It is hard to believe it, but we are already starting our editorial planning for Contact Lens Spectrum for 2018! As always, we want to provide the most up-to-date, cutting-edge, clinically relevant information—and we cannot do that without your input. So, please send us your thoughts and ideas on topics that you would like to see both more and less of within the pages of Contact Lens Spectrum (email@example.com). We are grateful for this valuable information that you provide.
Jason J. Nichols, OD, MPH, PhD
Spectrum International to Distribute Europa Scleral Lens in Additional Markets
Visionary Optics has signed an exclusive agreement with Spectrum International to distribute the Europa Scleral lens in the South America, Central America, and Caribbean markets. The Europa lens offers customizations such as presbyopia, toric haptics, bitoric, and notching.
Avedro Launches Effort to Secure Coverage and Facilitate Reimbursement
Avedro, Inc. announced a comprehensive effort to secure commercial coverage and support reimbursement of Photrexa Viscous, Photrexa, and the KXL System used in corneal cross-linking for the treatment of progressive keratoconus and corneal ectasia following refractive surgery. According to the company, the multi-faceted initiative will help improve patient access to medically necessary treatment for these sight-threatening orphan diseases.
The initiative encompasses several components, including the launch of the Avedro Reimbursement Customer Hub (ARCH) Program. Starting June 15, the ARCH Program will offer a Reimbursement Support Service, including a hotline for questions and resources to assist with the commercial payer appeals process; a Patient Assistance Program that supports financially eligible, uninsured patients by providing Photrexa Viscous and Photrexa at no charge; and a Prescription Assistance Program, which minimizes insured patients’ out-of-pocket expenses for Photrexa Viscous and Photrexa in cases of commercial insurance coverage denials. In addition, Avedro has established commercial pricing for Photrexa Viscous and Photrexa.
Bio-Tissue Launches Cliradex Light Globally, Redesigns Site
Bio-Tissue, a business unit of TissueTech, Inc., has announced the global online availability of its newest product, Cliradex Light advanced foaming eyelid cleanser, on its newly redesigned website, www.cliradex.com. International purchases may be directed to Amazon Marketplace.
Cliradex Light was launched last year and is ideal for preventative eyelid care, everyday ocular hygiene, and mild-to-moderate ocular irritation, according to the company. Cliradex products are natural, preservative-free lid, lash, and facial cleansers formulated with 4-Terpineol, a molecule found in tea tree oil. The company says that Cliradex Light works best for mild-to-moderate blepharitis and is also recommended for maintenance use after Cliradex towelettes are discontinued in the treatment of moderate-to-severe blepharitis and for Demodex mites.
The new site features an integrated branding experience with packaging for consistency; product placement for easy access to important information; the company’s money back guarantee; and a new blog with a Facebook newsfeed.
Allergan Granted Marketing Authorization by the FDA for TrueTear
Allergan plc was granted marketing authorization from the U.S. Food and Drug Administration (FDA) for TrueTear Intranasal Tear Neurostimulator, an FDA-cleared device developed to temporarily increase tear production during neurostimulation in adult patients.
TrueTear is a handheld stimulator with daily disposable tips that is inserted into the nasal cavity to induce the production of tears. The new advancement is an addition to Allergan's current eyecare portfolio.
Oasis Medical Debuts New Punctal Plug, Lid Hygiene Products
Oasis Medical Inc. has added the Medium Term plug to its Soft Plug punctal occlusion line and has added Oasis Lid & Lash Eyelid & Lash pre-soaked pads, available with or without Tea Tree Oil, to its daily lid hygiene line of solutions.
The new Soft Plug Extended Duration 180 is a canalicular implantable plug made of an absorbable polydioxanone material. Oasis Medical says that the punctal occluder can lasts up to 180 days, and it is available in three sizes: 0.3mm x 2.0mm, 0.4mm x 2.0mm, and 0.5mm x 2.0mm.
