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Sunday, January 27, 2012  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

Today is the final day of yet another successful Global Specialty Lens Symposium, which was held again in Las Vegas. The program was packed with new and exciting clinical information on all aspects of contact lens wear, and attendance was over 500 individuals. We would like to thank all of the attendees, in addition to our sponsors, for all of their support in making this meeting a success. Please look for a full recap of the meeting in March edition of Contact Lens Spectrum.

Valley Contax Introduces Custom Stable

Valley Contax introduced their Custom Stable scleral lens system at this year's Global Specialty Lens Symposium in Las Vegas. The Custom Stable System offers practitioners an easy and consistent means of fitting scleral lenses and boasts much better visual acuity and comfort than traditional corneal gas permeable lenses, according to the company.

The Custom Stable lenses are initially being offered in three sizes, 15, 16 and 18 including near zone and reverse geometry versions. All are manufactured with high performance materials and include unique production characteristics such as digital radial edge profiling, laser etching, plasma treatment and NIMO analysis, that make them easier to fit and wear. The system also includes an advanced fitting toolkit, support media, marketing tools as well as a stylized carrying case and tools for the patient upon delivery. The Custom Stable system is made to be all inclusive for both the practitioner and the patient so that both will find it easy to adopt and implement.

For more information about Valley Contax and the Custom Stable System visit their website at valleycontax.com.

GSLS Sets Attendance Record

The Global Specialty Lens Symposium welcomed a record of over 500 eyecare practitioners from 32 countries to this year's conference in Las Vegas this weekend.

An expert international faculty covered in depth key topics including: myopia control, management of irregular corneas, risk factors impacting safe contact lens wear, fitting presbyopes, and more. A variety of free papers and posters were also presented.

In addition, 46 exhibiting companies had an opportunity to present their latest innovations both in the exhibit hall and during special sponsored sessions.

Contamac US Expands Keratoconus Foundation Grant

Contamac US announced the addition of the Soft K lens design for keratoconus as the latest lens design earning grant revenue for the Keratoconus Foundation. Contamac US donates a portion of the sale of every keratoconus lens made in its Definitive silicone hydrogel material to the Keratoconus Foundation.

The Soft K design for keratoconus and irregular corneas is manufactured and sold by Advanced Vision Technologies in Golden, Colorado. For more information on the Soft K lens visit www.avtlens.com.

3rd Annual Harvey Yamamoto Award Submissions Open

The American Optometric Society announced that the eligibility for the 2013 Dr. Harvey Yamamoto Award has opened. The award is a $1000 scholarship, to be awarded to a graduating optometry student, based on an original essay submission. This year's topic is: "How can Social Media be used in the Optometric Practice to improve patient care and outcomes?" The winner will be presented with their check, plaque and membership in the AOS at the AOS annual CE meeting to be held at the Westin Riverwalk, San Antonio, April 12-14, 2013.

Deadline for submission is midnight PST March1, 2013. The rules for submission can be found at http://www.optometricsociety.org/students/student-award.html.

Mini-Scleral Lens on Keratoconic INTACS Patient
By Augusto Rosse, Santiago, Chile

Be creative when you have troubles with keratoconus patients with INTACS. This patient has nasal and temporal pinguecula and a mini-scleral lens caused red eye in these areas. I made a cut in both sides to eliminate touch in pingueculas. The result was VA 20/15, no red eye and no lens movement.

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 an explanation of the photo and your full name, degree or title and city/state/country.
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Katherine M. Mastrota, MS, OD, FAAO

OSD in Patients with Prosthetic Eyes: Part 1 of 2

A 2010 study from the Yonsei University College of Medicine in Seoul, Korea investigated whether fourier-domain optical coherence tomography (FD-OCT) could measure the tear meniscus of patients using prosthetic eyes and compared the characteristics of the tear meniscus of normal and prosthetic eyes. Patients completed a dry eye questionnaire prior to the study. Thirty patients who had been wearing artificial eyes for more than 6 months were included. Exclusion criterion included inflamed sockets, contracted sockets or eyes with eyelid abnormalities. Tear meniscus height, tear meniscus depth, and tear meniscus angle were measured with computer calipers.

