The 2019 Global Specialty Lens Symposium (GSLS) started this past Thursday with a bang! The preconference sessions were among the best attended to date, with tracks covering myopia management, practice management, keratoconus, and GP and scleral lenses. The meeting opened with a "controversies in contact lenses" point-counterpoint format that included discussion on controversies related to scleral contact lenses and myopia control. We look forward to covering the meeting in full in our April 2019 edition of Contact Lens Spectrum.
Jason J. Nichols, OD, MPH, PhD
Contamac Introduces HyClear
Contamac announced the introduction of HyClear, a hypochlorous acid 0.01% solution for daily eyelid health management. HyClear is a Class II medical device.
According to Contamac, HyClear has a broad antimicrobial spectrum that can kill most pathogens in as little as 15 seconds in a solution that provides a non‐irritating, non‐cytotoxic experience for the patient. Contamac says that HyClear also provides extended shelf life stability of up to 18 months. HyClear comes in a safe plastic bottle with a patient-friendly spray pump.
HyClear is currently available only in the United States.
Bausch + Lomb Introduces Zen Multifocal Scleral Lens for Presbyopia
Bausch + Lomb (B+L) introduced the Zen Multifocal scleral lens for presbyopia, which will be exclusively available with Zenlens and Zen RC scleral lenses through the company’s Specialty Vision Products unit. According to B+L, this lens will allow practitioners to fit presbyopic patients who have irregular and regular corneas as well as those who suffer from ocular surface disease, such as dry eye, with add power ranges from +1.00D to +3.50D in 0.25D steps.
Building upon the Zenlens and Zen RC scleral lens technology, the new Zen Multifocal scleral lens incorporates decentered optics, enabling the near power to be positioned over the visual axis, according to the company. The multifocal design also offers variable near zones from 1.5mm to 3.0mm in 0.5mm steps.
B+L says that with the Zen Multifocal design, eyecare practitioners can continue using the current Zenlens or Zen RC diagnostic sets when fitting patients.
Paragon Vision Sciences Selects Five U.S. Markets for Expansion
Paragon Vision Sciences, part of the CooperVision Specialty Eye Care division, is targeting five U.S. regions for expansion, citing rising eyecare professional (ECP) demand for myopia education and support. By mid-year, the company anticipates placing teams in Northern California, Southern California, New York/New Jersey, Houston/Dallas, and Phoenix. Each team will consist of an account manager and a practice management consultant.
Leading the effort is Anita Greggs Perez, who has been hired as Paragon’s U.S. Commercial Director. She has more than two decades of experience in launching and growing initiatives in medical device and healthcare channels, most recently serving as director, U.S. Sales and Marketing, for diagnostics manufacturer ACON Laboratories. Previously, she founded and managed National Launch Group, spearheading market introductions for multiple pharmaceutical, medical device, food, and mass market brands.
Tangible Science Launches Care System for Hydra-PEG Treated Lenses
Tangible Science, LLC launched its complete system of products for custom contact lenses coated with Tangible Hydra-PEG. Tangible Clean is a daily multi-purpose cleaning and disinfecting solution designed to protect the Tangible Hydra-PEG coating on custom contact lenses, while Tangible Boost is a monthly conditioning solution that the company says restores the Tangible Hydra-PEG coating and its benefits. Tangible Clean will be available in early 2019. Tangible Boost will be available later in the year, pending U.S. Food and Drug Administration clearance.
Coalition Drafts Letter to U.S. Surgeon General Regarding Vision Programs
Surgeon General Calls to Action are science-based summary documents intended to stimulate action nationwide to solve urgent public health problems, typically across multiple sectors. This Call to Action would be used to increase public awareness, improve surveillance, clarify the disability and financial cost from vision loss, help standardize public health and clinical practice, and, ultimately, ensure that all people enjoy the lifelong benefits of healthy eyes and clear sight.
