At the recent SECO meeting, CIBA Vision announced its new Air Optix Night & Day Aqua lenses, which, according to the company, have the highest oxygen transmissibility of any available soft contact lens and provide patients and improved insertion comfort.
     Air Optix Night & Day Aqua lenses allow up to six times more oxygen through the lens than traditional soft lenses. Approved for up to 30 nights of continuous wear, the company states that Air Optix Night & Day Aqua lenses show no statistically significant difference in overnight corneal swelling compared to no lens at all.
     "Air Optix Night & Day Aqua lenses fully replace our original Night & Day lens product," said George Pastrana, Vice President of U.S. Marketing. "It has the same lens material, lens design and base curves as our original Night & Day lens but we've added significant comfort and handling improvements to make these lenses the best option for patients, especially those who want to nap or sleep in their lenses."
     The Aqua Moisture System lubricates for initial comfort. A patented lens material helps maintain an ultra-smooth surface with superior wettability, and excellent deposit resistance for comfort every day, per the company.
     Air Optix Night & Day Aqua lenses have a Dk/t = 175 @ -3.00D, and are recommended for monthly replacement. They are approved for daily wear and up to 30 nights continuous wear. The lenses will be available in an 8.6mm and 8.4mm base curve with a 13.8mm diameter. The lens power range will include +6.00D to -8.00D in 0.25D steps and -8.50D to -10.00D in 0.50D steps.
     For more information, visit www.cibavision.com.

Bausch & Lomb (B&L) has launched an integrated marketing initiative with the goal of raising U.S. awareness of presbyopia and multifocal contact lenses. More than 78 million baby boomers in the U.S. are either already presbyopic or becoming presbyopic. "Three out of five presbyopic patients don't even know multi-focal contact lenses exist as an alternative to cumbersome reading glasses and we want to change that," states Keir Meisner, Director, U.S. Marketing, Lenses, B&L. Once learning about multifocal contact lenses, 75 percent of patients wearing contact lenses or readers want to try them, according to the company.
     The multi-channel marketing initiative incorporates:
   · A new B&L Multi-Focal contact lens TV spot which starts airing nationally on March 14, 2009. Backed by an integrated online awareness building campaign, with a variety of placements on sites, the advertising is scheduled to run throughout 2009.
   · A website, www.goodbyereaders.com, where consumers can find information about presbyopia and multifocal contact lenses, an online lens demonstration of how the B&L Multi-Focal lens design works, a new doctor locator, and download a free trial certificate.
   · An online promotion entitled, "See a New You" will launch on www.goodbyereaders.com on March 23rd, highlighting the fashion and lifestyle benefits of multi-focal contact lenses.

PolyVue Distribution, Inc. announced the introduction of their second generation high definition contact lenses: the HD2 and HDX2. With patented aberration control optics, these high definition aspheric lenses are optimized to reduce spherical aberration for myopic and hyperopic corrections, as reported by the company.
     HD2 aberration control optics naturally mask up to 0.75 diopter astigmatism and can be fit to give up to a +1.00 add. With Comfort Perfected technology in a moisture rich 55% methafilcon A and state of the art Hypathin cast-molded manufacturing, the company states that the HD2 aspheric lens provides superior comfort and unparalleled visual acuity.
     The HDX2 progressive multifocal lens combines the performance of the HD2 aspheric with dual patented technology to create a lens for presbyopes with +1.25 to +2.25 add requirements. Also manufactured using the Hypathin cast-mold process, the HDX2 drapes and contours the cornea, providing stability and minimum lens movement per the company. PolyVue also says that, with minimized adaptation time and aberration reducing high definition optics, the HDX2 provides exceptional comfort and visual acuity.
     Fitting kits are available, and by purchasing a kit, the ECP qualifies for two free boxes of lenses. For a complete list of authorized distributors, or for more information on how to purchase a fitting set, contact PolyVue at 1-877-734-2010.

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Hydrogel Vision Corporation, makers of Extreme H₂O contact lenses, announced the expansion of their product line with the addition of Clarity H₂O. Clarity H₂O is the only monthly disposable lens made with hioxifilcon D, the 3rd generation Benz G-Material. Only Benz G-Material is distilled to produce the highest purity GMA/HEMA copolymer (hioxifilcon D) which, when combined with water, creates a low energy state, resulting in a low contact angle with properties that deliver extreme hydrophilicity, according to the company.
     The lens is available in three base curves. The initial launch includes flat and median with the steep option available in the second quarter 2009. Available parameters are: median: +6.00 to -10.00, flat: -0.25 to -6.00, and steep: -0.25 to -10.00. It is packaged in both a 6-pack and a money saving 12-pack. Free diagnostic sets area available through Hydrogel Vision or their authorized distributors. For more information call 877-336-2482 or visit www.hydrogelvision.com.  

