In less than two weeks, we are set to kick off our 11th annual Global Specialty Lens Symposium in Las Vegas (www.gslsymposium.com). As always, the meeting is packed with a plethora of information for contact lens practitioners at every level. We hope you are able to attend, but will cover the full meeting in depth in an upcoming edition of Contact Lens Spectrum.
Jason J. Nichols, OD, MPH, PhD
Bausch + Lomb Ultra for Presbyopia Parameters Expanded
Bausch + Lomb announced that Bausch + Lomb Ultra for Presbyopia contact lenses are now available in an expanded parameter range. Since the contact lenses first launched in February 2016, Bausch + Lomb Ultra for Presbyopia lenses have been available in parameters between –7.00D to +2.00D. The expansion extends the power range available to +4.50D to –10.00D (in 0.25D steps) in both low add and high add. Additional parameters are expected later this year.
Bausch + Lomb Ultra for Presbyopia contact lenses, monthly replacement silicone hydrogel lenses, combine the company’s MoistureSeal technology with the 3-Zone Progressive design also found in Biotrue Oneday for Presbyopia daily disposable contact lenses.
CooperVision Begins Rollout of Avaira Vitality Toric
CooperVision, Inc. announced the beginning of its limited rollout of Avaira Vitality toric. The lens is the latest addition to the new Avaira Vitality family, which was first introduced last summer with the launch of Avaira Vitality sphere lenses.
Made from a new silicone hydrogel material (fanfilcon A), Avaira Vitality toric delivers a higher water content (55%) and high level of oxygen permeability and transmissibility. UV protection has also been improved to Class I. In addition, a uniform horizontal ISO thickness improves lens stability and reduces rotation and a large toric optic zone provides clear visual acuity, according to the company. An optimized ballast toric design provides a stable, comfortable fit, while its smooth, continuous ballast maximizes comfort during eyelid interaction.
Avaira Vitality toric is available in a power range of plano to –6.00D with cylinder options of 0.75D, 1.25D, and 1.75D in axes from 10° to 180° in 10° steps. They have a modulus of 0.6MPa, a DK of 90, and a Dk/t of 90. The base curve is 8.5mm and the diameter is 14.5mm. Plus powers, high minus powers, and a –2.25 cylinder will be available later in 2017.
Paragon CRT Contact Lenses Approved by CFDA
Paragon Vision Sciences announced China Food and Drug Administration (CFDA) approval and commercial availability of its corneal reshaping/orthokeratology brand, Paragon CRT Contact Lenses, in China.
Essilor China will serve as the exclusive distributor for Paragon CRT Contact Lenses in China. The lenses will be widely available to eye care practitioners within the next few months.
Don’t Miss the Live Scleral Lens Manufacturing Demonstration at the GSLS!
The 2017 Global Specialty Lens Symposium will be held January 26-29, 2017 at the Rio Hotel in Las Vegas. This year the GSLS is co-locating with the Contact Lens Manufacturers Association (CLMA) annual meeting!
With the co-location of these two meetings, attendees will have several opportunities in the GSLS exhibit hall to watch the live fabrication of scleral, corneal, multifocal, and toric GP lenses from start to finish. For any practitioner who has not been able to see this process with their respective CLMA labs, this is a great chance to see how your specialty GP lenses are manufactured.
The GSLS is a must-attend meeting, brought to you by Contact Lens Spectrum, focusing on the successful management of ocular conditions using today’s specialty contact lenses. The meeting includes insightful presentations by international experts in the field, hands-on demonstrations of cutting-edge products and valuable continuing education credits.
LensFerry S Expands to Include All Contact Lens Modalities
EyeCare Prime, a subsidiary of CooperVision, Inc. announced that LensFerry S has expanded to include all modalities, bringing the convenience of automatic monthly payments and quarterly or semi-annual contact lens deliveries to a broader spectrum of patients while maintaining a central role for the eye care professional (ECP).
When it launched in April, the subscription-based ordering service focused specifically on one-day contact lenses. With today’s announcement, LensFerry S includes monthly, two-week, and one-day lenses from multiple manufacturers at ECP’s specified prices. When patients enroll in the service, the annual cost of their lenses is divided into automatic monthly payments and they receive a three- or six-month supply of lenses, depending upon modality. The prescribing practice receives the sales revenue as if the lenses had been paid for in-office.
