CONTACT LENSES TODAY
January 8, 2006
Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more
than 12,000 readers in 74 countries.
New One-Step Peroxide System
Sauflon USA introduced its new One-Step system to the U.S. in December. It is a preservative-free, multi-action
peroxide cleaning and
disinfecting solution for use with soft contact lenses. The system combines a non-ionic cleaner with hydrogen peroxide and a lubricant and does not require patients
to rub their lenses. The One-Step system will be available exclusively to licensed eye care professional in January.
GP Continuous-wear Study Results Promising
Results of a study conducted at the University of Melbourne in Australia show the Menicon Menifocal Z alternating vision, concentric,
bifocal, GP lens can be safely worn for up to 30 days of continuous wear. Researchers followed 35 existing GP wearers over a six-month period, 27 of whom completed
the study. Adverse responses and lens binding were minimal and no significant increase in corneal staining, vascularization or superior palpebral conjunctival papillae
was noted. They concluded that the hyper-Dk tisilfocon A material allows for safe wear of the lenses on a continuous-wear basis. The study appears in the December issue
of Optometry and Vision Science.
BCLA Sets 2006 Meeting Program
The British Contact Lens Association (BCLA) has announced the program for its 2006 Clinical Conference and Exhibition, from May 19-21 at
the Hilton Birmingham Metropole Hotel. Lecturers include Joseph Shovlin, O.D., F.A.A.O., Jennifer Craig, Ph.D., M.C.Optom, Dwight Cavanagh, M.D., Ph.D., Charles
McMonnies, M.Sc. U.N.S.W., A.S.T.C. and Joanna Hollingsworth, Ph.D., who will deliver the Irving Fatt memorial lecture. This year’s conference will cover a range of
topics including special sessions on public health and ocular risks, the latest silicone hydrogel lenses and specialist lens fitting. For the full conference program,
go to http://www.bcla.org.uk.
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France Designates Keratoconus Center
The French Ministry of Health has designated the University of Bordeaux’s Service d’Ophtamologie-CHU as the Reference Center for keratoconus
in France. As such, it will receive a five-year grant encompassing the care of keratoconus patients and disease research in honor of Dr. Joseph Colin’s research, including
the use of Intacs implants. Dr. Colin is professor and chief of ophthalmology at the University and will direct the program. The grant will also cover research of ectasia
following LASIK surgery.
VCA Data Shows Increase in Eye Exams
The Vision Council of America’s (VCA) Visionwatch data shows that more than 90.8 million adults received eye exam between October 2004 and
September 2005, with almost 250,000 exams performed each day. In the six months before September 2005, patients cited various reasons for their eye care visit; one third
scheduled the exam after receiving an appointment reminder card from their eye care provider, 25% said vision problems were the reason for the visit. Other reasons
included seeing vision health ads, for insurance purposes and as a job requirement. Finally, during the three months prior to September 2005, 25% of American adults
said they plan to visit an eyecare professional during the next three months, up slightly from previous years.
Abstract:
Long-term Bandage Contact Lens Wear
Researchers at Wills Eye Hospital in Philadelphia present a case of aniridic ocular surface disease that was successfully managed with
long-term bandage contact lens (BCL) wear. A 73-year-old aniridic woman who had failed PK complicated by ocular surface disease refused limbal stem cell transplantation
and underwent repeat PK in her right eye. She presented with an epithelial defect along the inferotemporal graft margin adjacent to an exposed, loose interrupted suture
two months postoperatively. While the initial defect healed after the suture was removed, the patient suffered recurrent episodes of epithelial breakdown and generalized
whorl epitheliopathy. Doctors inserted a BCL, which produced prompt healing of the graft epithelium. The graft has remained thin and clear for four years, with a smooth
and intact epithelial surface beneath the BCL and no signs of limbal stem-cell deficiency. Researchers conclude that long-term BCL wear provided good corneal transplant
surface protection, thereby sparing the need for limbal stem cell transplantation and the use of potentially toxic systemic immunosuppressive therapy in this patient.
They also note that meticulous follow-up is required to monitor contact lens loss and epithelial breakdown as well as signs of secondary infectious keratitis.
Ozbek Z, Raber IM. Successful management of aniridic ocular surface disease with long-term bandage contact lens wear. Cornea. 2006 Feb;25(2):245-7.
Editor's Commentary:
Patient Recalls
Our story on examinations being more frequent in the U.S. is interesting. Only 25% indicated they responded to a recall from the practitioner.
This may or may not seem low depending upon who responded to the survey. I've been criticized before for recommending an annual eye examination for myopes, especially
contact lens wearers. Nevertheless, we have a responsibility to monitor our patients' eye health. Recall cards can work, but there is no substitute for a pre-appointment,
or even a telephone recall. Getting contact lens patients back into the office to monitor their eye health, ensure compliance and determine if a new product would improve
their well-being is a high priority for us all.
Fitting Tip:
The Difficulties of "Year One"
The first year of new product release requires more questions, more re-fits, and more follow-ups. The second and third years are much easier.
The following year, another product is released, followed by another cycle of questions, refits, etc.
If this scenario is relatively correct, every tough year should
be followed by two easier years. This is that tougher year! The sharper, wetter and higher-Dk lenses we have been waiting for are ready to alleviate problems of dryness
and oxygen delivery.
How does this affect our day-to-day practice? In those "new product" years, the time you spend on each patient and the number of follow-ups you
see may increase. It makes for a tough day sometimes when you're a patient behind, and simply asking, “How are the old lenses doing,” would allow you to catch-up. The
time you invest in this difficult year will pay-off with easier exams in the short-term future and happier patients in the long run. If we don't, someone else will,
and we will have more time than we ever wanted!
Mark Greenwell, O.D.
Papillion, Neb.
Best of the Month
Dr. Joshua Coleman of Paris, Texas, submitted the “Best Fitting Tip of the Month” for December. His “Help Contact Lens Patients Pick
Frames” tip can be seen in the December 11th, 2005 edition of CLToday.
This month at http://www.siliconehydrogels.org, track worldwide trends in silicone hydrogel fitting; examine the
dynamic mechanical properties, dynamic wettability and frictional properties of these lenses; read up on successful clinical strategies for maintaining patients‚
comfort and ocular health with extended wear; and review new developments and information that came to light in 2005.
Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ or
call (800) FDA-1088.
Access a reporting form for complications you've seen that were a result of contact lenses dispensed without a valid
prescription at the Association of Regulatory Boards of Optometry's (ARBO's) Web
site: http://www.arbo.org/arbo.asp?dt=R&doc=Complications. Complete and send the form online or print
it out and fax it to (866) 886-6164.
Send your favorite tips to tips@cltoday.com -- if your tip is
selected as 'Best of the Month,' you'll receive a free golf shirt (see http://www.CLToday.com for details). Please include your
full name, degree or title and city/state/country.
Visit Contact Lens Spectrum ( http://www.clspectrum.com ) for interactive clinical posters and issue archives.
Visit Contact Lenses Today for our Best Fitting Tips.
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