As you can see from our monthly poll (below), 58% of respondents feel that having contact lens materials with a low coefficient of friction is key in reducing contact lens discomfort (followed by low modulus, deposit resistance, and oxygen permeability). What is more interesting is how this distribution has changed over the last six years.
When we asked this same question in April 2011, 33% of respondents reported that low coefficient of friction helps with contact lens discomfort, followed by deposit resistance (32%), high oxygen permeability (21%), and low modulus (14%).
Thank you to everyone who responded to our poll this month, and please look for more interactive monthly polls going forward.
Jason J. Nichols, OD, MPH, PhD
Shire Appoints Boyd as Director, Market Development
Shire announced that Joe Boyd has joined the Ophthalmics team as director, Market Development. In this role, Mr. Boyd will lead the Market Development team, which will work closely with thought leaders, key opinion leaders, and teaching institutions to further Shire’s commitment to eye health. Additionally, he will play an integral part in marketing and engagement strategies.
Mr. Boyd has more than 20 years of experience in the pharmaceutical and medical device industry, where he played a key role in large, mid-size and startup companies and built the sales and marketing, commercial operations, managed care, medical communication, medical affairs, and compliance teams at these organizations.
Mr. Boyd most recently worked at Primus Pharmaceuticals as director, Commercial Planning & Operations. He has also held roles at Inspire Pharmaceuticals as director of Medical Development; Astellas US LLC as director of Global Compliance Operations; and Nicox as director of Medical Development & Advocacy.
New Eyeglass Lens Designed for Contact Lens Wearers
Zeiss now offers Zeiss EnergizeMe Lenses, which the company says is the first and only eyeglass lens in the industry designed specifically for vision needs of contact lens wears.
Contact lens wearers often wear their lenses for extended periods, which causes them to experience eyestrain and fatigue. Zeiss says that its EnergizeMe Lenses are a unique combination of a new lens design with Digital Inside Technology and DuraVision BlueProtect coating for optimum comfort and protection from digital eyestrain and blue light. They help tired eyes relax and prevent eyestrain caused by digital devices, according to Zeiss.
Three EnergizeMe lens options are available. Zeiss EnergizeMe Single Vision Lenses are designed for patients in their 20s and early 30s. They use a small addition of 0.40D to help tired eyes relax. Zeiss EnergizeMe Digital Lenses are designed for patients in their 30s and early 40s who are in between single vision and progressive lenses. They have a power boost of 0.65D. Zeiss EnergizeMe Progressive Lenses are intended for those 40 years and older who require a power boost of 0.75D to 4.00D. Zeiss says that these lenses adapt to the visual behavior of presbiopic contact lens wearers who are used to eye movements rather than head movements while wearing contact lenses. They provide a balanced reading zone and a seamless distribution of power across the progressive lens to ensure a relaxed vision experience, according to the company.
Novaliq GMBH Announces NovaTears Licensing Agreement with AFT Pharmaceuticals
Novaliq, a specialty pharmaceutical company, announced a strategic licensing agreement with AFT Pharmaceuticals for the commercialization of Novaliq’s NovaTears in Australia and New Zealand. NovaTears is an ophthalmic product for the treatment of evaporative dry eye diseases (DEDs) that incorporates the company’s proprietary EyeSol technology, is a multi-dose, non-aqueous and preservative-free topical eye drop for the lubrication of the ocular surface. NovaTears has been classified as a class IIa medical device and received CE mark approval in Europe in July 2013. In Europe, NovaTears is distributed by URSAPHARM under the brand name EvoTears.
Under the terms of the agreement, Novaliq has granted AFT an exclusive license for the commercialization of NovaTears across Australasia. In return for these rights, Novaliq will receive an undisclosed upfront payment and royalties on net sales of NovaTears.
SSF Calls Upon Eyecare Professionals to Help Educate Public
April 2017 marks the 19th annual Sjögren’s Awareness Month. Once again, The Sjögren’s Syndrome Foundation (SSF), along with members and volunteers across the country, will unite to continue its mission of educating patients and families about Sjögren’s, an autoimmune disorder affecting more than 4 million Americans, with an estimated 2.5 million patients currently undiagnosed.
Each day during Sjögren’s Awareness Month, the SSF will be using one or more of its social media channels (Twitter, @SjogrensOrg; Facebook @SjogrensSyndromFoundation; and LinkedIn, Sjögren’s Syndrome Foundation) to educate consumers, healthcare professionals, and others by providing facts about the disease, offering resources, and sharing stories of those with Sjögren’s to help others visualize and better understand what it is like to suffer from Sjögren’s. SSF will be employing the #ThisisSjogrens hashtag.
