It seems like more and more often, we are hearing reports about corneal cross-linking and its beneficial effects of slowing the progression of keratoconus. Although many reports are promising, it is important to remember that this is a procedure that isn’t without complications. Albeit infrequent, those complications can include delayed re-epithelialization, corneal haze, sterile infiltrates, scarring, post-operative infection, and endothelial issues. We do not yet have a full understanding of predictors for complications, so careful selection of patients to undergo the procedure is critical.
Jason J. Nichols, OD, MPH, PhD
FTC to Host Contact Lens Rule Workshop
The Federal Trade Commission (FTC) announced that it would host a free, public workshop at the Constitution Center in Washington, DC, on March 7 to further explore contact lens marketplace competition, consumer access, prescription release and portability, and other contact lens-related subjects. The workshop is being held in conjunction with the Commission’s regulatory review of the Contact Lens Rule.
The workshop will cover topics including consumers’ ability to comparison shop for contact lenses; the use of electronic health records, patient portals, and other technology to improve prescription portability; the interaction between the Contact Lens Rule and emerging telehealth business models; the potential for new technology to improve the prescription verification process; and modifications to the Rule to foster competition and maximize consumer benefits, including benefits to eye health.
New Jersey Finalizes Patient Access Measure
On Jan. 8, A-2336 was signed into law by former New Jersey Governor Chris Christie. The bipartisan legislation includes prohibitions on requirements that doctors participate in a vision plan as a condition for contracting with a health plan; restrictions or limitations on doctors’ choice of materials, services, or optical labs provided to a patient; and requirements on noncovered services and materials.
Chicago College of Optometry Welcomes New Dean
Kathleen H. Goeppinger, PhD, president and CEO of Midwestern University, announced the promotion of Melissa Suckow, OD, to dean of the Chicago College of Optometry (CCO). Dr. Suckow joined Midwestern University in 2015 and has served as CCO’s associate dean of Academic Affairs for the past year.
Previously, Dr. Suckow was an assistant professor at the New England College of Optometry. In 2011, she joined the clinical faculty of the Illinois College of Optometry and was a preceptor for third- and fourth-year students on rotation at the Illinois Eye Institute at Princeton School.
As dean of the Chicago College of Optometry, Dr. Suckow will provide guidance and leadership for CCO, which welcomed its inaugural class in the fall of 2017.
ForEyes Optical Launches Healthy Eyes
For Eyes Optical, a division of GrandVision NV, has launched Healthy Eyes, a savings program that aims to provide affordable, quality eye care to patients by tailoring its offerings to organizations and companies. Those organizations and companies can sign up for Healthy Eyes and receive benefits such as 10% off eye exams, 30% off complete frames and lenses, 20% off conventional contact lenses, 10% off disposable contact lenses, 10% off sunglass frames, and 10% off accessories. Healthy Eyes will become a regular offering for businesses at all For Eyes retail locations and online at www.foreyes.com/HealthyEyesSavingsPlan.
EyeGate Pharmaceutical Promotes Sarah Romano
EyeGate Pharmaceuticals, Inc. announced the promotion of Sarah Romano from interim CFO to CFO. Ms. Romano joined EyeGate in 2016, serving as corporate controller. She was promoted to interim CFO on Feb. 1, 2017. Prior to joining EyeGate, Ms. Romano served as assistant controller at TechTarget and corporate controller at Bowdoin Group, a healthcare-focused executive recruiting firm. Previously, she held financial reporting positions of increasing responsibility at SoundBite Communications until its acquisition by Genesys in 2013, and she was a senior financial reporting analyst at Cognex Corporation.
Brent Rasmussen Joins Opternative
Opternative, Inc. announced that Brent Rasmussen has joined the company as CEO and as a member of the Board of Directors. Rasmussen recently served as CEO at Halo Group and previously was COO and president, North America, at CareerBuilder.
NovaBay Receives Stockholder Approval for Proposed Financing Agreement
NovaBay Pharmaceuticals, Inc. announced stockholder approval to issue NovaBay common stock as part of a $10.32 million financing agreement with Ch-gemstone Capital (Beijing) Co., Ltd. The vote was announced at a special meeting of stockholders held Dec. 20, 2017.
On Nov. 20, 2017, NovaBay entered into an agreement with Ch-gemstone Capital (Beijing) Co., Ltd. to purchase 2.4 million shares of NovaBay common stock for $10.32 million. The private placement was expected to close in January 2018, subject to the satisfaction of certain closing conditions, including approval for funds transfer by the applicable regulatory authorities in China.
Art Optical Celebrates Milestone Anniversary
Art Optical's theme for 2018 is "Experience the Legacy of Excellence" as it kicks off of its 60th year in custom contact lens manufacturing and design; the company's contact lens legacy began in 1958 under the direction of Thomas Anastor. Its year-long 60th anniversary celebration will begin at the Global Specialty Lens Symposium in Las Vegas this week, with giveaways and promotions on its latest product introductions. Special events and savings opportunities will continue throughout 2018.
Your Interesting Case Photo Here in the Next Issue
Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in Contact Lenses Today in the coming weeks!
We 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.