Groups signing onto the letter include American Academy of Ophthalmology, American Academy of Optometry, American Optometric Association, The Association for Research in Vision and Ophthalmology, Casey Eye Institute, Dana Center for Preventive Ophthalmology, Dean McGee Eye Institute, Eye Bank Association of America, Himalayan Cataract Project, Hellen Keller International, Illinois College of Optometry, International Agency for the Prevention of Blindness- North America Region, International Eye Foundation, Lighthouse Guild, Lions Clubs International, National Alliance for Eye and Vision Research, Orbis International, Prevent Blindness, SEE International, SEVA Foundation, University of Utah-John A. Moran Eye Center, University of Rochester Medical Center, Vision Impact Institute, and Volunteer Optometric Services to Humanity International.
J&J Vision Launches Contact Lens Recycling Program in the United Kingdom
Johnson & Johnson Vision launched the Acuvue Contact Lens Recycle Programme, a free program in the United Kingdom that enables consumers to easily recycle their contact lenses and the blister and foil packaging after use. The program is available to all soft contact lens wearers regardless of which contact lens brand they use. The recycled materials will be turned into new products such as outdoor furniture and plastic lumber.
Consumers will have the option to either hav their contact lens material collected or to simply drop it off through a network of recycling bins at public drop-off locations at optical stores across the United Kingdom, including Boots Opticians Ltd. The goal is to provide more than 1,000 public drop-off recycling locations for contact lens waste across the United Kingdom.
Johnson & Johnson Vision is collaborating with TerraCycle to run the program. Contact lens wearers can check the Acuvue and TerraCycle websites for details on their nearest public drop-off location points or to recycle from home via courier collection.
Joe Garibaldi Appointed as Vice President of U.S. Sales at Optovue
Optovue promoted Joe Garibaldi to vice president of U.S. Sales, where he will continue to lead the U.S. sales force as well as identify new strategic partnering opportunities to grow the company’s U.S. product portfolio.
Mr. Garibaldi joined Optovue in 2009 as a territory manager, and he has been promoted into multiple leadership positions within the sales organization where he has led sales growth in both the optometry and ophthalmology markets. In recent years, he expanded the Optovue sales organization to commercialize the AngioVue optical coherence tomography angiography (OCTA) imaging system. Prior to joining Optovue, he was a sales manager for Ophthalmic Instruments. And, prior to that, he was a recruiter for Apex Systems.
If you practice myopia control using atropine, what percentage do you use?
This image shows a long-term keratoconus patient who has twin peaks of scarring. The patient was able to successfully wear a mini-scleral lens with all-day comfort.
We thank Mr. Ezekiel 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
Did you know that corneas are the most commonly transplanted tissue worldwide?1 Specifically, keratoconus, pseudophakic bullous keratopathy, Fuchs’ dystrophy, corneal scarring, and aphakic bullous keratopathy remain the primary indications for corneal transplants in the United States.2 High regular and irregular astigmatism following corneal transplant is common, and thus approximately 47% of patients require a contact lens to improve vision.3
Five classic postoperative configurations are typically described: prolate, oblate, mixed, asymmetrical, and steep-to-flat. The first three types typically show regular astigmatism, whereas the latter two show predominantly irregular astigmatism.4
A prolate-type graft will exhibit regular astigmatism and is steeper centrally and flattens toward the periphery, whereas an oblate graft is flatter centrally with a steep periphery. Regular astigmatism can also be observed throughout the entire topographic area in a mixed-shape graft. Irregular astigmatism is a dominant characteristic of both asymmetrical and steep-to-flat configurations. Similar to an asymmetrical bowtie, an asymmetrical graft is when two steep hemi-meridians are not displayed at 180º from each other with topography. Lastly, steep-to-flat will demonstrate a topographical pattern in which the steep hemisphere is adjacent to the flat hemisphere.
Regardless of the graft shape, each type can present its own challenges with respect to contact lens fitting.4,5 In any case, knowledge of graft shape can help guide practitioners in their initial lens selection.
1. Eye Bank Association of America. 2016 Eyebanking Statistical Report. Available at http://restoresight.org/wp-content/uploads/2017/04/2016_Statistical_Report-Final-040717.pdf. Accessed on Apr. 10, 2018.
2. Patel NP, Kim T, Rapuano CJ, Cohen EJ, Laibson PR. Indications for and outcomes of repeat penetrating keratoplasty, 1989-1995. Ophthalmology. 2000 Apr;107:719-724.