SEED and BHVI to Collaborate on New Contact Lens Technology
Brien Holden Vision Institute (BHVI) will be collaborating on research and development of new contact lens technologies with SEED Co., Ltd in Japan to deliver advanced vision correction for ageing people. SEED is a contact lens manufacturer in Japan with 60 years history. It produces and delivers a wide range of contact lens products including GP, soft conventional, and disposable contact lenses.
According to Professor Kovin Naidoo, CEO of BHVI, the opportunity to collaborate with one of Asia’s leading contact lens companies with a fast growing global presence would help take its technology global.
Rose K2 Silicone Hydrogel lenses Now Available From Art Optical
As a U.S. manufacturer of the Rose K series of irregular cornea lenses from Menicon, Art Optical has added the Rose K2 Soft lens to its custom silicone hydrogel product line and is now accepting orders. Rose K2 Soft is a daily wear, quarterly replacement lens for irregular corneas.
Manufactured in Definitive (efrofilcon A) material by Contamac, Rose K2 Soft lens fitting begins with an eight-lens diagnostic set and follows a five-step fitting method common to the Rose K GP lens series. Diagnostic sets are priced at just $250 and are available for immediate shipment. Rose K2 custom soft Rx lenses ship from Art Optical within two business days and are backed by Art Optical’s comprehensive warranty protection programs.
IACLE and BUCCLE to Enhance Contact Lens Teaching and Supervision Skills
The International Association of Contact Lens Educators (IACLE) and British Universities Committee of Contact Lens Educators (BUCCLE) will hold an Education Day for contact lens educators and clinic supervisors at the Pullman Liverpool Hotel in Liverpool, United Kingdom on June 8. A reception for all attendees, hosted by BCLA, will follow the program.
Attendance is free to all contact lens educators and university/college clinic supervisors, thanks to the support of BUCCLE. Topics covered will include: communicating with students in the clinic; electronic learning styles; core competencies of U.K. optometry students; assessment of students’ skills; and merging academic teaching into clinical practice.
IACLE presenters include: Dr. Shehzad Naroo, Dr. Luigina Sorbara, Judith Morris, and Dr. Etty Bitton. BUCCLE presenters include: Neil Retallic, Professor James Wolffsohn, Dr. Graham Mouat, and Arnold Cochrane. In addition, business coach and leadership development specialist Andy Cole will deliver the final presentation on the effects of brain model on teaching style. IACLE members should email firstname.lastname@example.org and BUCCLE members and clinic supervisors Neil.Retallic@manchester.ac.uk by April 30 to reserve a spot.
POLL: What soft lens material characteristic do you feel makes the most difference for patients who experience discomfort and reduced comfortable wearing time?
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.
S. Barry Eiden, OD
Breathe Deep: Oxygen Permeability of Soft Lenses Is Influenced by Tear Protein Deposition
Practitioners seem to be obsessed with Dk/t values as an indicator of how oxygen permeable a contact lens is. We all must take into consideration many variables that impact how much oxygen gets to the ocular surface through a contact lens. Of course, the local thickness has a significant impact. Dk/t refers only to the value at the center of the lens for typically a –3.00D lens.
We are now becoming more cognizant of the importance of limbal physiology where the critically important stem cells reside, and as such, thick peripheral lens designs may challenge these cells. Additionally, the surface condition of the lens–in terms of deposition–can also have an impact on oxygen availability.
A recent study looked at the influence of tear protein deposition on the oxygen permeability of soft contact lenses.1 Three hydrogel lenses (polymacon, nelfilcon A, and etafilcon A) and two silicone hydrogel lenses (lotrafilcon A and balafilcon A) were investigated. Etafilcon A lenses were incubated in artificial tear solution for one, six, 12, and 48 hours, whereas the other soft contact lenses were incubated for one, three, seven, and 14 days. Oxygen permeability was measured using the polarographic method, and lenses were stacked in four layers to correct the boundary effect.
The authors found that the Dk of all investigated soft lenses was decreased by the protein deposition. Silicone hydrogel lenses showed a smaller deposition of artificial tear proteins compared to conventional hydrogel lenses. However, their Dk was reduced twofold over those of three conventional hydrogel lenses when compared at the same level of protein deposition. Despite a large amount of total deposited protein in etafilcon A lenses, their Dk was more stable compared to other studied contact lenses.
The researchers concluded that the degree of Dk change in soft contact lenses, although negatively impacted by tear protein deposition, was not simply correlated with the amount of tear protein deposition. Lens material seems to play a significant role.