FD-OCT was able to visualize the tear meniscus of both normal and artificial eyes. The mean tear meniscus height of artificial eyes was significantly lower than that of normal eyes. The mean tear meniscus depth, tear meniscus area, and tear meniscus volume also were significantly lower in artificial eyes than in normal eyes. Also, dry eye symptom scores showed significantly negative correlation with tear meniscus height.

The authors conclude that FD-OCT is a valuable clinical tool in the evaluation of tear meniscus height in normal and artificial eyes. Additionally, tear meniscus height can be a useful clinical parameter that estimates symptoms of ocular dryness and discomfort in both normal and artificial eyes.

Kim SE, Yoon JS, Lee SY. Tear measurement in prosthetic eye users with fourier-domain optical coherence tomography. Am J Ophthalmol. 2010 Apr;149(4):602-607

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Susan J. Gromacki, OD, MS, FAAO

Solution-Induced Corneal Staining (SICS): Symptoms and Staining Patterns

One of the characteristics that makes the American Academy of Optometry Annual Meeting unique is that is provides both clinical education and a scientific program. At the meeting last fall, there were several original research projects on contact lens care and compliance. One such presentation was a poster by Jill Woods, PhD, and her colleagues.

There is still much to learn regarding the relationship between silicone hydrogel contact lens materials, their uptake of contact lens solution, and its affect on the cornea. Whether one terms the glow of sodium fluorescein preservative-associated transient hyperfluorescence (PATH) or solution-induced corneal staining (SICS), there is no disputing that hyperfluorescence occurs more commonly and more intensely with certain solution-material combinations.

It had also been thought that SICS often presents as a peripheral corneal annulus of diffuse staining. However, their study showed that it was more common to see pan-corneal staining than peripheral annular staining. All but one of the 20 patients demonstrated staining to be almost equivalent in density to the peripheral staining. They concluded by stating, "The exact mechanism of corneal staining in general... remains unclear and requires more investigation."

While we have learned much about solution-material interaction, and its impact on the cornea, we still have a long way to go.

Woods J, Keir NJ, and Woods L. Solution-Induced Corneal Staining (SICS): Symptoms and Staining Patterns. Optom Vis Sci 2012;89: E-abstract 125625. http://member.aaopt.org/Submission/Search/SubmissionViewer.asp?SID=30625&BR=SP
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Utility of a Semi-Scleral Contact Lens Design in the Management of the Irregular Cornea

Researchers in Spain wanted to evaluate the utility of the Rose K2 XL semi-scleral contact lens (Menicon Co. Ltd., Nagoya, Japan) in the management of the irregular cornea. Twenty-seven subjects (34 eyes) with irregular corneas referred for contact lens fitting were evaluated. A diagnostic trial set was used in the fitting process. Once the trial lens was considered optimal, a final lens was ordered from the manufacturer with the necessary changes in power, edge lift and diameter. They analyzed visual acuity, number of lenses ordered and patients' ability to wear and handle lenses.

Twenty-three subjects (30 eyes) were fitted with the Rose K2 XL lens. Four subjects (4 eyes) decided not to conclude the fitting process for different reasons. Average logMAR visual acuity without correction and with the lens was 0.82 and 0.09, respectively (p<0.001). An average of 1.4 ordered lenses (range 1-3) were necessary to achieve the optimal fit. Nineteen eyes (63%) were fitted with the first lens ordered. Three subjects (13%) had problems with lens handling, and three subjects (4 eyes) abandoned the wear of the lenses after three months due to discomfort (3 eyes) and unsatisfactory visual acuity (1 eye), respectively. Follow-up ranged from 6 to 9 months.

The authors concluded that the Rose K2 XL semi-scleral contact lens provides good visual acuity and comfort in patients with irregular corneas.

Romero-Jimenez M, Flores-Rodriguez P. Utility of a semi-scleral contact lens design in the management of the irregular cornea. Cont Lens Anterior Eye. 2013 Jan 3. [Epub ahead of print]
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