3. Geerards AJ, Vreugdenhil W, Khazen A. Incidence of rigid gas-permeable contact lens wear after keratoplasty for keratoconus. Eye Contact Lens. 2006 Jul;32:207-210.
4. Szczotka LB, Lindsay RG. Contact lens fitting following corneal graft surgery. Clin Exp Optom. 2003 Jul;86:244-249.
5. Schanzlin DJ, Robin JP. Corneal topography – Measuring and modifying the cornea. New York:Springer-Verlag; 1992:70-72.
MATERIALS & DESIGNS
David L. Kading, OD
I’m a Crash Test Dummy
Years ago, I was having lunch with my mentor during my residency. I asked him how he started to do speaking engagements and how he started writing. A major part of what I learned from him, in addition to fitting contact lenses, was how to get involved with our industry on a whole other level. Over the years, I have learned the importance of our industry partners. I’ve assisted them in getting what they need from practitioners, and I’ve learned what being a key opinion leader (KOL) really means in that it can help bridge the gap between industry and clinicians. Along these lines, many companies have great products, but they do not know how to bring those products to market. These companies may believe that their product does one thing and, as a clinician, I realize that that would be a waste of my time. As such, the last 10 years have allowed me to become a crash test dummy (of sorts) for the contact lens industry’s products and technologies … and it has been a blast.
I have seen products that should never have made it to my door and other products that are best sellers around the world. I have learned a lot about product development, marketing, and how (some) companies swindle their way to market to make a buck; fortunately, that doesn’t happen often because our amazing industry partners generally proceed with incredible integrity and the desire to truly help patients.
Rather than becoming clinicians, these companies devote themselves to supporting the eyecare practitioners who are in the exam room. I encourage all of you to work with your local and national/international industry partners. Ask them how you can help. Share that you would be happy to work with them on product development. See whether you can help them to be better so that they can help you to be better.
When we all have the best for patients in mind, the circle works. And to my friends in the industry, I just put my helmet back on—let’s crash some more!
A Randomized Trial to Evaluate the Effect of Toric Versus Spherical Contact Lenses on Vision and Eyestrain
The purpose of this study was to compare the effect of toric versus spherical soft contact lenses on objective measures of visual performance using visual acuity and electromyography of the orbicularis oculi muscle.
Current soft contact lens wearers who had –0.75D to –1.75D of astigmatism in each eye were binocularly fitted with toric (1-Day Acuvue Moist for Astigmatism, Johnson & Johnson Vision Care) and spherical (1-Day Acuvue Moist) contact lenses in random order. After each fitting and at a one-week follow-up visit, high- and low-contrast visual acuities were measured. Electromyography was used to objectively evaluate eyestrain. Linear mixed models were used to assess differences between toric and spherical contact lenses.
The mean age (±SD) of the 60 participants was 27.5 years ± 5.0 years, spherical refractive error was –3.68D ± 2.01D, and cylinder was –1.28D ± 0.36D. High- and low-contrast visual acuities with toric lenses were better than with spherical lenses at both fitting (toric high-contrast: –0.065 ± 0.078 and low-contrast: 0.133 ± 0.103 versus spherical high-contrast: 0.001 ± 0.104 and low-contrast: 0.224 ± 0.107) and follow up (toric high-contrast: –0.083 ± 0.087 and low-contrast: 0.108 ± 0.107 versus spherical high-contrast: –0.015 ± 0.095 and low-contrast: 0.211 ± 0.104) (all P < 0.0001). Electromyography-measured eyestrain was less with toric versus spherical contact lenses at fitting (least-square ratio of toric over spherical = 0.72; P = 0.0019) but not at follow up (ratio = 0.86; P = 0.11).
These results suggest that toric contact lenses provided improved objective measures of vision in a low-to-moderate astigmatic population.
Berntsen DA, Cox SM, Bickle KM, Mathew JH, Powell DR, Seidman SH, Little BK, Lorenz KO, Nichols JJ. A Randomized Trial to Evaluate the Effect of Toric Versus Spherical Contact Lenses on Vision and Eyestrain. Eye Contact Lens. 2019 Jan;45:28-33.