As noted in the results of this month's Quick Poll, it appears as though most practitioners (62%) feel that their patients are more likely to purchase daily disposable soft lenses online, compared with other soft lens wearing modalities. This is an interesting contrast to when we asked this question five years ago. At that time, practitioners felt more mixed about daily disposables and online sales, and only 48% of practitioners felt that daily disposable lens wearers were more likely to purchase their contact lenses online (http://www.cltoday.com/issues/CLToday_012013.htm). With alternative online distribution channels for soft lenses, it will be important to follow this trend to verify its veracity.
Jason J. Nichols, OD, MPH, PhD
Johnson & Johnson Vision Expands Parameters of 1-Day Acuvue Moist Lenses for Astigmatism
Johnson & Johnson Vision announced the U.S. launch of expanded parameters for 1-Day Acuvue Moist Brand Contact Lenses for Astigmatism, a daily disposable contact lens that offers patients Blink-Stabilized Design for clear, stable vision and Lacreon Technology that provides a cushion of moisture for long-lasting comfort, according to the company. The lenses also provide Class II UV protection, blocking approximately 82% of UVA and 97% of UVB rays.
Full parameters now include around-the-clock coverage (in 10° steps) in low-minus powers (plano to -6.00D in 0.25D steps) across -0.75D, -1.25D, and -1.75D cyl; against-the-rule and with-the-rule coverage (in 10° steps) in low-minus powers for -2.25D cyl; against-the-rule and with-the-rule coverage (in 10° steps) in high-minus powers (-6.50D to -9.00D in 0.50D steps) across -0.75D, -1.25D, and -1.75D cyl; and against-the-rule and with-the-rule coverage (in 10° steps) in plus powers (+0.25D to +4.00D in 0.25D steps) across -0.75D, -1.25D, and -1.75D cyl.
Johnson & Johnson Vision will launch expanded parameters of 1-Day Acuvue Moist Brand Contact Lenses for Astigmatism through its operating company, Johnson & Johnson Vision Care, Inc.
CooperVision Creates Specialty Eye Care Business Unit
CooperVision, Inc. has announced the creation of its Specialty Eye Care business unit. Dr. Juan Carlos Aragón has been named president of the business, effectively immediately.
The new Specialty Eye Care business currently encompasses Soflex, Procornea, and Paragon Vision Sciences, which design and manufacture highly specialized contact lenses for the management of myopia and other indications. These organizations will continue to operate independently, yet share technical, clinical, and commercial knowledge while benefitting from CooperVision's global presence and infrastructure.
An industry veteran, Dr. Aragón has three decades of experience in general management, professional services, sales, marketing, and business development. Since joining CooperVision in 2000, and has held senior roles in the Americas, Europe, and Asia Pacific. Most recently, he was responsible for overseeing the company's Southern & Central European Commercial Operations. He previously served in leadership positions with Ocular Sciences, Ciba Vision, and Bausch + Lomb.
SynergEyes Expands into Daily Disposables with Tangible Science and Expands Duette Progressive Hybrid Line
SynergEyes announced a new partnership with Tangible Science. The expansion of this partnership adds daily disposable soft contact lenses to the SynergEyes contact lens portfolio. The new partnership combines the branding and operational support of SynergEyes with lenses that incorporate the polymer technology from Tangible Science, which will be incorporated into the disposable lens material and in the lens packaging. The new line of SynergEyes soft contact lenses will be introduced later in 2018.
In unrelated news, SynergEyes, Inc. expanded its Duette Progressive hybrid line with the addition of a customizable Center Distance contact lens. The new design has Center Distance FlexOptics, with an adjustable center distance zone size ranging from 1.8mm to 4.0mm, is driven by photopic pupil size and has add powers from +0.75D to +5.00D. The Duette Progressive line now offers hybrid lenses customizable for the continuum of presbyopia, even for those with astigmatism, according to the company.
BCLA Names Luke Allen as Student Rep
The British Contact Lens Association (BCLA) added a new council member, who will be tasked with "representing the leaders of the future." Luke Allen, a 25-year-old optometrist who qualified two years ago, has been unveiled as the association's official student representative. Mr. Allen, who specializes in contact lenses in his job at Winchester independent Rawlings, will sit in on all council meetings and discuss new ways of engaging with younger members and students. Currently, BCLA's student resources include an annual Fitting Skills Day, which gives delegates the chance to get hands-on experience of fitting contact lenses and improving their confidence.
Do you think daily disposable contact lens wearers are more likely to purchase their contact lenses online compared with other soft lens-wearing patients?
Andrew M. Vo, OD, Anaheim, CA
This patient presented at our clinic for a contact lens examination after wearing his current scleral lenses for five years. The annular-patterned deposits were first noticed on the front lens surface after sodium fluorescein (NaFl) instillation, which led to the yellow coloration. Organic material tends to absorb NaFl more readily; therefore, the deposits were most likely protein in composition. The debris accumulated between the limbal curve and landing zone, a common deposition area due to its abrupt junction. An enzymatic GP lens cleaner was utilized to remove the deposits after multipurpose solution was unsuccessful.
