This is the time of year that our editorial team at Contact Lens Spectrum begins planning for our 2017 editorial calendar. As always, we solicit editorial ideas from our team of contributing editors, editorial staff, and trusted advisors, in addition to our readership. Please let us know if you have ideas for articles and content for next year. We look forward to hearing from you in this regard. Email us at firstname.lastname@example.org.
Alcon, a division of Novartis, introduces Dailies Total1 Multifocal contact lenses, the first and only contact lens with water gradient technology for patients with presbyopia, a condition that affects an estimated 84 million people in the United States. This innovative multifocal lens provides both seamless distant, intermediate and near vision, and the outstanding comfort of the Dailies Total1 water gradient lens technology, according to the company.
The Dailies Total1 water gradient technology reduces end-of-day dryness, as the water content approaches nearly 100% at the outermost surface of the lens. Per the company, the “hydrophilic” (water-loving) surface of the lens is almost as soft as the surface of the cornea (corneal epithelium) to enhance comfort, while the innovative optical design of this new multifocal lens offers a smooth progression of power designed to provide a seamless experience between distant, intermediate and near vision.
Dailies Total1 Multifocal contact lenses use Alcon’s Precision Profile lens design, a design also included in Alcon’s Air Optix Aqua and Dailies Aqua Comfort Plus multifocal contact lenses. These designs also share the same fitting process. One simplified fitting process for every Alcon Multifocal contact lens allows the eyecare practitioner to efficiently and successfully fit their presbyopic patients.
Dailies Total1 Multifocal contact lenses are recommended for daily wear in a daily disposable replacement schedule, for patients with presbyopia. The contact lenses are available with a power range of -6.00D to +3.00D (in 0.25 steps), with LO, MED, and HI add powers.
Dailies Total1 Multifocal contact lenses are commercially available in Australia, Canada, United States and Switzerland as of July 27 and are expected to be available in various EU countries by September 1.
The U.S. Food and Drug Administration (FDA) has approved Xiidra (lifitegrast ophthalmic solution) 5% from Shire plc, a twice-daily eye drop solution indicated for the treatment of the signs and symptoms of dry eye disease in adult patients. Xiidra is the only prescription eye drop indicated for the treatment of both signs and symptoms of this condition. Shire expects to launch Xiidra in the United States in the third quarter of 2016.
Xiidra is dosed twice per day, approximately 12 hours apart, in each eye. The safety and efficacy of Xiidra was studied in 1,181 patients (of which 1,067 patients received lifitegrast 5%) in four placebo-controlled 12-week trials. Each of the four studies assessed the effect of Xiidra on both the signs and symptoms of dry eye disease at baseline, week two, six and 12. Assessment of symptoms was based on change from baseline in patient reported eye dryness score (EDS; 0-100 visual analogue scale). Assessment of signs was based on inferior corneal staining score (ICSS; 0-4 scale). In all four studies, a larger reduction in EDS was observed with Xiidra at six and 12 weeks. In two of the four studies, an improvement in EDS was seen with Xiidra at two weeks. At week 12, a larger reduction in ICSS favoring Xiidra was observed in three of the four studies. The most common adverse reactions reported in 5 to 25 percent of patients were instillation site irritation, altered taste sensation (dysgeusia) and reduced visual acuity.
The inflammation associated with dry eye is thought to be primarily mediated by T-cells and associated cytokines. One effect of this process may be increased expression of intracellular adhesion molecule-1 (ICAM-1); ICAM 1 may be overexpressed in corneal and conjunctival tissues in dry eye disease. Lifitegrast is a small-molecule integrin antagonist that binds to the integrin lymphocyte function-associated antigen-1 (LFA-1), a cell surface protein found on leukocytes, and blocks the interaction of LFA-1 with its cognate ligand intercellular adhesion molecule‑1 (ICAM‑1). LFA‑1/ICAM‑1 interaction can contribute to the formation of an immunological synapse resulting in T‑cell activation and migration to target tissues. In vitro studies demonstrated that lifitegrast may inhibit T‑cell adhesion to ICAM‑1 in a human T-cell line and may inhibit secretion of inflammatory mediators (cytokines) in human peripheral blood mononuclear cells. The exact mechanism of action of lifitegrast in dry eye disease is not known.
