019 BCLA Conference
Registration is now open for the 2019 British Contact Lens Association’s (BCLA) Clinical Conference and Exhibition, which is scheduled for May 30 to Jun. 1. The flagship event is returning to Manchester and will feature a new hashtag for 2019 of #AlwaysLearning. Highlights of the three-day program include keynote speakers Professor Lyndon Jones from the University of Waterloo in Canada, who is the 2019 Medal recipient, and Dr. Nicole Carnt, who will present the Irving Fatt Memorial Lecture.
Alcon and CooperVision are Partner Sponsors for the event, while Johnson & Johnson Visioncare is a Platinum Sponsor, Menicon is a Gold Sponsor, and Topcon is the Technology Sponsor.
For more information or to register, visit www.bcla.org.uk. Early bird pricing closes on Mar. 31.
National Optometry Hall of Fame Begins Accepting Nominations for 2019
Optometry Cares—The AOA Foundation has begun accepting online nominations for the 2019 National Optometry Hall of Fame. Nominations may be submitted through Feb. 12. This year’s inductees will be honored at Optometry’s Meeting, which is scheduled for June 19 to 23 in St. Louis. Administered by Optometry Cares—The AOA Foundation, the National Optometry Hall of Fame recognizes and honors luminaries of the profession for their long-lasting contributions to optometry in the areas of academia or private practice/federal services.
Nominees should be those eyecare practitioners who have advanced the profession and demonstrated their dedicated service, lifetime achievement, and enduring legacy. Nominations must be submitted online and must include PDF versions of a nominee’s curriculum vitae and a minimum of two letters of support. To view the complete eligibility requirements and/or to access the online nomination form, visit http://www.aoafoundation.org/halloffame.
Kala Pharmaceuticals Launches Inveltys
Kala Pharmaceuticals announced the launch of Inveltys (loteprednol etabonate ophthalmic suspension) 1%, a twice-daily ocular corticosteroid indicated for the treatment of postoperative inflammation and pain following ocular surgery. Kala also announced the hiring of a specialty ophthalmology sales organization. Inveltys, which was approved by the U.S. Food and Drug Administration in Aug. 2018, is now in national and regional U.S. pharmaceutical distribution centers, and patients have access to Inveltys through their local retail pharmacies.
**NEW** Download the GSLS App
Among the exciting additions to the Global Specialty Lens Symposium in 2019 is a mobile app that attendees can use onsite to create a personal agenda, map out visits to their favorite exhibitors, provide feedback, interact with speakers and sessions, and more! Download the app on the Google Play Store or the App Store by searching "PentaVision Conferences," then log in using your registered email address and the universal password, gsls2019 (case-sensitive)
Tom Arnold, OD, Sugar Land, TX
Forgetting to turn the room lights off when taking pictures at the slit lamp leads to unwanted reflections. Sometimes, however, the unexpected result is very interesting. The parallel or "plano" post-lens tear reservoir in this scleral lens is clearly defined.
We thank Dr. Arnold 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
Doc, I’m Seeing Rainbows!
Believe it or not, there is potential for some of your patients to see rainbows. This phenomenon known as Sattler’s veil is due to corneal edema.1 Patients will state that they see a full rainbow around a point of light and have hazy vision. There are several causes for corneal edema, but in the setting of contact lenses, it may be beneficial to review.
Corneal edema can result from several causes within the cornea or can be exacerbated by a contact lens. The cornea itself may be susceptible due to decreased cell density in the corneal endothelium. Patients who have undergone surgical intervention—such as a corneal transplant, vitreous or retinal surgery, or procedures for cataract and glaucoma—can also increase the rate of reduction.2-5
Patients who have dry eye disease are also susceptible to a decline in endothelial density. It is estimated that between 400 to 700 cells/mm2 are needed in the corneal endothelium to maintain proper corneal transparency; however, this number must be increased to compensate for oxygen deprivation under a contact lens.6 Studies have shown that soft lenses and GP lenses accelerate the decline of the corneal endothelium density faster compared to age-related decline.7-9 However, to date, there is no clear estimation of the ideal corneal density with scleral lens wear, and further studies are warranted to determine the impact of scleral lenses on corneal cell density. In any case, if a patient presents with a chief complaint of seeing rainbows, it’s due to edema. Now both you and your patient can determine the next best course of action.
1. Barnett, M. The right fit for the irregular cornea, smooth things over with scleral lenses. Rev Optom. 2017 Aug 15. Available at https://www.reviewofoptometry.com/article/the-right-fit-for-the-irregular-cornea-smooth-things-over-with-scleral-lenses. Accessed on Jan. 8, 2019.
2. Friberg TR, Doran DL, Lazenby FL. The effect of vitreous and retinal surgery on the corneal endothelial cell density. Ophthalmology. 1984 Oct;91:1166-1169.
