Some of the most innovative research of the year is presented at the ARVO Annual Meeting. Here are some of the latest findings regarding contact lens care, as presented in Fort Lauderdale, Florida this week:

• Soft contact lens wearers have a higher risk for microbial keratitis than rigid lens wearers; 2 week and daily replacement contact lenses had and increased risk of MK as compared with monthly replacement. The authors stated the reasons to be noncompliance with care, the "absence of professional supervision" of daily disposables, and wearing 2 week lenses longer than recommended. (Borcier T, Sauer A)
• Contact lens cases of patients with contact lens-related microbial keratitis were analyzed. The more severe the disease and acuity, the more likely there to be greater numbers of bacterial types isolated from the case. (Wiley L, McAllister M, Wiley LA, et al.)
• Any residual amounts of hydrogen peroxide remaining after neutralization do not adversely affect stratified corneal epithelial cells. (Konynenbelt BJ, Mlnarik DS, Schotanus AK et al.)
• Silver-infused contact lenses reduce adherence of potential microbes to contact lens surfaces. They do not result in any statistically or clinically significant alterations to the ocular biota over 5 months of daily wear. (Lakkis C, Anastasopoulis F, Slater J, et al.)
• Rinsing with multipurpose solution or hot water followed by 6 hours of air-drying is not sufficient to remove biofilm from a contact lens case. (Vijay AJ, Zhu H, Willcox M, et al.)

www.ARVO.org

Following my last column on comfort (or in my case, discomfort) with contact lens insertion, I received several excellent comments including a wonderful paper from Dr. Charles McMonnies, an extremely well respected clinician and scientist. In his paper, published in 1997 in Clinical and Experimental Optometry, vol .80, March-April, a patient's perceived insertion comfort and three methods of immediately addressing discomfort were studied. Of the 1,234 eyes fit in the study, 54% experienced initial comfort and no settling methods were needed. However, for those experiencing discomfort the following steps resulted in improved comfort: localizing the irritation, looking away from the location, sliding the lens away from the discomfort, and then back into position. This settling procedure was 86% effective in eliminating the initial discomfort (in those with discomfort on insertion).

On the basis of this study, it seems as though this very easy technique should be a step in every clinician's fitting routine in that it eliminates the need to remove the lenses in a majority of cases with initial discomfort. However, in context of my last column, what is even more interesting to me are the 14% that needed to remove the lens in an attempt to alleviate discomfort when the settling techniques failed. What makes this 14% different? Do they have an ocular surface environment that puts them at risk for contact lens related dry eye? Is this a red flag signaling that we need to pay more attention to these patients, at follow up—their lens fit, care solutions and rewetting drop use? We would be remiss to overlook signs of mild dry eye or even MGD, especially when an early indicator may be staring us right in the face.

VSP Vision Care and Vistakon Offer Exclusive Satisfaction Guarantee

VSP Vision Care and Vistakon, a Division of Johnson & Johnson Vision Care, Inc., announced an exclusive satisfaction guarantee on Acuvue Brand Contact Lenses for VSP members, beginning May 1, 2011.

Members with contact lens coverage can try Acuvue Brand Contact Lenses with little or no financial risk through their VSP provider. If they're not completely satisfied, up to $60 of their benefit will be reinstated as long as their eyecare professional contacts VSP within 30 days of the start of the trial. Members can use their reinstated benefit toward glasses or a replacement of their current contact lenses.

VSP and Vistakon also continue to offer an enhanced national contact lens rebate program which launched in October 2010. Under this program, members who purchase an annual supply of Acuvue Brand Contact Lenses from one of VSP's network providers, receive an additional $25 rebate on top of the current national rebate program offered by Vistakon.

For more information about the exclusive offer and rebate program, visit www.vsp.com/cms/offers/acuvue.

