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Sunday, April 14, 2013  
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Last question:
When using a custom soft contact lens, which parameter do you most often customize

 Power
   50%

 Base curve
   40%

 Diameter
   8%

 Thickness
   2%

Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

Allergy season is upon us. Don't forget about some of the more simple steps you implement in your contact lens wearers. Consider all options—increasing lens replacement frequency, emphasizing lens care, and pharmaceuticals. While seasonal allergies are often short-lived, they can have a significant impact on your lens wearers.


Menicon Announces WebStore Challenge

Menicon America Inc. has launched its "WebStore Sign up Challenge." All U.S. eyecare practitioners with a Menicon WebStore account are eligible. Before taking the challenge, practitioners log into their WebStore account and enroll. By signing up 20 new GP patients who purchase on the WebStore prior to July 1, 2013 they are eligible to receive a free one year subscription to i-Vue.

i-Vue is patient education digital signage that runs on a PC connected to a waiting room TV monitor and incorporates medically accurate 3-D ophthalmic animations. The software includes a large library of 3D animations covering a range of ophthalmic subjects. The i-Vue screen can display real time information including news and weather. Users create personalized playlists with a drag and drop interface.

Menicon developed the WebStore to offer patients a convenient online source for Menicon solutions and providing practitioners with a "virtual" way to sell solutions and monitor patient compliance. All patients on the WebStore are "connected" to their practitioner.

The WebStore transactions are secure and orders are shipped within 48 business hours. Patient orders are shipped free of charge. To learn more, contact Menicon America at 1.800.MENICON or visit: http://www.meniconamerica.com/promotions.

Vistakon Offers Help Coping with Allergy Symptoms

Just in time for this year's allergy season, Vistakon Division of Johnson & Johnson Vision Care, is once again offering a complimentary educational brochure titled Eye Health and Allergies to provide patients with useful information on how eye allergies occur, common signs and symptoms, and practical advice on how to treat eye allergies. This brochure also includes helpful information about eye allergies and contact lenses, including advice on the benefits of daily disposable contacts.

A downloadable PDF of the brochure is available in the Patient Education section of the www.ACUVUEProfessional.com website. Printed copies of Eye Health and Allergies are also available to eyecare practitioners free of charge. To receive bulk copies for your office, please e-mail your request, making sure to include your name and mailing address to eyeallergybrochure@rprny.com.

Vistakon is also offering a variety of rebates on both 1-Day Acuvue Moist brand contact lenses and 1-Day Acuvue Moist for Astigmatism brand contact lenses. There are different rebate offers for new and current wearers as well as special offers for those who buy an annual supply.

Unilens, B+L Extend Licensing Agreement

Unilens Vision Inc. through its wholly owned subsidiary Unilens Vision Sciences Inc. announced that the company and Bausch + Lomb (B+L) have extended the parties' existing licensing agreement.

The amended agreement continues B+L's exclusive worldwide license for Unilens' multifocal technology and grants B+L an exclusive worldwide license to use Unilens' new multifocal technology. Terms of the arrangement were not disclosed; however the parties have agreed that the existing royalty rates will remain in effect and will apply for both technologies. B+L recently introduced the PureVision 2 for Presbyopia in certain European markets. The new addition to the PureVision portfolio incorporates B+L's lens technology using certain licensed elements of Unilens' next generation technology.

Unilens will continue to develop, manufacture, license, and market contact lenses, including its C-Vue Hydravue Multifocal, as well as a full line of customized silicone hydrogel lenses under the C-Vue HydraVue brand exclusively to independent eyecare professionals.

Lens Care Card Receives Start-up Award

Refresh Innovations, creators of The Contact Lens Refresh Card, was the recipient of the $50,000 grand prize of the 14th-annual Duke Start-Up Challenge. The competition was created to encourage startups among the members of the Duke University community.

The Contact Lens Refresh Card is an ultra slim, all-in-one contact lens case and multipurpose solution package. The patent-pending design is the size of a credit card, disposable and designed to fit in a wallet. The inventors said they talked to eyecare industry experts and lens wearers to determine the need for the product and hone the design.


LASIK with Bilateral Epithelial Ingrowth
By William Townsend, OD, FAAO; Photos Courtesy of Janet Townsend

The individual in these photos presented six months after laser-assisted in-situ keratomileusis (LASIK) with bilateral epithelial ingrowth. This is a relatively uncommon finding. In approximately 1 percent of eyes that have undergone LASIK, corneal epithelium gains egress into the flap-bed interface and may grow to significant proportions. This phenomenon is associated with lower endothelial cell counts, thinner flap thickness, and enhancement.

For more information on this patient and epithelial ingrowth, visit http://www.clspectrum.com/articleviewer.aspx?articleID=106856.

We welcome photo submissions from our other 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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RESEARCH REVIEW
Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Are Tear Proteins Friend or Foe for Contact Lens Wearers?