The Educational Program Committee of the Global Specialty Lens Symposium invites the submission of abstracts for the Free Paper Section and the Scientific Poster Competition. Papers and posters related to presbyopia, keratoconus, corneal topography, post penetrating keratoplasty or related irregular corneal surface, myopia control, orthokeratology and lens care topics are welcome.
The GSLS will be held January 19-22, 2017 at The Rio Hotel in Las Vegas, Nevada. Visit www.GSLSymposium.com for more information. Web submissions only. Deadline for submissions is August 31, 2016.
Bausch + Lomb announced the introduction of its updated rebate website for its portfolio of contact lenses, offering patients and eyecare professionals a more streamlined user experience to obtain timely redemptions. The newly designed program will also make it possible for patients to use a portion of their rebate to directly support Optometry Giving Sight, a global foundation dedicated to preventing blindness and impaired vision. The site’s launch coincides with the introduction of a mail-in rebate offer for products across B+L’s contact lens portfolio.
The website works seamlessly on digital devices, including smartphones and tablets, and features an intuitive scan and upload functionality that provides patients with the options to complete and submit their rebate forms online or print and mail rebate submissions. These features allow users to more easily track rebates and redeem them up to two weeks faster. Patients will also have access to a customer service representative via live chat, e-mail or phone and can choose to donate part or their entire rebate to Optometry Giving Sight.
After receiving an eye exam, the mail-in rebate offer will save patients up to $130 on select B+L contact lenses, including Bausch + Lomb Ultra, Biotrue ONEday and SofLens daily disposable lenses. This offer will be valid from July 1 – December 31, 2016. For more information, patients can visit www.BauschRebates.com.
OCuSOFT Inc. announced its continued partnership with Prevent Blindness, the nation’s oldest volunteer eye health and safety organization. Prevent Blindness has declared August as Children’s Eye Health and Safety Awareness Month to inspire parents to make their child’s vision health a priority. To support children’s vision, OCuSOFT has agreed to donate 10 percent of all online sales to Prevent Blindness during August. The donation will go to support various children’s vision programs.
For information on children’s eye health and safety, the The National Center for Children’s Vision and Eye Health at Prevent Blindness, or eye care assistance programs, please call Prevent Blindness at (800) 331-2020 or visit preventblindness.org.
Langston Joins IDOC’s Prima Practice Management Team
IDOC announces the hire of Maddie Langston as Prima Practice Marketing Consultant. Langston will help members achieve success by creating customized marketing plans based on the practice’s specific needs. She brings extensive experience in marketing and sales administration and has developed strategies and platforms for small businesses in a variety of industries. Langston has the tools and expertise to help independent optometrists develop successful marketing programs that fit the needs of their business.
Some of the marketing tools and services Langston will deliver to members include:
Social media channel advice
How to maximize the practice website
Tips for video marketing on social media channels
Community outreach examples
In-office signage best practices
Advertising, printed materials and direct mail strategies
Event marketing programs (trunk shows, open houses)
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 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.
We all know that contact lens discomfort is the number one cause for patients’ dissatisfaction with their contact lenses. In fact, we know that most of our patients have stopped wearing their lenses by the time that they are in the 40s. We have looked long and hard to find ways to halt this dropout, and maybe the solution is the dropout. And by dropout I mean meibomian gland dropout. Meibomian glands are so critical to our tear film, and in our dry eye center we have been blown away by how often patients have gland dropout. Prior to having our meibographers, we knew gland dropout was present, we just didn’t realize how frequent it is.
Over the last three years we have started looking more diligently at contact lens wearers. First, we ensure that they are in the best lens possible. But in addition to that, we consider everyone to have dry eye disease until proven otherwise. We conduct a comprehensive evaluation of the flow of their meibomian glands using a meibomian gland evaluator to look to see if the glands are flowing. If we see any decrease in the oil flow, we bring them back for a comprehensive assessment which includes evaluating their meibography.
Regardless of the material that you are selecting, your patients with MGD will not be able to succeed long term in their contact lenses. Although selecting the proper material and design are critical to our success, perhaps we have to look at dropout more closely to really realize the true reason for the dropouts.