CARE SOLUTION CORNER
Andrew D. Pucker, OD, PhD
Contact Lens Recycling by the Numbers
In the Nov. 19, 2017 Contact Lenses Today issue,1 I provided a summary of how wearing contact lenses (CLs) impacts the environment (comparable to ~15 cans of soda per year).2 While wearing CLs results in a relatively small environmental footprint, some patients may still be weary of generating non-biodegradable materials, but they may find comfort in recycling some of their products. Nevertheless, it may not be clear to them what CL-associated products are accepted by their local recycling facility.3
The bulk of soft CL-associated materials are either paper/cardboard (packaging) or plastics (solution bottles, blister packs); there is also a small amount of metal in some products (CL case, CL blister packs).2 After reviewing the recycling criteria for major cities such as Chicago, I have found that recycling facilities typically accept most clean paper, cardboard, and aluminum products.4
Plastic recycling is slightly more complex, because there are many types of plastics.3 Specifically, there are seven plastic categories, which are often listed on the product: 1. polyethylene terephthalate (PET), 2. high-density polyethylene (HDPE), 3. polyvinyl chloride (PVC), 4. low-density polyethylene (LDPE), 5. polypropylene (PP), 6. polystyrene (PS), and 7. other.3 A survey of my practice found CL products made of plastics 1 through 5 and 7. Thankfully, all but category 6 plastics are accepted by most recycling facilities.3 Small pieces of plastic, like CLs, are not accepted by most facilities because they can clog their machines, though one contact lens manufacturer has developed a CL-specific recycling program that can accept these products.
Therefore, if you have environmentally conscious patients, you can ease their worries by educating them that much of their CL-associated materials can be recycled.3 Regularly educating your patients about medical waste recycling could also remind your patients about recycling other types of products, which could help protect the Earth for future generations.3
Ya know those low-plus patients who are just starting to get frustrated with their presbyopia? We need to sympathize with them; they have had it pretty good their entire lives. Now, their vision is going down the drain. Their accommodation system is not only failing them with their near vision, but they are noting decreased clarity of vision at distance, especially in the evening.
Some of these patients are hypercritical of their vision. They might be the patients whom you would never consider fitting with multifocal soft lenses. You may even hesitate to suggest progressive addition glasses to them. Other patients are far less critical of their vision.
They don't like what this presbyopia condition is doing to them, but they grin and bear it. What do these patients want more than anything else? Laser-assisted in situ keratomileusis (LASIK). They just want to get away from wearing glasses and contact lenses and have heard that LASIK will solve all of their vision problems. They desire to be free from having to hassle with lenses, and they have never had to look “old” by wearing glasses.
Enter orthokeratology (ortho-k). Yes, that’s right, we can do hyperopic ortho-k. This treatment works very well for patients who are not excessively critical of their vision. The outcome that we desire is a more intense aspheric shape that we create by steepening the cornea. The treatment is most successful with a well-centered zone of steepening. Not only do we create a hyperopic correction, but we also induce an add due to the new shape that we make on the cornea. Realize that you are inducing some additional aberrations, which will cause some new negatives for the patients’ vision. However, with the proper patient selection, they will not be overly bothered by this change.
Hyperopic ortho-k is an excellent option for low hyperopes. At first, the treatment may not be intuitive. If this is the case, I suggest that you consult with your laboratory prior to doing a fitting and consult with them on your case. Happy Fitting.
Corneal Collagen Cross-Linking with Riboflavin and Ultraviolet A Light for Pediatric Keratoconus: Ten-Year Results
The purpose of this study was to assess the 10-year follow-up efficacy and safety of riboflavin ultraviolet A-induced cross-linking (CXL) in a population of pediatric patients aged 18 years and younger who have progressive keratoconus (KC).
The prospective longitudinal cohort study included 62 eyes of 47 keratoconus patients undergoing epithelium-off CXL who completed 10 years of follow up. The surgical procedure was performed in all patients according to the Siena (Dresden modified) protocol. Evaluation included uncorrected distance visual acuity (VA), corrected distance visual acuity, Scheimpflug corneal tomography, and optical coherence tomography demarcation line measurement. Follow-up measurements taken up to 10 years after treatment were compared with baseline values, and statistical analysis was performed using a two-tailed paired sample Student t test.
Uncorrected distance VA and corrected distance VA improved from 0.45 to 0.23 logarithm of the minimum angle resolution (P = 0.0001) and from 0.14 to 0.1 logarithm of the minimum angle resolution (P = 0.019). KC stability was recorded after 10 years of follow up in nearly 80% of the patients. The overall 10-year follow-up progression rate was 24%, including 13 eyes of nine patients with Kmax progression greater than one diopter and two eyes of two patients who underwent corneal grafting.
The study demonstrates the ability of CXL to slow down KC progression in pediatric patients, improving functional performance. Long-term stability may be correlated with CXL-induced delay in corneal collagen turnover and with spontaneous age-related KC stabilization. A 24% regression rate could be contemplated in the patients who were aged 15 years and younger at the time of inclusion in the treatment protocol.
Mazzotta C, Traversi C, Baiocchi S, Bagaglia S, Caporossi O, Villano A, Caporossi A. Corneal Collagen Cross-Linking with Riboflavin and Ultraviolet A Light for Pediatric Keratoconus: Ten-Year Results. Cornea. 2018 Jan 9. [Epub ahead of print]