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Sunday, January 23, 2011  
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Ocular Surface Update
Kelly K. Nichols, OD, MPH, PhD, FAAO

We often think of dry eye relative to the U.S. market — in terms of prevalence estimates, research studies, and product/drug development. The ophthalmic pharmaceutical companies we are most familiar with are based in the U.S.; however, it is increasingly important to think of dry eye in terms of the global market, specifically relative to drug development.

There have been several "global" news items recently that have reminded me of this. In December, Allergan's Restasis (cyclosporine ophthalmic emulsion) became available in Canada. Also in December, Santen announced the launch of Diquas (diquafosol tetrasodium 3%), which was approved last April by the Japanese Ministry of Health, Labour and Welfare. This drug is the same as that developed and tested by Inspire Pharmaceuticals, although Diquas is higher in concentration and applied more frequently than that tested in the U.S.

Finally, last week Resolvyx Pharmaceuticals (Cambridge, MA) and Celtic Therapeutics, a global private equity firm based in the U.S. Virgin Islands, but with primary operations in New York City and Lausanne, Switzerland, entered into a final agreement to acquire and license the worldwide rights related to Resolvyx's RX-10045, a late-stage program for the treatment of dry eye syndrome.

These events, among others, demonstrate that dry eye has gained a global presence worth watching.

Care Solution Corner
Susan J. Gromacki, OD, MS, FAAO

A full 25.6% of care systems purchased in the United States are of the private label ("generic") variety.1 Of course, few if any of us actually prescribe these brands to our patients. And none of us dispense generic sample care kits, because they don't exist.

It is common knowledge that generics are typically older formulations, not equivalent to companies' recently launched premium products.2,3 But what we are still discerning is, exactly who deviates from our prescribed solutions, and why? And if so, what are the consequences?

A recent publication by Forister, Forister, Yeung, et al. helps shed some light on the issue. They found a statistically higher rate of contact lens-induced ocular complications with patients who use private label, rather than name-brand, solutions.4 I look forward to subsequent publications on this topic.

1. Nichols JJ et al. Contact Lenses 2010. CL Spectrum 2011;26(1): 24-29. http://www.clspectrum.com/article.aspx...
2. Gromacki SJ. The truth about generics. CL Spectrum 2005;20(12): 24.
3. Smythe J. What's in a solution name? CL Spectrum 2003;18(5): 27.
4. Forister JY, Forister EF, Yeung KK, et al. Prevalence of contact lens-related complications: UCLA contact lens study. Eye & CL 2009;35(4):174-80.


CooperVision Expands Availability of Avaira Toric Contact Lenses

CooperVision announced the national rollout of Avaira Toric silicone hydrogel lenses in the United States. When Avaira Toric was launched in June, availability was restricted to a few thousand customers who had a fitting set.

According to the company, Avaira Toric contact lenses provide improved visual performance in a broad range of astigmatic patients, regardless of their cylinder power or axis, through the positioning of the lens ballast and the smooth, junctionless surface. In addition, the lens features a consistent horizontal thickness across the power range to improve lens stability and to reduce rotation, and a wide ballast band that completely encircles the optic zone to optimize lens-lid interaction for both orientation and comfort.

The lens uses Aquaform Comfort Science to create a naturally hydrophilic contact lens that retains water, minimizing dehydration and eliminating the need for wetting agents, coatings or additives, per the company.

The two-week replacement lens is manufactured from enfilcon A material. Water content is 46%, Dk is 100, and Dk/t is 91. It features sphere powers from Plano to -6.00D; a base curve of 8.5mm; a diameter of 14.5mm; cylinders of -0.75, -1.25, and -1.75; and an axis from 10 degrees to 180 degrees in 10-degree steps.

For more information, visit www.coopervision.com.


Unilens Launches C-VUE Advanced HydraVUE Silicone Hydrogel Custom Contact Lenses

Unilens Vision, Inc. announced the launch of its new C-VUE Advanced HydraVUE line of silicone hydrogel custom contact lenses for monthly replacement. According to the company, the new family of products incorporates highly developed lens design technology, including Unilens' patented Toric Multifocal and Multifocal designs and made-to-order Custom Toric and Single Vision options, with the Definitive silicone hydrogel material from Contamac. The C-VUE Advanced HydraVUE presbyopic lens technology allows the eye care professional to specify the exact ADD power and zone size.

All four monthly replacement lens options, which will be sold exclusively to independent eye care professionals, are completely customizable and feature a risk-free trial program and exceptional deliverability.

C-VUE Advanced HydraVUE lenses are the result of a partnership between Unilens and Contamac. The Definitive material provides a high water content of 74%, Dk of 60 Barrers, and low modulus.

For more information, visit www.unilens.com.

Vistakon Names Schnider Senior Director of Medical Affairs

Vistakon, Division of Johnson & Johnson Vision Care, Inc., has named Cristina M. Schnider, OD, MBA, FAAO, Senior Director, Medical Affairs, responsible for providing strategic direction and leadership for Medical Affairs in the area of specialty contact lens products. In her new role, she will report to Colleen Riley, OD, MS, FAAO, Dipl CL, Vice President, Professional Development and Medical Affairs.

