CONTACT LENSES TODAY

April 29, 2007

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more than 12,000 readers in 74 countries.


May is Healthy Vision Month
The National Eye Institute observes Health Vision month in May, an annual observance designed to raise awareness of the importance of eye care for those at risk for developing eye and vision problems. This year’s observance highlights the importance of early glaucoma detection. The NEI is encouraging patients to get a dilated eye exam and to spread the word to family and friend using its e-cards and brochures. For more information, visit http://www.nei.nih.gov.glaucoma.

A Confident Choice
ACUVUE® ADVANCE™ Brand Contact Lenses for ASTIGMATISM are the # 1 astigmatic lenses for new wearers. Eye Care Professionals surveyed said the comfort level of ACUVUE® ADVANCE™ Brand for ASTIGMATISM was superior to other lens designs, and they also gave it high marks for its average settle time of 53 seconds. In a survey of more than 200 ECPs participating in a market test, 99% rated the lens very good to excellent for ease of fit; and 98% agreed the rotational stability and predictable orientation of ACUVUE® ADVANCE™ for ASTIGMATISM was very good to excellent. With the increased comfort, ease of fit and the highest UV protection available, ACUVUE® ADVANCE™ for ASTIGMATISM is designed to quickly give you complete confidence in your first choice lens. And now, ACUVUE® ADVANCE™ for ASTIGMATISM meets more patients' needs with the introduction of -2.25 cylinder.
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Abstract: MPDS Vs. Serratia Marcescens
Researchers at the University of New South Wales in Sydney recently compared the susceptibilities of clinical isolates of Serratia marcescens and the standard ISO ATCC 13880 strain against five contact lens multipurpose disinfection solutions (MPDS). They tested five commercially available MPDS, containing either polyquaternium or polymeric biguanide using ISO/CD 14729 stand-alone test for contact lens products against four ocular isolates of S. marescens and the strain ATCC 13880. Investigators measured the average log reduction in bacterial numbers at the manufacturer’s recommended disinfection time and compared this with the criteria for stand-alone disinfection products for each MPDS against each bacterial strain.
    All the MPDS tested met stand-alone criteria of 3-log reduction of viable bacteria against the ATCC strain. However, they found more variability in the MPDS’ ability to meet disinfection criteria when testing against the clinical isolates. Two clinical isolates were found to be significantly more resistant to disinfection than was the recommended ISO strain. Two polyquaternium-1-based solutions were less effective overall than the other MPDS against S. marscens.
    The authors conclude that the results indicate the importance of strain selection for the testing of MPDS and say the use of a single laboratory strain may be insufficient to provide assurance that the disinfection solution will be effective against clinical isolates. They also note that clinical isolates of S. marscens may show increased resistance to disinfection with polyquaternium.
Hume EB, Zhu H, Cole N, Huynh C, Lam S, Willcox MD. Efficacy of contact lens multipurpose solutions against serratia marcescens. Optom Vis Sci. 2007 Apr;84(4):316-20.


Editor's Commentary: Irregular Cornea: Whatever Works
A few years ago, I conducted a survey among practitioners who I knew fitted contact lenses on a lot of irregular corneas. The most common comment: Do "whatever works." We all know that the keratometer doesn’t tell a very complete story about corneal topography by a long shot. We had a penetrating keratoplasty (PK) case last week that failed with many lens types. The topography illustrated about 6.00D of toricity, which was decentered nasally, and a tight suture at 9 o'clock. I usually don't try bitorics on PK eyes, and even though this patient’s against-the-rule toricity wasn't perfectly centered, I thought we'd try what we had not tried. We put on a diagnostic SPE bitoric lens with only 2.00D of toricity. A +6.00D sphere over-refraction provided the patient with 20/20 visual acuity over this plano/-2.00D lens. I am always happy when I can use the SPE trial set. We have many articles on fitting these cases on the Contact Lens Spectrum Web site archives. Feel free to check it out at http://www.clspectrum.com.

CLToday Tip: Preventing Acanthamoeba
With the recent rise of Acanthamoeba in the news (see last week’s edition of CLToday), and the summer months quickly approaching, it’s important to educate our patients on the importance of caring for their contacts while engaging in water sports and activities. I always tell my patients to remove their lenses while swimming, whether in a pool, lake or ocean. If they can not go without their lenses, tight-fitting goggles are best, but regardless of whether water seeps in, patients should always discard contacts as soon as they come out of the water. For those patients who would not dream of throwing a monthly-replacement lens out only after a week of wear, a hydrogen peroxide system is the second-best option. Or you can fit them with daily-disposables.
Brianne J. McCarthy, N.C.L.E.C.
Somerville, Mass.


This month at http://www.siliconehydrogels.org, consider a strategy for using SiH lenses to increase the success of your practice; investigate the potential for using SiH lenses in the treatment of dry-eye; review the recent research into silicone hydrogels (SiH) presented at the American Academy of Optometry, and learn how the SiH market has evolved over the past seven years.

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 T-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 and issue archives. Visit Contact Lenses Today for our Best Fitting Tips.
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