LensFerry S is available to all eye care practices in the United States. It costs $49 per month, plus $2.50 per shipment. For every completed patient annual subscription through LensFerry S, EyeCare Prime makes a donation to Optometry Giving Sight for an eye exam.
AOSA Elects 2017-2018 Officers
Andy Mackner has been elected the 50th president of the American Optometric Student Association (AOSA). A third-year optometry student at Pacific University College of Optometry, Mackner chairs AOSA’s Advocacy Committee. He holds a bachelor’s degree in biology from Concordia College.
Other elected officers who will begin their terms in March include:
* Vice President Melissa Zaleski of Nova Southeastern University. She holds a bachelor’s degree in biobehavioral health from Penn State University.
* Secretary Jodi Baker of the University of Alabama at Birmingham School of Optometry. She holds a bachelor’s degree in biomedical sciences from Auburn University.
* Treasurer Jon Beeson of Inter American University of Puerto Rico. He holds a bachelor’s degree in biology from Arizona State University.
In other AOSA business, the board approved creation of a National Liaison to the Ocular Nutrition Society. And, Ana Bonaldi of MCPHS University and Alyssa Drew of Michigan College of Optometry, were elected to represent the AOSA in the American Optometric Association House of Delegates.
AccuLens Announces 2017 Scleral Warranty Program
AccuLens Inc. announces a licensing agreement with Tangible Science LLC. The alliance enables AccuLens to offer Tangible Hydra-PEG, a polymer coating on The Maxim, Comfort SL, and EasyFit lenses.
In unrelated news, effective Jan. 1, 2017, AccuLens is offering a new warranty program on Maxim, EasyFit, and Comfort SL scleral lenses. All scleral designs will enjoy a six-month warranty that includes one free exchange and a nominal material fee thereafter, as well as a turnkey digital marketing program for all practice partners.
Daniel G. Fuller, OD, Memphis, TN
In 2011, this female patient received laserpexy 360 degrees for lattice OD (not shown) and multiple surgeries for retinal detachment repair OS. Silicone oil is known to cause band keratopathy (seen here). She had not replaced her OD trial lens, which she had received elsewhere, since 2011. EDTA chelation with superficial keratectomy was performed, but recurrences such as seen here are common. Her visual acuity was 20/25+ OD with a CooperVision Proclear lens with a power of –16.00D, a base curve of 8.6mm, and an overall diameter of 14.2mm. Visual acuity OS was light perception. She declined a second superficial keratectomy with EDTA.
We thank Daniel G. Fuller 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
Beyond Visual Acuity Outcomes with Multifocal Contact Lenses
Simultaneous vision multifocal contact lens designs have the advantage of not being gaze dependent in order to achieve near vision, however inherent in these designs is the interplay between the distance and near power arrays. The result is a negative impact on vision quality due to straylight that often is not measured with traditional visual acuity testing.
A recent study was published that attempted to investigate the effect of multifocal contact lenses on disability glare by means of ocular straylight.1 A prospective randomized, comparative study was performed that included 16 subjects free of ocular pathology. Straylight was measured using a commercial straylight meter with the natural and dilated pupil. Participants were fit with CooperVision’s Proclear Multifocal (Distance/Near), Johnson & Johnson Vision Care, Inc.’s ACUVUE Oasys for Presbyopia, and Alcon’s Air Optix Aqua Multifocal randomized to the left or right eye. Straylight measurements were repeated with the contact lens in situ after the pupil dilation.
Results obtained with the dilated pupil without contact lens acted as a control. Results found that the diameter of the natural and dilated pupil was 2.87mm ± 0.40mm and 7.45mm ± 0.86mm, respectively (P < .001). After pupil dilation, straylight increased from 0.92 log(s) ± 0.13 log(s) to 1.04 log(s) ± 0.11 log(s) (P < .001). Of the studied lenses, a significant difference was only found between Air Optix and the control group (P = .006). The latter showed also slightly increased light scatter. The authors concluded that a difference in measured straylight was found between the studied multifocal lenses. The observed variability and the straylight-pupil size dependency should be taken into account to avoid elevated straylight in multifocal contact lens wearers. The reason for the observed differences in straylight must be the subject of future studies.