The take home from this study, however, is that keeping the lens surface as pristine as possible will maximize the oxygen transmission properties of the lens. This can be achieved by frequent replacement (optimally, daily disposable) or via the use of the most effective cleaning systems available.
1. Lee SE, Kim SR, Park M. Influence of Tear Protein Deposition on the Oxygen Permeability of Soft Contact Lenses. J Ophthalmol. 2017;2017:5131764.
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Something I Never Considered
Meibomian gland epithelial cells are essential in maintaining the health and integrity of the ocular surface via the production of meibum critical to a functional pre-ocular tear film. However, very little is known about their physiological regulation.
An immortalized cell line is a population of cells from a multicellular organism that would normally not proliferate indefinitely. However, due to mutation, these cells have evaded normal cellular senescence and instead can keep undergoing division. The cells can therefore be grown for prolonged periods in vitro.
It has been demonstrated through immortalized meibomian gland epithelial cells that those cells express numerous lipid-, keratin-, and protease-related genes that are common to other sebaceous gland epithelial cells.1
The extracellular matrix (ECM) is a collection of extracellular molecules secreted by cells that provides structural and biochemical support to the surrounding cells. The ECM serves diverse functions and is a major component of the cellular microenvironment. It also is a highly dynamic structure, constantly undergoing a remodeling process in which ECM components are deposited, degraded, or otherwise modified. ECM dynamics are indispensible during restructuring of tissue architecture. ECM remodeling is an important mechanism whereby cell differentiation can be regulated, including processes such as the establishment and maintenance of stem cell niches, branching morphogenesis, angiogenesis, bone remodeling, and wound repair.2
Proteases and their inhibitors have been recognized as key players in remodeling extracellular matrices and promoting the normal integrity of glandular tissue. They modulate a wide range of biological processes, such as cell proliferation and differentiation, and can contribute to disease when aberrantly expressed. Deciphering the role of proteolytic activity in the meibomian gland offers an opportunity to gain a more comprehensive and fundamental understanding of the developmental, physiological, and pathological processes associated with this gland.3
I have never thought about this, have you? The more we learn about the meibomian glands, the less we know. Amazing.
1. Liu S, Hatton MP, Khandelwal P, Sullivan DA. Culture, Immortalization, and Characterization of Human Meibomian Gland Epithelial Cells. Invest Ophthalmol Vis Sci. 2010 Aug;51:3993-4005.
2. Lu P, Takai K, Weaver VM, Werb Z. Extracellular matrix degradation and remodeling in development and disease. Cold Spring Harb Perspect Biol. 2011 Dec;3(12).
3. Argüeso P. Proteolytic activity in the meibomian gland: Implications to health and disease. Exp Eye Res. 2017 Mar 8. [Epub ahead of print]
Effect of Sleep Position on the Ocular Surface
Dry eye disease is a multifactorial disease with numerous well-documented risk factors. However, to date, sleep position has not been associated with this condition. After the researchers observed patients in their practice, they believe that, in some cases, sleep position may significantly affect dry eye and meibomian gland dysfunction (MGD).
The study was a single-centered, cross-sectional, non-interventional, institutional review board-approved, single-masked, non-randomized assessment of 100 patients whose complaints were related to dry eye disease and a control group of 25 age-matched asymptomatic patients. Two questionnaires were used: one to analyze patients’ sleep habits and the other to assess patients’ Ocular Surface Disease Index (OSDI). Dry eye severity was graded based on the MGD stage, fluorescein corneal and lissamine green staining, Schirmer 1 testing, tear osmolarity levels, and clinical examination.
Those who slept on their back had a lissamine green score of 4.4. Those who slept on alternating sides had a score of 4.9. Those who slept on their right side had a score of 5.6. Finally, the patients who slept on their left side had a lissamine green score of 9.7. Thererfore, the study showed statistically significant difference with back sleeping compared with left side sleeping using lissamine green staining (analysis of variance, P = 0.005). The OSDI score was also found to be elevated in patients who slept on their right or left side (36.4 and 34.1, respectively) as opposed to back sleepers (26.7) with P < 0.05. There was no statistically significant correlation found between the sleep position and degree of MGD.
The researchers concluded that, in addition to current treatment, patients who sleep on their side or face down might see a reduction in dry eye and MGD if they change their sleep pattern to the supine position.
Alevi D, Perry HD, Wedel A, Rosenberg E, Alevi L, Donnenfeld ED. Effect of Sleep Position on the Ocular Surface. Cornea. 2017 Mar 1. [Epub ahead of print]