There is no doubt that we have become a data-driven world. There few days that go by without mention of this—“metrics,” “big data,” “analytics,” and “precision medicine” are all words I read or hear almost every day. It is also well known that we are generating data at exponential rates—and at all levels including personal, corporate, institution, and governmental. While scary to some, there is tremendous potential in harnessing this data to improve things like security, education, healthcare, and our business decisions, among many other things. Of course, that’s true in the field of contact lenses as well, with significant potential technologies on the perhaps not-so-distant horizon.
Jason J. Nichols, OD, MPH, PhD
Menicon Launches Rose K2 Soft in the United States
Menicon America, Inc., Menicon’s U.S. subsidiary, announced the availability of the Rose K2 Soft contact lens design for the irregular cornea. Dr. Paul Rose, inventor of the Rose K family of lens designs for the irregular cornea led the development of the new Rose K2 Soft lens.
The new Rose K2 Soft design is a daily wear silicone hydrogel soft lens for irregular corneas, available as a three-month replacement lens. The primary indications are intolerance to GP lenses, new contact lens wearers with irregular corneas, early to moderate irregular corneas, or conditions where the environment may be unsuitable for GP wear or where a GP lens may be unstable, such as sport.
The Rose K2 Soft design features an aspheric back optic zone, front surface toricity, and front surface aberration control for optimal visual acuity, according to the company. Additionally, Rose K2 Soft offers precise edge lift control, prism ballast stabilization, and reverse geometry for a trouble-free fit.
Rose K2 Soft is available now in the United States from ABB Optical, Art Optical Contact Lens, Inc., and Blanchard Contact Lens.
Essilor and Luxottica to Merge
Essilor and Delfin announced the signing of an agreement designed to create an integrated player dedicated to visual health and superior consumer experience through a combination of Essilor and Luxottica Group. Luxottica has a portfolio of proprietary eyewear brands, operates a retail and wholesale network in both developed and emerging markets, and has e-commerce platforms. Essilor provides a full array of ophthalmic spectacle lenses as well as custom contact lenses. Leveraging its cutting-edge methods, Essilor also has developed new approaches in the sunwear segment and online retail.
Essilor would become a holding company with the new name EssilorLuxottica via a hive-down of all of its operating activities into a wholly owned company, to be called Essilor International, and the contribution by Delfin of its Luxottica shares. Together, Luxottica and Essilor would have more than 140,000 employees and sales in more than 150 countries. Based on the companies’ 2015 results, the new company would have posted combined net revenues of more than 15 billion euro and combined net EBITDA of approximately 3.5 billion euro.
Luxottica’s Executive Chairman, Leonardo Del Vecchio, will serve as executive chairman and CEO of EssilorLuxottica. Essilor Chairman and CEO, Hubert Sagnières, will serve as executive vice-chairman and deputy CEO of EssilorLuxottica with equal powers as the chairman and CEO. They will also keep their positions of executive chairman of Luxottica and chairman and CEO of Essilor International, respectively.
According to reports, no operational changes will occur until the transaction is completed and logistics are worked out over the coming one to three years.
Contamac Ltd Announces U.S. Launch of Tangible Hydra-PEG
Contamac Ltd, manufacturer of the Optimum line of GP materials, announced the official U.S. launch of Tangible Hydra-PEG at this year's Global Specialty Lens Symposium, which will take place Jan. 26-29 in Las Vegas.
Available on Optimum Comfort (Dk 60), Extra (Dk 100), and Extreme (Dk 125), Tangible Hydra-PEG is a novel contact lens coating technology that encapsulates the Optimum GP material in an ultra thin layer of a PEG-based polymer (polyethylene gylcol), creating a lens surface that is extremely wettable and lubricious.
To date, six specialty contact lens laboratories now offer Tangible Hydra-PEG coating on their lens designs: AccuLens, Advanced Vision Technologies, Art Optical Contact Lens, Metro Optics, TruForm Optics, and X-Cel Specialty Contacts.
4 Days Until GSLS 2017
The 2017 Global Specialty Lens Symposium (GSLS) will be held January 26-29, 2017 at the Rio Hotel in Las Vegas. 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.
The Registration Desk will open Wednesday, January 25 from 3:00 p.m. - 6:00 p.m., and will reopen on Thursday, January 26 at 7:30 a.m.
Bausch + Lomb (B+L)’s Specialty Vision Products (SVP) business has introduced the Zen RC Scleral Contact Lens. The lens is specifically designed to fit normal corneas and features SmartCurve technology, which simplifies the fitting process by giving eyecare professionals the ability to modify to the desired parameters, according to the company.