Those of us that fit patients in multifocal contact lenses are well aware of the fact that these lenses impact vision beyond visual acuity measures. We often see patients who achieve acuity outcomes that typically would be considered excellent, yet they report to us that their vision quality is poor. One of the causes is glare and light scatter, which is quite common in simultaneous multifocal designs. We should continue to look at clinically applicable diagnostic tests that can quantify these factors and incorporate them into our contact lens multifocal diagnostic armamentarium.
1. Łabuz G1, López-Gil N, van den Berg TJ, Vargas-Martín F. Ocular Straylight with Different Multifocal Contact Lenses. Optom Vis Sci. 2016 Dec 22. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Cataract Surgery, Ocular Discomfort, and Mom
In the course of my career, my mother has been the impetus for many article topics. Today, I was once again wondering about something related to my mom.
My mother is a very tough “old bird.” Nothing much related to physical injury phases her—not blood, burns, bites, bruises, nor bunions. For my mom, these are no problem.
Today, my mother had cataract surgery on her second eye. Last month, when the first eye was done, she happily (repeatedly) told me that she had “no pain.” There was no comment to her vision. None. Nada. Zero. Zippo. Zilch. Successful surgery, as defined by my mother (and, frankly, many other patients) is no post-operative discomfort.
Today, however, was different. Today, my mom was uncomfortable after her surgery. Today, I was asked if everything went well during the procedure. Today, I was queried if her eye looked OK. Today, my mom had concern and uneasiness after surgery.
As we all agree, transient discomfort after cataract surgery is not uncommon. Yet, discomfort is the gauge by which patients measure their ocular health. Although disturbed, my mom understood and accepted my explanation for her aches after surgery.
This made me think of the challenge we face with our ocular surface disease patients who suffer chronic, and sometimes debilitating, ocular sensation. Certainly, we have a lot to learn about chronic pain and dry eye.
And, while you’re at it, check out this interesting read: Vehof J, Sillevis Smitt-Kamminga N, Nibourg SA, Hammond CJ. Predictors of Discordance between Symptoms and Signs in Dry Eye Disease. Ophthalmology. 2016 Dec 23. [Epub ahead of print]
Trends in Corneal Transplantation in Keratoconus
A study was conducted to determine recent trends in, and socio-demographic/comorbid conditions associated with, penetrating keratoplasty (PK) and lamellar keratoplasty (LK) for keratoconus.
Patients with keratoconus and subsequent PK and LK procedures were identified using International Classification of Diseases, 9th revision (ICD-9) and Current Procedural Terminology (CPT) billing codes. The change in surgical rates was calculated over a decade, and multivariate analysis demonstrated factors associated with undergoing surgery.
During the study period, a total of 21,588 patients with keratoconus underwent 1306 PK procedures and 109 LK procedures. Individuals were significantly less likely to undergo PK from 2009 to 2012 compared with 2001 to 2008 (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.47-0.68, P < 0.001). Multivariate analysis revealed the factors that increased the likelihood of PK alone. These factors included age 20 to 40 (OR 1.90, 95% CI, 1.19-3.04, P < 0.001), black race (OR 1.36, 95% CI, 1.06-1.74, P = 0.01), and education less than a bachelor's degree or only a high school diploma (OR 1.94-2.84, P < 0.001 for all comparisons). Female sex (OR 0.74, 95% CI, 0.63-0.88, P < 0.001) and household net worth either between $150,000 and $249,000 (OR 0.64, 95% CI, 0.48-0.84, P < 0.001) or more than $500,000 (OR 0.71, 95% CI, 0.51-0.99, P = 0.03) were traits associated with decreased odds of PK. No significant associations for LK were observed.
The study concluded that the rate of PK in keratoconus is decreasing in the United States. However, it also noted that the third or fourth decade of life, male sex, black race, lower education, and greater household net worth are associated with increased odds of PK.
Sarezky D, Orlin SE, Pan W, VanderBeek BL. Trends in Corneal Transplantation in Keratoconus. Cornea. 2017 Feb;36:131-137.