We thank Dr. Vo 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
Should We Be Concerned About Preservatives in Drops Used with Bandage CLs?
The use of bandage contact lenses has assisted in the management of pain and in promoting healing in many cases we see in clinical practice. The use of concomitant eye drops for antibiotic, anti-inflammatory, and lubrication purposes often is done with preserved preparations. There is always a concern regarding the uptake of these preservatives and the potential for induced deleterious side effects.
A recent study looked at the effects of ophthalmic solutions on a silicone hydrogel bandage lens material.1 Silicone hydrogel contact lenses are commonly used as bandage lenses and are often combined with ophthalmic solutions in the treatment of ocular diseases. Concerns have been raised regarding the compatibility and effect of eye drop solutions on the bandage lenses. Some patients experience pain or discomfort during treatments, and the accumulation of drugs and preservatives in lenses has been suggested as a possible reason.
The aim of this study was to investigate the effect of ophthalmic solutions on the silicone hydrogel bandage lens material senofilcon A in vitro and in vivo. The effect of three common ophthalmic solutions—Isopto-Maxidex (Alcon Laboratories, Inc.), Timosan (Santen Pharmaceutical), and Oftaquix (Santen Pharmaceutical)—on Acuvue Oasys (Johnson & Johnson Vision) bandage lenses was evaluated.
An in vitro model method was developed in which drug and preservative uptake by Acuvue Oasys was monitored with ultraviolet-visible spectroscopy and laser desorption ionization mass spectrometry. Surface morphology changes of the lenses were evaluated using scanning electron microscopy. The method was then implemented for the in vivo pilot study evaluating lenses worn by patients.
The authors reported that, with in vitro model study monitoring, the drug and preservatives uptake showed that the active ingredients from all of the eye drops together with preservatives were taken up by the lenses in significant amounts. For the in vivo study, no traces of active ingredients or preservatives could be found on the worn and treated lenses regardless of time being worn or dosage profiles. The surface morphology changes in the in vivo study were also minor in contrast to the changes observed in the in vitro scanning electron microscopy images.
The authors concluded that the in vivo results demonstrate minor effects of the ophthalmic solutions on the worn lenses. These results do not support the building up of preservatives and drugs on the contact lenses as the cause of pain or discomfort experienced by some patients, which is encouraging for the use of bandage lenses in combination with ophthalmic solutions.
1. Erdal NB, Adolfsson KH, De Lima S, Hakkarainen M. In vitro and in vivo effects of ophthalmic solutions on silicone hydrogel bandage lens material Senofilcon A. Clin Exp Optom. 2018 Jan 11. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
File This Under "Not Surprising, but Interesting"
A recently published study aimed to determine the association between blepharitis and keratoconus.1 In this prospective, comparative, observational study, 50 keratoconus patients underwent comprehensive eye examination; 72 healthy medical personnel of similar ages were randomly chosen as a control group.
The signs and symptoms of blepharitis in each participant were assessed. A thorough survey of the eyelids (scales and foam on the eyelashes, missing eyelashes, and expression of meibomian gland contents) was performed. All participants were required to complete two questionnaires—the Ocular Surface Disease Index questionnaire and a questionnaire regarding symptoms, signs, and risk factors for blepharitis.
Blepharitis was more common in keratoconus participants than in the control group (p < 0.001). A higher proportion of keratoconus participants reported rubbing their eyes more than once a day (p = 0.002) as well as red and tired eyes (p = 0.009). On external eye examination, signs of blepharitis and meibomian gland dysfunction were found more frequently in the keratoconus group (p < 0.05).
The authors concluded that signs and symptoms of blepharitis occur more often in keratoconus participants than in healthy individuals. Blepharitis-related inflammation and associated eye rubbing may contribute to disease progression.
1. Mostovoy D, Vinker S, Mimouni M, Goldich Y, Levartovsky S, Kaiserman I. The association of keratoconus with blepharitis. Clin Exp Optom. 2017 Dec 12. [Epub ahead of print]
Assessment of Clinical Trials for Devices Intended to Control Myopia Progression in Children
This review looked at previous key studies and discussed study design and regulatory issues relevant to future clinical trials.
The increased prevalence of myopia in the United States and other regions of the world, and the sight-threatening problems associated with higher levels of myopia, have led to great interest in research designed to reduce these rates. As most of the progression of myopia occurs in childhood, these investigations have been directed toward slowing the progression of myopia in children. Treatments described to potentially slow the progression of myopia have included pharmacological interventions, multifocal spectacles, and multifocal correction created by contact lenses.
Although some contact lens clinical trials have demonstrated promising results in slowing the progression of myopia, many of these studies have significant limitations, including only short follow-up times, limited randomization, and incomplete masking. Such limitations have underscored the need to develop a more robust clinical study design, so that future studies can demonstrate whether contact lenses, as well as other medical devices, can be used in a safe and effective manner to control myopia progression.
Robboy MW, Hilmantel G, Tarver ME, Eydelman MB. Assessment of Clinical Trials for Devices Intended to Control Myopia Progression in Children. Eye Contact Lens. 2018 Jan 15. [Epub ahead of print]