The Zen RC is available with sagittal depth range of 3500 to 5000 in 10 micron steps. Available diameters are 14.8mm and 15.4mm. Lens powers range from +20.00D to –20.00D. The Advanced Peripheral System can be in Steep-10 through Steep-1, Standard, and Flat-1 through Flat-10 (in 30 micron increments). Other lens options include: toric peripherals curves, a flexure controlling profile, custom center thickness, front toric prescriptions, and MicroVault. The Zen RC scleral lens can be customized to nearly any parameter, though fitting within the standard parameters should be adequate for most patients. Toric peripheral curves, customized center thickness, flexure controlling profiles, and front toric prescriptions can also be ordered when needed.
Additionally, B+L SVP announced the addition of Karen Slaughter to its sales team. Ms. Slaughter’s appointment is part of an effort to align the B+L SVP sales territories, as she will be responsible for growing the Western United States region, while increasing B+L’s fitter base for the specialty lens market.
She brings more than 20 years of sales experience in the contact lens industry, with previous senior roles at Ocular Sciences and CooperVision.
Management Additions at Shire
Shire Ophthalmics announced that Sushanta Mallick has joined the Ophthalmics team as vice president and global development lead for Clinical Development, Ophthalmics. He brings more than 20 years of experience in ophthalmology research and development. Most recently, he worked at Aerie Pharmaceuticals as VP, Clinical Research/Glaucoma. Prior to that, he was VP R&D at QLT Inc. Vancouver where he led the R&D activities of the company and directed the development of oral synthetic retinoid as an orphan drug in inherited retinal diseases—LCA and RP. He was also with Alcon for 19 years where he held various positions.
Additionally, Christie Markowitz was appointed as the senior director and ECP Marketing Lead for Shire Ophthalmics. She will report to Vic Noble, vice president and head of Marketing for Ophthalmics. In this role, she will lead the ECP Marketing Team and the professional educational and marketing endeavors for the Ophthalmics franchise. Most recently, she served as the ECP launch lead for Xiidra (lifitegrast ophthalmic solution) 5% and executional rollout to the market. She was also lead for the ECP launch of the disease state awareness campaign, eyelove and www.myeyelove-ecp.com.
Art Optical Adds New Technology to Specialty Contact Lens Portfolio
Paragon Vision Sciences and Art Optical have renewed their long-standing relationship resulting in lower Paragon material prices and a long-term commitment to continued leadership of Paragon CRT distribution services and practice management support. New lower prices on Paragon HDS, Paragon HDS 100, and the FluoroPerm family of GP lens materials become effective Jan. 25, 2017. Art Optical has also extended its CRT distribution agreement with Paragon and will continue serving existing CRT practitioners, welcoming newly certified CRT fitters, and offering CRT practice management support.
Additionally, through a sublicense agreement with Contamac, Art Optical is one of the first U.S. laboratories to offer the new Hydra-PEG coating technology. Tangible Hydra-PEG, the FDA-approved polymer coating from Tangible Science, LLC, is now available from Art Optical exclusively on Optimum GP materials. Hydra-PEG will be available on Art Optical’s complete suite of specialty lens designs, including the Ampleye Scleral and Renovation Multifocal product lines.
Sergina M. Flaherty, COMT, OSC, San Antonio, TX
This image shows a pretty impressive nuclear cataract.
We thank Sergina M. Flaherty 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.
CARE SOLUTION CORNER
Andrew D. Pucker, OD, PhD
Contact Lenses and Cold Weather
It is January, and most of the United States is in the thick of winter. It was recently -1°F in my hometown, and my employer, the University of Alabama at Birmingham, closed for extreme winter weather. Bad weather may affect your practice too. Obviously, the cold weather may prevent your patients from keeping their appointments. But, it could even affect the questions your patients ask. For instance, does cold weather affect contact lenses?
Temperature does have the potential to affect contact lens fit. This fact is highlighted by a pair of studies by Young and colleagues, who compared the diameter and modulus of contact lenses at room temperature and at ocular surface temperature (~36°C).1,2 They found that the diameter of non-silicone hydrogel soft lenses and silicone hydrogel soft lenses generally decreased with increasing temperature; decreases ranged from 0.04mm to 0.69mm.1,2 Higher water content soft lenses generally shrank in diameter more than lower water content soft lenses. Therefore, the shrinkage is likely related to water loss, though it is also likely due to the material itself; it is important to note that decreases in diameter can “steepen” curvature of the lens on the eye, reducing movement and tightening the fit.2
Young et al also found that, in general, higher temperatures resulted in lower modulus values for silicone hydrogel contact lenses while temperature had a non-significant effect on the modulus of conventional hydrogel contact lenses.1
Since the majority of soft contact lenses have a diameter of about 14.00mm and the population has a number of patients who have a corneal diameter near 14.00mm, the on-eye diameter of a contact lens may change from an acceptable value to an unacceptable value after the contact lens has settled and reached eye temperature.1,2 This highlights the need to let contact lenses settle on the eye before dispensing them.