3. Brooks AM, Gilles WE. Effect of angle closure and surgical intervention of corneal endothelium. Cornea. 1991 Nov;10:489-497.
4. Writing Committee for the Cornea Donor Study Research Group; Lass JH, Benetz BA, Gal RI, et al. Donor age and factors related to cell loss 10 years after penetrating keratoplasty; specular microscopy ancillary study. Ophthalmology. 2013 Dec;120:2428-2435.
5. Kaufman HE, Baron BA, McDonald MB. Cornea. 2nd Edition. Butterworth-Heinemann. Boston 1998.
6. Klyce SD, Beuerman, et al. Structure of function of the cornea. In Kauffmann HE, Barron BA, McDonald MB, eds. Cornea, 2nd Edition. Butterworth-Heinemann. Boston, 1998.
7. Caldwell DR, Kastl PR, Dabezies OH, Miller KR, Hawk TJ. The effect of long term hard lens wear on corneal endothelium. Contact Intraocul Lens Med J. 1982 Apr-Jun;8:87-91.
8. Setälä K, Vasara K, Vesti E, Ruusuvaara P. Effects of long term contact lens wear on corneal endothelium. Acta Ophthalmol Scand. 1998 Jun;76:299-303.
9. Lee JS, Park WS, Lee SH, Oum BS, Cho BM. A comparative study of corneal endothelium changes induced by different durations of soft contact lens wear. Graefes Arch Clin Exp Ophthalmol. 2001 Jan;239:1-4.
MATERIALS & DESIGNS
David L. Kading, OD
What Happens in Vegas …
We are only weeks away from the 2019 Global Specialty Lens Symposium (GSLS). Every year, GSLS pulls out something new and takes on a new look and feel. This year will be no different.
With international speakers, we will get a worldwide perspective on specialty lenses and management of some of the most rewarding cases. I love hearing practitioners—both those who practice on the other side of the globe as well as those who practice next door to me—share how they manage the same types of patients that I see. It brings a newness to what I do. Whether it is validating the treatment that I am doing or it brings a new perspective, it makes me better.
At some points during the conference, I may even hear a speaker with whom I wholeheartedly disagree, and that is awesome too. It challenges me to look at the way that I am reading the literature, looking through the slit lamp, and discussing things with patients.
One of my favorite parts of GSLS is the exhibit hall, but not for the reasons that you might think. Although I love walking around and meeting all of the vendors that make me look like a hero, I love chatting with colleagues and getting to know what they are up to. You never know when you might pull up next to a stranger at a standing round (that’s a tall table where you eat the delicious food that GSLS always has that is included as part of the registration) and discover that he or she has the largest contact lens practice in Denmark.* Your new Danish friend might share that one tip that has made him or her grow and become more successful. In passing, you might share something that you have learned that is the very thing that he or she needed to hear at the meeting. That is the beauty of the global aspect of this meeting.
If you have not been to the meeting in the last, I don’t know, say 12 months, it is time to book your trip to Vegas. Because when it comes to specialty lenses, what you learn in Vegas never stays in Vegas.
*If you have the largest contact lens practice in Denmark, please look for me. I’ll be looking for you and will gladly buy you a drink at the free bar in the exhibit hall.
The Role of Soft Contact Lens Wear on Meibomian Gland Morphology and Function
The purpose of this study was to evaluate the impact of soft contact lens (CL) wear on the morphology and function of the meibomian glands (MGs).
One hundred seventy-three eyes of 87 soft CL wearers and 103 eyes of 55 age-matched healthy volunteers were included in this study. The patients were divided into three groups according to the total duration of lens wear: less than three years, three to seven years, and more than seven years. Ocular Surface Disease Index (OSDI) scores, slit lamp biomicroscopy findings, fluorescein staining of the ocular surface, tear film breakup time (TBUT), Schirmer I test, and meibography findings were recorded in all patient eyes and were compared with controls.
The mean meiboscores of the upper and lower eyelids were significantly higher in CL wearers compared with controls (P < 0.05). The mean TBUT and the mean MG expressibility were significantly lower, whereas the mean OSDI score, corneal staining scores, percentage of partial/complete gland loss, and percentage of thickened and curled MGs in upper/lower lids were statistically significantly higher in CL wearers (P < 0.05). Meiboscores were significantly higher in patients who had a total lens wear duration of more than three years compared to those who had less than three years of lens wear for both upper/lower lids (P < 0.05). The earliest morphological change in the MGs of CL wearers was MG thickening, and this parameter was the only meibography finding that had the highest diagnostic ability for MG dysfunction.
The authors concluded that soft CL wear causes significant morphological and functional changes in MGs, with thickening of MGs presenting an early diagnostic finding of MG dysfunction on meibography.
Uçakhan Ö, Arslanturk-Eren M. The Role of Soft Contact Lens Wear on Meibomian Gland Morphology and Function. Eye Contact Lens. 2018 Dec 28. [Epub ahead of print]