Dr. Schnider joined Vistakon in 1999 as Manager of Claims Substantiation and Product Assessment, Research & Development, where she provided claims strategy and support for numerous new products, and played an integral role in the conception of the Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) Study. In 2003, she was named Director of Professional Affairs and later, Medical Affairs, where she provided technical education and support for the launch of several innovative new products.

Dr. Schnider recently returned to Vistakon from a three-year assignment in Tokyo, Japan where she served as a member of the management board, leading the Professional and Medical Affairs team and The Vision Care Institute of Johnson & Johnson KK.

Before joining Vistakon, Dr. Schnider served as the director of Professional and Clinical Affairs at Menicon USA, and spent 14 years as a contact lens educator and researcher.

Dr. Schnider is a Fellow of the American Academy of Optometry and a Diplomate in its Cornea, Contact Lenses and Refractive Technologies Section. She is a council member of the International Society for Contact Lens Research (ISCLR), author of numerous scientific papers and book chapters, and an internationally recognized lecturer on cornea and contact lenses.

Don't Miss the Global Specialty Lens Symposium This Week! Registration Still Available.

The 2011 Global Specialty Lens Symposium is this week, January 27-30, at the Paris Hotel & Casino in Las Vegas. You may still register online and onsite registration will be available. With an expert international faculty and a CE-accredited agenda, the 2011 GSLS will include insightful presentations by experts in the field, hands-on demonstrations of cutting-edge products as well as scientific papers and posters. For more detailed information and to register, visit www.GSLSymposium.com.

Art Optical To Offer Scleral Lens Fitting Webinar

To address the increased interest in large diameter contact lens fitting, Art Optical Contact Lens, Inc. has scheduled a free fitting webinar in February. Two live sessions of "Fitting SoClear Corneal Scleral Lenses" will be lead by Jason Jedlicka, OD, FAAO and moderated by Craig Norman, FCLSA and Mike Johnson, FCLSA of Art Optical. The webinars, scheduled on February 16 at 8:00 pm EST and February 22 at 1:00 pm EST, will introduce practitioners to this emerging category and provide tips on how to get started and grow your contact lens practice.

To register, visit http://www.artoptical.com/soclear-webinar/.

Shelly Joins Alden Optical

Alden Optical, Inc. announces that Bill Shelly has joined the organization. Shelly will lead the company's U.S. sales efforts and will report to Tom Shone, President, Alden Optical.

Most recently, Shelly served in sales management and customer oriented roles at CooperVision. Shelly also worked in sales related capacities at Paragon Vision Sciences, UCO Optics and Gordon Contact Lenses. He served as a member of the Board of Directors of the Contact Lens Society of America and has attained NCLC status as bestowed by the National Contact Lens Examiners.

This month at www.siliconehydrogels.org: Children and contact lenses, myopia progression, use of silicone hydrogels for patients with epidermolysis bullosa, and our synopsis of silicone hydrogels at the 2009 ARVO meeting.
Editor's Commentary
Jason J. Nichols, OD, MPH, PhD, FAAO

This last year, we were blessed with many new contact lens products, further expanding our horizons in terms of fitting more patients in contact lenses. The editorial staff at Contact Lens Spectrum and Contact Lenses Today diligently tries to comprehensively report on those products in our regular editorial coverage. It is important to emphasize that when our editorial staff writes about products, it does not mean that they or our publications are endorsing the products per se. If you are aware of things we've missed, please let us know. Likewise, please be proactive in letting us know about important events, meetings and newsworthy topics that could be of interest to the community. You can always email us at news@cltoday.com.

CLToday Quick Poll
Last week's question:
Do you feel that daily disposable lens use is associated with a reduction in contact lens related dry eye in your patients?



Anxiety and Depression in Patients with Dry Eye Syndrome

This study aimed to determine whether patients with dry eye syndrome [DES] have more symptoms of anxiety and depression than controls without DES.

In this case-control study, the sample consisted of 89 DES subjects (13 diagnosed with Sjogren's syndrome [SS]) and 73 control subjects. Each subject was diagnosed as having DES or was chosen as a control subject by an ophthalmologist.

The Zung Self Rating Anxiety Scales (SAS), Zung Self Rating Depression Scales (SDS), and Ocular Surface Disease Index (OSDI) were administered to all subjects. Scores of SAS and SDS, measuring level of anxiety and depression symptoms, were compared between the DES group and the control group. Correlations with other health status measures were conducted.

The SAS and SDS scores of the DES group were significantly higher than the control group (P < 0.001, P < 0.001). The prevalence of DES subjects with anxiety or depression symptoms was significantly higher than in the control group (P = 0.003, P < 0.001). In the DES group, SAS scores were found to be correlated with OSDI and educational level. SDS scores were found to be correlated with OSDI.

Neither SAS nor SDS scores were correlated with age, sex, household income, tear break up time (BUT), Schirmer Test 1 (S1T), corneal fluorescein staining (FL), or visual acuity.

The researchers concluded that anxiety and depression are correlated with DES, demonstrating that DES is an important public health problem that merits increased attention and research.

Li M, Gong L, Sun X, Chapin WJ. Anxiety and depression in patients with dry eye syndrome. Curr Eye Res. 2011 Jan;36(1):1-7.

Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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