The new Oasis Lid & Lash Eyelid & Lash Cleansing Pads are packaged in a jar with pads that are pre-soaked with the original pump formulation for daily eyelid and lash cleansing and hydration.
Oasis is now accepting preorders for all three products. The company estimates that the plug will begin shipping in late June 2017. Oasis Lid & Lash Eyelid & Lash Cleansing Pads (original formulation) and Oasis Lid & Lash +Tea Tree Oil Eyelid & Lash Cleansing Pads are scheduled to start shipping to eyecare providers by the end of May 2017.
Imprimis Pharmaceuticals and SightLife Surgical to Launch Serum Tears
Imprimis Pharmaceuticals, Inc. and SightLife Surgical signed an exclusive strategic sales and marketing agreement. Under the agreement, SightLife Surgical will deploy its sales team to offer Imprimis’ Serum Tears compounded formulations to physicians, large practice groups, surgery centers, hospitals, and healthcare organizations nationwide. Imprimis’ Serum Tears autologous serum eye drops (ASEDs) are prescribed for chronic dry eye patients who do not respond to traditional dry eye treatments. Under the planned Imprimis ASEDs program, Serum Tears will be available in all 50 states in varying ranges of saline dilution combinations.
Which of the following do you most frequently recommend for the daily cleaning and disinfection of a scleral contact lens?
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
Water, Water Everywhere …
The risks of water exposure associated with contact lens wear have been well known for quite some time. The question is whether we, as eyecare professionals, have had any impact on our patients’ contact lens wear and care habits.
A recent study was published that explored the understanding of soft contact lens (SCL) and GP lens wearers’ behaviors and knowledge regarding exposure of contact lenses to water.1 The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1,056 SCL and 85 GP lens wearers aged 20 to 76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions.
Results indicated that GP lens wearers were more likely compared to SCL wearers to rinse lenses with or store lenses in water (rinsing: 91% GP, 31% SCL, P < 0.001; storing: 33% GP, 15% SCL P < 0.001). Among SCL wearers, men were more likely to store their lenses in (24% versus 13%, P = 0.003) or rinse their lenses with (41% versus 29%, P = 0.012) water. Showering while wearing lenses was more common in SCL wearers (86%) than in GP lens wearers (67%) (P < 0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP lens wearers (P = 0.027). Wearers who rinsed lenses with water (SCL, P < 0.0001; GP, P = 0.11) or stored lenses in water (SCL, P < 0.0001; GP, P = 0.007) reported that this behavior had little or no effect on their infection risk compared with those who did not. Both SCL (P < 0.0001) and GP lens wearers (P < 0.0001) perceived that distilled water was safer compared to tap water for storing or rinsing lenses.
The authors concluded that despite previously published evidence of Acanthamoeba keratitis’ association with water exposure, most SCL and nearly all GP lens wearers regularly expose their lenses to water, with many unaware of the risk.
So where does the fault lie? It lies with us, the eyecare professionals of the world. We continue to fail to properly educate our patients about the serious nature of contact lens wear. We must emphasize education to our patients in terms of proper wear and care behaviors. Contact lens wear is amazingly safe and effective; however, it surely is not without risk. We can significantly mitigate that risk by doing our best to educate our contact lens wearing patients both at initial fitting and with ongoing efforts as we provide after care and annual comprehensive eye care for them.
1. Zimmerman AB, Richdale K, Mitchell GL, Kinoshita BT, Lam DY, Wagner H, Sorbara L, Chalmers RL, Collier SA, Cope JR, Rao MM, Beach MJ, Yoder JS. Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers. Cornea. 2017 Apr 13. [Epub ahead of print]
OCULAR SURFACE UPDATE
Katherine M. Mastrota, MS, OD
Don’t Meddle with Metal
The impact of cosmetics on the ocular surface and the area around the eye is a topic of much interest. Added to the mix are concerns regarding application of cosmetics to the lashes, lids, and lid margin. In fact, a 2015 study assessed the allergenic properties of metals in cosmetic products.1 The aim of this study was to investigate the concentration of allergen metals—nickel (Ni), cobalt (Co), and chromium (Cr)—in the most commonly used cosmetic products including mascara, eyeliner, eye shadow, lipstick, and nail polish.