TearLab Corporation announced that it has initiated an international clinical study which is designed to demonstrate the efficacy of the TearLab Osmolarity System as a practical tool for the diagnosis and assessment of severity of Dry Eye Disease (DED) by measuring the osmolarity of tears. Osmolarity, simply stated, is a measure of the concentration of particles or solute per liter of solution.
     The TearLab Osmolarity System Core Validation Study is a 10-site clinical study that will enroll up to 500 subjects at sites in the United States, Europe and Japan. Inclusion criteria includes patients with or without a history of DED. Enrollment is expected to be completed by the end of the second quarter of 2009. Alcon is a sponsor of the study.
     By using osmolarity values derived from the TearLab Osmolarity System, clinical investigators will evaluate the validity of the system to diagnose DED and the severity of the disease. The system will be compared with current diagnostic tools clinicians use to establish DED. Subjects will be assessed at a single visit and the diagnosis will be based on positive responses using established objective and subjective criteria.
     The TearLab Osmolarity System is currently available in the U.S. for investigational use only. For more information, visit www.tearlab.com.

SynergEyes, Inc., the developer of the first FDA-cleared hybrid contact lens specifically designed for patients with keratoconus, launched a new educational website, www.SharingOneVision.com, for patients seeking information on keratoconus and treatment with hybrid contact lenses.
     At this website patients can learn about keratoconus, read detailed information on the SynergEyes KC hybrid contact lenses and view stories from other keratoconus patients who have been successfully treated with hybrid contact lenses. The site also offers a doctor locator search tool to make it easy for patients to find certified practitioners that fit SynergEyes lenses. In addition, keratoconus patients can watch educational videos on how to properly insert, remove and clean hybrid contact lenses. 

Dry eye is thought to be the most common ocular problem in the United States. However, it is only recently that it has been recognized as a disease with significant economic burden and impact on quality of life. This article presents an economic model of cost-effectiveness of two ophthalmic lubricants commonly used in the treatment of dry eye: Systane and Refresh Tears.
     We conducted a meta-analysis, pooling the results of two clinical trials of patients with dry eye treated with Systane and Refresh Tears which presented response rates for improvements in ocular dryness, the key symptom of dry eye. An economic model was used to estimate the incremental cost-effectiveness ratio (ICER) for Systane versus Refresh Tears over a 12 month treatment period.
     Systane is significantly more effective than Refresh Tears at improving symptoms of "dryness" (75% vs 41%). Systane costs on average $57.79 per year more than Refresh Tears. Assigning a quality-adjusted life year (QALY) gain of 0.03 to responders results in an incremental cost per QALY gain of $5,837.
     The authors concluded that both Refresh Tears and Systane are effective and cost-effective interventions. Systane costs more than Refresh Tears, however clinical trial evidence shows it to be more effective. The ICER for Systane versus Refresh Tears is well below the generally accepted $50,000 per QALY threshold.
Wlodarczyk, J. and C. Fairchild (2009). United States cost-effectiveness study of two dry eye ophthalmic lubricants. Ophthalmic Epidemiol 16(1): 22-30.

I think the most serious compliance issue is ignoring problems. Every year I emphasize to patients that they shouldn't wear their lenses when their eyes are bothering them, and every year I see patients (often new patients) whose infections started 2 or 3 days ago and they still have their lenses in. I also emphasize the importance of back-up glasses.
Sandra Lehman, OD
Park City, UT

There have been numerous studies published on the subject of contact lens wearer "drop out." Surveys of these individuals resulted in the statistic that either inadequate comfort, vision, or both were given as the most frequent reasons for discontinuing contact lenses. In the group of those who felt that the lenses were not comfortable enough to wear on a regular basis, the solution(s) used to maintain the lenses was found to be the causative agent.
     In a distorted attempt to save money the contact lens wearer will frequently switch to a generic brand of contact lens solution in the erroneous belief that they are all the same; "They are all saline, aren't they?"
     There have been frequent occurrences where we re-educate a patient on the importance of using the solution system we prescribed at dispensing, when they have returned for a follow up visit with either red eyes, reduced comfortable wearing time, or both. Placing them back on the system we had originally prescribed will most often resolve these symptoms and signs.
Charles D. Allen, OD, FAAO
Princeton, NJ

Last week, I commented on compliance with contact lens wear and care as it relates to the ultimate success of our patients. Clearly, many of you feel strongly about the importance of compliance. I have chosen a few of the comments that you sent to me which will appear in the next few issues, and I hope these provide others unique insight into this complicated issue.
Jason J. Nichols, OD, MPH, PhD, FAAO

This month at www.siliconehydrogels.org: incorporating Acanthamoeba testing into the MPDS licensing process; prescribing silicone hydrogels for post-RK patients; variability in corneal swelling with different silicone hydrogel lenses; and part 2 of our 2008 BCLA update.