April 24, 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.

Multifocal LASIK began in development in 1992 and up until recently has only been available outside the United States. But as of now, a handful of U.S. clinics are performing the multifocal LASIK procedure, which is an off-label use of the FDA-approved excimer lasers. In multifocal LASIK, the excimer laser creates more than one curvature on the cornea. The newer treatment allows for vision for driving, reading and for intermediate distance. According to one developer, Robert L. Epstein, M.D., multifocal LASIK has been used to reduce or eliminate the need for bifocals and works for people even past the age of 65. For more information, check out the following Web site: http://www.icansee.com.

---

B&L Reports First Quarter Results, Offers VST Certification Training
Bausch & Lomb released results for the first quarter ending March 16, 2005. According to B&L, the company's lens care multi-purpose solutions category led sales growth, increasing 13% in the quarter. Soft contact lens sales were important to B&L's growth as well.
In other company news, B&L has kicked off a series of traveling educational programs that offer eyecare professionals certification for its Vision Shaping Treatment (VST) system as well as the specific lens designs for overnight orthokeratology under VST. (The company requires eyecare professional interested in fitting their patients with specific VST, ortho-k lens designs to receive this certification.) The certification program continues through early summer. For locations and dates, visit http://www.bausch.com/vst/tour.com

---

Actress to Work on Dry Eye Initiative
Actress Janine Turner (Maggie O'Connell from Northern Exposure) is teaming up with prominent ophthalmologist Amy Niles, who's also president and CEO of the National Women's Health Resource Center, to form an expert panel about chronic dry eye and to offer education, tips and testimonials about the condition.

---

The Accelerated Stabilization Design of ACUVUE ADVANCE for ASTIGMATISM
The biggest breakthrough in toric contact lens technology in 15 years, ACUVUE ADVANCE Brand Contact Lenses for ASTIGMATISM harnesses the power of the blink to quickly orient and stabilize the lens in approximately 60 seconds. The four active zones and accelerated slope of thickness of the proprietary Accelerated Stabilization Design work with the eyelids to balance the lens in place when the eye is open and quickly re-align the lens if it rotates out of position. This new design provides your patients with crisp, stable, all-day vision and provides doctors with a fast, predictable fit.
http://www.ecp.acuvue.com
--ADVERTISING

---

Two New GPs From Con-Cise
Last month, Con-Cise Contact Lens Co. introduced two new GP lens designs: the New Natural Vision Bifocal, which includes thinner designs, blended seg line, reliable duplication, higher Dk materials, symmetrical peripheral curves and enhanced edge profiles, and the GBL Design for kones and difficult irregular corneas. A Reverse GBL design is also available for those extreme and unique cases. For more information, visit http://www.con-cise.com.

---

FDA Approves Xibrom
Last month, the FDA approved Ista Pharmaceuticals, Inc.'s topical, twice-daily NSAID, Xibrom (bromfenac ophthalmic solution) 0.09%, for the treatment of ocular inflammation following cataract surgery. Senju Pharmaceuticals Co. Ltd. has marketed Xibrom in Japan since 2000.

---

Art Optical Adds to Its Specialty Product Line
Art Optical is answering growing practitioner demand for ortho-k designs by manufacturing and distributing the BE Retainer overnight ortho-k design, which is a design partner in Bausch & Lomb's Vision Shaping Treatment and is now FDA-approved for overnight wear. Dr. John Mountford and Don Noak designed the BE Retainer in Australia using topographical data only. According to Art Optical, each BE Retainer is custom fit to each patient's cornea and is a software-driven fitting system. To learn more, visit http://www.beretainer.com.

---

SofPort Makes Cataract Surgery More Efficient
Bausch & Lomb recently unveiled its SofPort Easy-Load Lens Delivery System, which it designed to make cataract surgery more efficient by allowing surgeons to load the lens into the inserter without touching or aligning the IOL with forceps. According to B&L, avoiding the use of forceps also virtually eliminates mishandling and damage to the lens. For more information, go to http://www.sofportrevolution.com.

---

Editor's Commentary: Repeat Your Message to Patients
We had an interesting comment from a reader that I think is critical:
I think that Dr. Opferman should win the prize for his comment ("Don't Recommend Over Wear," April 10, 2005 CLToday Fitting Tip). I have to agree with him. I see way too many patients who tell me the same thing about their last doctor saying that it's okay to wear their contact lenses for longer than they are recommended. This is bad for the patient, bad for the doctor and bad for our profession. I'm constantly working to get patients to wear their contact lenses for the correct amount of time.
--John Chatelain, O.D./Houston, Texas
I know I've said this many times, but getting patients to comply with any treatment requires education about why the treatment (in this case, lens replacement) is important and ongoing, repeated communication, communication, communication to reinforce the importance of what some call compliance or treatment plan adherence. Cost and patients who don't comply because they think they're not being harmed are always barriers, but you can overcome these barriers by repeating your message.

---

Fitting Tip: Much Ado about Monovision
With reference to Dr. Mark Greenwell's Tip of the Week "Before You Give up on Monovision" (April 17, 2005 CLToday), I'd like to mention an additional thought before selecting a toric lens in one eye for monovision. I normally have excellent results in these types of cases by selecting the more spherical eye for distance and the mild cylinder eye for near. Patients usually tolerate mild uncorrected cylinder well at near with virtually no subjective symptoms, whereas this isn't the case for distance.
The common conception of always selecting the dominant eye for distance will not create your best track record for success when prescribing monovision or modified monovision (using a bifocal in one eye). Be creative before complicating the fitting . . . select the eye capable of better acuity with a spherical lens for distance using the least amount of minus (or most plus) that renders good distance acuity, and the opposite eye for near using the most amount of minus (or least plus) that renders acceptable near acuity. This will create the least amount of disparity between both eyes and allow for easier adaptation, smoother transition and greater depth of focus at varying distances. Obviously, each case will be different, depending on the individual needs of the patient and the type and degree of cylinder. So, if the above does not work, then by all means, incorporate the cylinder.
--Michael Feldman, O.D.
Lynbrook, N.Y.

I agree with Dr. Greenwell about correcting low amounts of astigmatism in monovision fits. I have found many patients who feel better subjectively and objectively when demonstrated that cylinder with a handheld trial lens and after a successful toric fitting. Also, careful sphero-cylindrical over-refraction has been perhaps the most valuable tool in all of my astigmatic successful fits.
--Christopher R. Howard, O.D.
Crestview, Fla.

---