With that said, patients exposing their contact lenses to extreme winter temperatures should not have a clinically significant change in their contact lens fit because cooler temperatures may actually increase a contact lens’ diameter. Cold, arid environments have also been found to have a minimal affect on contact lens dehydration; thus, you can advise your patients that cold weather should have a minimal effect on the fit of their contact lenses, and they should be able to wear them as normal while braving inclement weather.3
1. Young G, Garofalo R, Peters S, Harmer O. The effect of temperature on soft contact lens modulus and diameter. Eye Contact Lens. 2011 Nov;37:337-341.
2. Young G, Potts M, Sulley A. The Effect of Temperature on Soft Contact Lens Diameter. Eye Contact Lens. 2016 Sep;42:298-302.
3. Morgan PB, Efron N, Morgan SL, Little SA. Hydrogel contact lens dehydration in controlled environmental conditions. Eye Contact Lens. 2004 April;30:99-102.
MATERIALS & DESIGNS
David Kading, OD
I Cringe at the Phoropter: The Moderate Astigmate
Do you cringe like I do when the refracting patients and the cylinder dial keeps going up and up, and you end up landing on –3.00? I do. I know that my standard lenses really don’t go much higher than –2.25 cylinder. Fortunately, two-week, monthly, and daily disposables go this high…but now I find myself wrapped up in a bit of an enigma. Do I compromise their vision to keep them in a less expensive lens (which they may want) or do I move them over to a custom lens?
Having had this problem several times, I have had to try to figure out how I am going to act (especially when they are referred in or have struggled to find lenses in the past). My conclusion is like I always state: Consider the patient’s health first, vision second, and pocketbook last when making my recommendations.
Health: We have some great monthly as well as custom lenses. Vision: I need to make sure that I am correcting as much of the refractive error as possible and ensure that the lens’ correction and vision fit like a glove. Pocketbook: I want to look for the best option for my patient and share with them that their correction is outside of the bell curve and that they may need to pay a little more in order to maximize their vision.
With individuals with higher amounts of cylinder, we can’t afford to have a lens decenter or rotate much. For that reason, we carefully observe their corneal size and Ks. If either of these is even slightly outside of normal, we will call up our fantastic consultants at any of the custom soft lens laboratories and share our patient’s information with them. They can then help design a lens that will be stable by having a proper diameter-to-base-curve relationship.
Getting the proper power and just as importantly the proper fit, brings about success for our high cylinder patients.
Conjunctival impression cytology evaluation of patients with dry eye disease using scleral contact lenses
This prospective interventional case series study evaluated conjunctival impression cytology and HLADR expression changes after wearing scleral contact lenses for moderate to severe dry eye disease (DED).
In the study, 41 eyes from 25 patients with moderate to severe DED were evaluated for Esclera (Mediphacos) scleral lens treatment. Best-corrected visual acuity (BCVA) and slit-lamp findings were assessed. Impression cytology specimens were obtained from DED patients at the baseline and after wearing scleral lenses for 12 months. The impression cytology specimens were analyzed using morphological results score, and HLA-DR positive cells were detected and quantified. The values were compared to assess the IC changes after wearing sclerals.
The underlying diseases found in the study subjects were Stevens-Johnson syndrome (22 eyes), Sjögren’s syndrome (11 eyes), graft-versus-host disease (two eyes), dry eye after keratomileusis (two eyes) and undifferentiated ocular surface disease (four eyes). The HE-PAS impression cytology score did not differ significantly before and after wearing the scleral lenses for 12 months in DED patients (p > 0.05). The percentage of eyes expressing the HLA-DR antigen in the temporal conjunctiva after wearing sclerals for 12 months significantly increased in patients with Sjögren’s syndrome (11.11% to 66.66%; p = 0.0498). In groups with Stevens-Johnson syndrome and other ocular surface disorders, the study authors did not observe statistically significant differences (p > 0.05).
The authors concluded that the scleral lenses did not change the parameters used to evaluate inflammatory processes, which were measured using conjunctival impression cytology and HLA-DR expression, except in Sjögren’s syndrome, in which there was an unexpected increase in HLA expression.
Weber SP, Hazarbassanov RM, Nasaré A, Gomes JÁ, Hofling-Lima AL. Conjunctival impression cytology evaluation of patients with dry eye disease using scleral contact lenses. Cont Lens Anterior Eye. 2017 Jan 6. [Epub ahead of print]