CONTACT LENSES TODAY

April 3, 2005

Contact Lenses Today is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday reaches more than 10,000 readers in 74 countries.


State of the UK CL Market in 2004
The Association of Contact Lens Manufacturers (ACLM) recently released its statistics on the 2004 contact lens market in the United Kingdom (UK). According to the ACLM, the market was made up of the sale of more than 424 million contact lenses and market value comprised daily disposables (55%), soft frequent replacement lenses (27%), silicone hydrogels (8%), soft traditional lenses (5%) and rigid lenses (6%). Of the 3.21 million wearers in the UK, more than one million (34%) wear daily disposables and approximately 345,000 (11%) are rigid contact lens wearers.

Vision Loss from Viagra?
U.S. researchers recently described the cases of seven patients who developed nonarteritic ischemic optic neuropathy (NAION) after taking sildenafil (Viagra). According to the researchers, combined with past reports, this study brings the total number of sildenafil-related NAION cases to 14. They reported in the March issue of the Journal of Neuro-Ophthalmology that all of the patients had one or more heart disease risk factors. (High blood pressure was invariably present and most men also had high cholesterol levels. Three patients had pre-existing eye problems that may have increased their risk of NAION.) The researchers concluded that not enough data exist to support performing an ophthalmic exam on every patient who is considering sildenafil treatment, but insist that doctors prescribing the drug be aware of the association.

HYDRACLEAR Technology -- The Science Inside ACUVUE ADVANCE Since the launch of ACUVUE ADVANCE Brand Contact Lenses with HYDRACLEAR, Eye Care Professionals across the country have reported an influx of patients requesting "that new lens with HYDRACLEAR." What is this remarkable technology that helps keep eyes looking clear and white and feeling great all day long? HYDRACLEAR is the VISTAKON brand name for our proprietary technology that brings together a remarkable moisture-rich wetting agent with high performance base materials to form clear, wettable lenses resulting in a unique, silky, soft feel. It's the science inside ACUVUE ADVANCE that delivers comfort for even the longest days.
http://www.ecp.acuvue.com

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FDA Approves AMO's Multifocal Refractive Lens
The FDA has recently approved Advanced Medical Optics, Inc.'s (AMO's) ReZoom multifocal refractive IOL for cataract patients. This approval adds to the company's portfolio of refractive intraocular lenses (IOLs). The ReZoom IOL is a new design and next-generation, acrylic three-piece multifocal IOL. The ReZoom IOL Balanced View Optics distribute light over five optical zones for enhanced restoration of visual function, providing distance, intermediate and near vision for reduced spectacle dependence, allowing the lens to match its performance characteristics with the lifestyle demands of the patient, according to AMO. The ReZoom Multifocal IOL has CE Mark approval in Europe for treatment of presbyopia.

Allergan to Collaborate on Implant for Macular Edema
Allergan, Inc. has entered into an exclusive licensing agreement with Sanwa Kagaku Kenkyusho Co., Ltd. to develop and commercialize Posurdex for the ophthalmic specialty market in Japan. Posurdex is an investigational, bioerodable, extended-release implant that delivers dexamethasone to the targeted disease site at the back of the eye to treat macular edema. Sanwa will develop and commercialize Posurdex in Japan and will incur associated costs as well as pay Allergan a royalty. Both companies will work collaboratively on the clinical development of Posurdex, as well as overall product strategy and management. Allergan is currently conducting two Phase III clinical programs worldwide with Posurdex focusing on macular edema associated with diabetes and other conditions. Sanwa is expected to begin Phase I/II development with Posurdex in Japan later this year.

ABB Optical's New Center Features State-of-the-Art Logistics System
ABB Optical's new 26,000 square-foot distribution center in Marshfield, Mass. is now fully operational and the company has an additional 40,000 square feet of warehouse space planned for the site.

Abstract: Results from LORIC Study
Researchers conducted a two-year pilot study (The Longitudinal Orthokeratology Research in Children [LORIC]) to determine whether ortho-k can effectively reduce and control myopia in children. They monitored the growth of axial length (AL) and vitreous chamber depth (VCD) in 35 children aged seven to 12 undergoing ortho-k and compared the rates of change with 35 control children wearing single-vision spectacles. The researchers also determined the changes in corneal curvature and the relationships with changes of refractive errors, AL and VCD for the ortho-k subjects. All of the ortho-k subjects found post-orthokeratology unaided vision acceptable in the daytime. They found significant initial corneal flattening in the ortho-k group, but no significant relationships between changes in corneal power and changes in AL and VCD. The researchers concluded that ortho-k can have both a corrective and a control effect in childhood myopia, but substantial variations exist in changes in eye length among children and there is no way to predict the effect for individual subjects.
Cho P, Cheung SW, Edwards M. The Longitudinal Orthokeratology Research in Children (LORIC) in Hong Kong: A Pilot Study on Refractive Changes in Myopic Control. Current Eye Research 30:71-80, 2005.


Editor's Commentary: Ortho-K and Myopia Progression
This week, our abstract discusses a rigorous study of overnight orthokeratology and myopia progression. Before you start telling all of your patients that ortho-k can halt the progression of myopia, keep this in mind: Even if it does decrease the progression of myopia, as with other treatments such as progressive addition spectacle lenses and GP lenses for daily wear, the treatment effect is not large. Jeff Walline, O.D., Ph.D., author of the CLAMP Study and experienced myopia and corneal reshaping in kids investigator comments:
The results from the LORIC Study are important and intriguing. This is the first evidence from a controlled study that indicates the potential for myopia control with corneal reshaping contact lenses. The treatment effect over two years is also greater than the treatment effect reported by recently completed, randomized clinical trials investigating myopia control with bifocal spectacles and alignment fitted GP contact lenses. However, caution should still be applied when telling patients about the potential for myopia control benefits with corneal reshaping contact lenses until the results are verified by an independent investigation and more information is available regarding which specific children will benefit from corneal reshaping myopia control.


Fitting Tip: Revisiting the Topic of CL CE
The reason why diagnostic continuing education is more prominent is related to the ability of optometrists to charge professional fees (established by ophthalmology) that provide higher compensation for diagnostic work ups than the fees that routine contact lens services provide. As contact lenses are available from many discounted sources in addition to the doctor's office, we have to expand diagnostic services (including specialty contact lenses) to attract and retain patients and to generate revenue. This change in market dynamics isn't going to go away and the ability to provide valuable expanded professional services that generate appropriate compensation is mandatory for our profession to continue to be independent and to provide employment opportunities for new graduates. In addition, continuing education (CE) licensure requirements mandate that the majority of CE is pathology-based.
--John Funnell, O.D., F.A.A.O.
Manhattan Beach, Calif.

Congratulations to Bruce Anderson, O.D., F.A.A.O., winner of March's CLToday Fitting Tip of the Month.


Include the Global Orthokeratology Symposium (GOS) in Your Summer Plans
(July 28 to 31, 2005 in Chicago, Ill. -- for the first time in the U.S.A.)
Learn how to manage and market your overnight orthokeratology practice. Register by April 30, 2005 to save $115 off the full symposium price.



This month at http://www.siliconehydrogels.org, read about the worldwide market success of silicone hydrogels, scan the latest research presented at the American Academy of Optometry 2004 and explore novel laboratory procedures facilitating accurate measurement of lysozyme deposited on these lenses.

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, issue archives and discussion forums. Visit Contact Lenses Today for our Best Fitting Tips and Photo Clinic, sponsored by Ocular Sciences.
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