Tear proteins such as lactoferrin and lysozyme have been known to be culprits and antigens for initiating contact lens papillary conjunctivitis, especially in their denatured state. However, these proteins have important functions, including antimicrobial functions, that are important as part of the defense mechanisms of the ocular surface. Thus, an argument can be made on the importance of retention of such proteins at the contact lens/ocular surface to maintain healthy lens wear.

A unique method of assessing whether tear protein structure and function can be maintained in the presence of care solutions was performed. Human lactoferrin and lysozyme were treated with sodium dodecyl sulfate (SDS) which is a potent denaturing surfactant, and either with or without an investigational version of a multipurpose solution (investigational version of Biotrue, Bausch + Lomb, which contains protein-stabilizing agents including hyaluronic acid, poloxamine, and sulfobetaine 10, the latter used previously as a laboratory tool to renature proteins). The structure was assessed by native-polyacrylamide gel electrophoresis (PAGE), differential scanning calorimetry (DSC), and fluorometry. Antimicrobial activity against Pseudomonas aeruginosa and Staphylococcus aureus were also measured. Their data showed that the investigational product (which is similar to the commercially available MPS without the disinfecting agents) prevented the denaturation of physiologic levels of human lactoferrin and lysozyme by SDS and that stabilized proteins retained their function. It would be of interest to know if the same effects would be found with the commercially available care solution.

Wright EA, Payne KA, Jowitt TA, Howard M, Morgan PB, Maldonado-Codina C, Dobson CB. Preservation of human tear protein structure and function by a novel contact lens multipurpose solution containing protein-stabilizing agents. Eye & Contact Lens. 2012 Jan;38(1):36-42.

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MATERIALS & DESIGNS
Ronald K. Watanabe, OD, FAAO

UltraHealth is Here!

SynergEyes has introduced the new UltraHealth hybrid lens for irregular corneas. At first glance, it looks a lot like its ClearKone design, but there are a few key differences between the two.

First, the materials used in the GP center and the soft skirt are a significant upgrade. The GP center has higher Dk (130), lower wetting angle, higher modulus to better mask irregularities, and a UV blocker. The soft skirt is a silicone hydrogel with Dk of 84, like in the Duette lenses. Next, the design is an evolution of the ClearKone design. The GP inner landing zone is wider to allow for softer landing on the cornea, and a "variable lift curve" helps lenses with greater sags to vault the cornea without relying as much on the soft skirt to vault the GP. The new soft outer landing zone also has a "lift curve" that aids in the overall vault of the lens. The skirt fitting philosophy is also different, shooting for the flattest acceptable skirt to ensure movement and tear exchange.

These improvements should help improve success of this reverse geometry hybrid lens for a wider range of irregular cornea patients.

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Effect of Lens and Solution Choice on the Comfort of Contact Lens Wearers

The purpose of the study was to determine if the ocular comfort of symptomatic contact lens wearers can be substantially influenced by choosing a better or worse performing contact lens/care product combination.

Twenty-four symptomatic and 13 nonsymptomatic lens wearers were enrolled into a prospective, crossover, randomized clinical trial. Two lens/lens care product combinations were chosen from studies previously conducted at the Brien Holden Vision Institute that were found to provide the best (galyfilcon A/polyhexanide, combination 1) and worst performance (balafilcon A/polyquaternium-1 and myristamidopropyl dimethylamine + TearGlyde, combination 2), in terms of end-of-day comfort. Subjects were not told their category (symptomatic/nonsymptomatic) or the rankings of each combination. Subjects were randomly allocated to one of the lens/lens care product combinations for eight days on a daily wear basis. Lens fitting was assessed after application from the packaging solution. Take-home questionnaires assessing ocular comfort and dryness (1 to 10 numeric rating scale) were completed on application and after two and eight hours of wear on days two, four, and six. Ocular symptoms were assessed on days two, four, and six after eight hours of wear. A 48-hour washout period during which lenses were not worn was applied, with the procedure repeated using the second combination.

In symptomatic subjects, combination 1 was rated significantly better than combination 2 after eight hours of wear for ocular comfort (7.7 +/- 1.3 vs. 7.1 +/- 1.5, p = 0.01) and ocular dryness (7.5 +/- 1.6 vs. 7.0 +/- 1.6, p = 0.045), with less frequent symptoms of ocular dryness (p < 0.01) and lens awareness (p < 0.01) reported. No significant differences were found in nonsymptomatic subjects.

Researchers concluded ocular comfort and symptoms in symptomatic lens wearers can be perceptibly improved by switching to an alternative lens/lens care product combination, and that the finding provides justification for the efforts of both eyecare practitioners and researchers to improve the comfort of lens wearers.

Tilia D, Lazon de la Jara P, Peng N, Papas EB, Holden BA. Effect of Lens and Solution Choice on the Comfort of Contact Lens Wearers. Optometry and vision science : official publication of the American Academy of Optometry 2013

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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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