Forty-eight makeup products were purchased randomly, and an atomic absorption spectrometer was used for metal content determination. According to the results of this investigation, at least two of the allergen metals (Ni and/or Co and/or Cr) were detected in all of the samples tested. Moreover, 97% of the Ni-detected products, 96% of Cr-detected products, and 54% of Co-detected products contained more than 1 μg/g of these metals, which is the suggested ultimate target value for the sensitive population and thereby can be considered as the possible allergen.
Contact dermatitis caused by cosmetics is most probably due to the allergen metal content of the products. In fact, the authors note that cosmetics are one of the most common reasons for hospital referrals with allergic contact dermatitis. The authors conclude that post-marketing vigilance and routine monitoring of allergen metals are important to protect public health.
It is important to note that the cosmetics used in this study were acquired in Instanbul, Turkey; however, this admonition can certainly translate to the U.S. market. In a 2014 study,2 the U.S. Food and Drug Administration contracted a private laboratory to determine the total content of seven potentially toxic or allergenic elements in 150 cosmetic products of 12 types (eye shadow, blush, lipstick, three types of lotion, mascara, foundation, body powder, compact powder, shaving cream, and face paint). Samples were analyzed for arsenic (As), cadmium (Cd), Cr, Co, lead (Pb), and Ni. The cosmetic products were found to contain As, Cr, Co, Pb, and Ni.
Moral: Never discount the allergenic properties of cosmetics when evaluating eye/eyelid inflammation.
1. Sipahi H, Charehsaz M, Güngör Z, Erdem O, Soykut B, Akay C, Aydin A. Risk assessment of allergen metals in cosmetic products. J Cosmet Sci. 2015 Sep-Oct;66:313-323.
2. Hepp NM, Mindak WR, Gasper JW, Thompson CB, Barrows JN. Survey of cosmetics for arsenic, cadmium, chromium, cobalt, lead, mercury, and nickel content. J Cosmet Sci. 2014 May-Jun;65:125-145.
Factors Related to Axial Length Elongation and Myopia Progression in Orthokeratology Practice
The purpose of this study was to investigate which baseline factors are predictive for axial length growth over an average period of 2.5 years in a group of children wearing orthokeratology (OK) contact lenses.
In this retrospective study, the clinical records of 249 new OK wearers (between January 2012 and December 2013 and from the contact lens clinic at the Eye and ENT Hospital of Fudan University in Shanghai, China) were reviewed. The primary outcome measure was axial length change from baseline to the time of review (July 2015 to August 2015). Independent variables included baseline measures of age at initiation of OK wear, gender, refractive error (spherical equivalent), astigmatism, average keratometry, corneal toricity, central corneal thickness, white-to-white corneal diameter, pupil size, corneal topography eccentricity value (e-value), intraocular pressure (IOP), and total time in follow up (months total). The contributions of all independent variables on axial length change at the time of review were assessed using univariate and multivariable regression analyses.
Univariate analyses of the right eyes of all the OK patients showed that smaller increases in axial length were associated with older age at the onset of OK lens wear, greater baseline spherical equivalent myopic refractive error, less time in follow up, and a smaller e-value. Multivariable analyses of the significant right eye variables showed that the factors associated with smaller axial length growth were older age at the onset of OK lens wear (p < 0.0001), greater baseline spherical equivalent myopic refractive error (p = 0.0046), and less time in follow up (p < 0.0001).
The authors found that the baseline factors demonstrating the greatest correlation with reduced axial length elongation during OK lens wear in myopic children included greater baseline spherical equivalent myopic refractive error and older age at the onset of OK lens wear.
Wang B, Naidu RK, Qu X. Factors related to axial length elongation and myopia progression in orthokeratology practice. PLoS One. 2017 Apr 18;12:e0175913.