CARE SOLUTION CORNER Andrew D. Pucker, OD, PhD, FAAO
Optical Contact Lens Changes Associated with Care Systems
A primary goal of the contact lens practitioner is to provide their patients with contact lenses that allow them to see comfortably and clearly. We accomplish this by meticulously fitting our patients with their best contact lens option; we allow them to try their new contact lenses at home, and we evaluate our patients again at a follow-up visit to make sure that everything is still optimal. While most patients are happy after their real-world trial, some patients complain of poor comfort and/or vision.
Many factors could be at play when vision is the primary issue. Have you ever considered if a care system is having a negative impact on a contact lens’ optics? Lira et al. investigated this by analyzing how multipurpose and hydrogen peroxide solutions affect the refractive index of hydrogel and silicone hydrogel contact lenses; they found that both types of care systems were able to cause statistically significant changes in refractive index in most contact lens materials studied, changes that they attributed to induced contact lens water content changes.1 In a similarly designed study, Chiericati et al. found that both types of care systems were able to induce statistically significant changes in on-eye silicone hydrogel contact lens optical aberrations.2 In general, both studies found that multipurpose solutions had a greater effect on the optical properties of soft contact lenses than hydrogen peroxide solutions, though effects did vary by contact lens material.1, 2
While both studies found statistically significant optical changes, the differences between the changes from baseline and the between solution differences were small, and they are likely not visually significant. With that said, care system-contact lens combinations can have an impact on soft contact lens optics, and this issue should be considered when prescribing or designing new products.
1. Lira M, Franco S, Vazquez-Dorrio JB, Real Oliveira ME, Costa MF. Surface roughness and refractive index changes in contact lens induced by lens care systems. Eye Contact Lens 2014;40:140-147.
2. Chiericati S, Borghesi A, Cozza F, et al. Care System Versus Transmitted Light Wavefront Pattern of Contact Lenses. Eye Contact Lens 2016.
Lid Wiper Epitheliopathy in Soft Contact Lens Wearers
The goal of this study was to evaluate lid wiper epitheliopathy (LWE) in soft contact lens (SCL) wearers on initial presentation and after using various SCL and solution combinations.
LWE was assessed in 253 habitual SCL wearers who attended a screening visit at one of three study sites. LWE was assessed using lissamine green and sodium fluorescein dyes (Korb scale); a final LWE grade was calculated as the averaged LWE grade of the two dyes. Eligible habitual wearers continued into the four study periods, during which they wore one of three SCL types (etafilcon A, galyfilcon A, or senofilcon A) while using each of four care solutions for 10 to 14 days in randomized order. Statistical analyses were performed using linear mixed models, testing for differences in LWE for subject characteristics and between three multipurpose (MPS) test solutions (BioTrue, OPTI-FREE PureMoist, RevitaLens OcuTec) compared to a hydrogen peroxide (Clear Care) control solution.
LWE was present in 85% of habitual SCL wearers. LWE was not different for age (p = 0.28), sex (p = 0.99), race (p = 0.34), and comfort (p = 0.38) and not correlated with refractive error (r = 0.07). LWE was lower in habitual senofilcon A wearers (least-squares (LS) mean ± SE = 0.82 ± 0.19) compared to wearers of lotrafilcon B (1.34 ± 0.20; p < 0.02), comfilcon A (1.41 ± 0.21; p < 0.01), and other (1.18 ± 0.16; p < 0.03). Two hundred three participants completed all four study solutions with their assigned lens type; LWE was not different between the MPSs compared to the peroxide control solution across lens materials, except for less LWE for BioTrue (0.88 ± 0.17) versus Clear Care for participants wearing galyfilcon A (1.11 ± 0.18; p < 0.01).
The researchers concluded that on initial presentation, LWE was present in 85% of habitual wearers and found to be independent of age, sex, race, comfort, and refractive error but dependent on habitual SCL type. There were no clinically meaningful differences in LWE between the MPSs and hydrogen peroxide solution for the three lens types studied.
Schulze MM, Srinivasan S, Hickson-Curran SB, Berntsen DA, Howarth GF, Toubouti Y, Morgan P, Nichols JJ, Jones LW; Performance of Contact Lens Solutions Study Group. Lid Wiper Epitheliopathy in Soft Contact Lens Wearers. Optom Vis Sci. 2016 Jul 6. [Epub ahead of print]