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New Patent for TearLab Protects Expansion of Tear Testing Beyond Osmolarity

TearLab Corporation has been granted a new patent entitled "Biomarker Normalization." According to the company, this patent provides the company with broad intellectual property regarding the ability to compensate for first order dynamics in the eye, which is fundamental to accurate tear biomarker analysis, whether involving proteins, genes, or small molecules. The patent allows TearLab to build upon its non-invasive in vitro diagnostic platform to expand testing beyond tear film osmolarity for dry eye disease.


New Exhibitors' Program at BCLA 2011

Industry support of the annual British Contact Lens Association (BCLA) Clinical Conference and Exhibition, May 26-29, will be heightened this year with the introduction of a new Exhibitors' Pavilion. For the first time, exhibitors and sponsors will run half-hour product and education sessions in a pavilion situated within the Central Hall of the venue.

Company supported sessions will include: Patient Education and Marketing Tools by Dr. Trusit Dave (Optimed); Duette: Perfection in Harmony by Caroline Burnett Hodd (No 7 Contact Lenses); Ultra Widefield Retinal Imaging by Mark Braddon (Optos); Eye Drops in Comod by John Freyne (Scope Healthcare); The Upgrade Opportunity by Dr. Caroline Christie (Sauflon); KeraSoft IC – Uniquely MoRoCCo by Lynn White (UltraVision); Tri Comfort: Try It Yourself by Dr. Christine Purslow (CIBA Vision); and Tear Film Osmolarity by Professor Giancarlo Montani (Abbott Medical Optics).

For conference information and registration, visit www.bcla.org.uk.

Menicon Appoints Martin CFO for Europe

Menicon Co., Ltd. appointed Manuel Martin as Chief Financial Officer for Europe. Martin brings over 15 years of experience in finance covering diverse companies and sectors.

Over the past three years, he was the CFO for a large Spanish real estate valuation company, where he was responsible for the implementation of all financial policies and internal control systems, as well as supporting the launch of new companies and business units. He was also actively involved in managing the sale of the company to a venture capital firm in the United States.

Martin has a degree in Business Administration, a Masters in Business Administration and a Masters in Finance.

This week, May 1-5, 2011, is the Association for Research in Vision and Ophthalmology's (ARVO) annual meeting. As is being discussed in our feature columns, there is a tremendous amount of high-caliber work being presented on contact lenses.

ARVO's annual meeting has been held in Fort Lauderdale for many years, although the venue will be changing starting in 2013 with the meeting moving to Seattle, followed by Orlando (2014), Denver (2015) and Seattle again (2016). Per ARVO's website, this decision was based on the convention center size and cost savings, in addition to a vote of the membership (with 59% of overall members voting for rotation between cities). I must admit, I do very much enjoy the Fort Lauderdale venue and will cherish these last couple meetings.

Look for more updates from the meeting from our editorial team in the future.

Last week's question:
What percent of your contact lens wearers with contact lens dry eye and reduced comfortable contact lens wearing time do you think have concurrent meibomian gland dysfunction?

 1. 0-15%
   8%


 2. 16-30%
   24%


 3. 31-45%  
 
  19%

 4. 46-60%
   26%

 5. 61-75%
   18%

 4. > 76%
   5%

Effectiveness of Cleaning Regimens and Current Guidelines in Contact Lens Case Biofilm Removal

Lens case hygiene is important for safe contact lens wear. However, there are no evidence-based data to suggest optimum hygiene regimens. This in vitro study aimed to evaluate and compare the effectiveness of manufacturers' guidelines and several other regimens in removing biofilm using various types of contact lens cases and disinfecting agents.

Biofilms of Staphylococcus aureus ATCC 6538 and Pseudomonas aeruginosa 122 were formed on two types of unused contact lens cases. Subsequently, each contact lens case was subjected to one of four cleaning regimens using two different multipurpose disinfecting solutions or distilled water: "rinse and air-dry (guidelines)," "rub, rinse and air-dry," "tissue-wipe and air-dry" and "rub, rinse, tissue-wipe and air-dry." The levels of residual biofilm were then quantified using viable counts and compared.

The manufacturers' guidelines resulted in 1-2 log CFU reduction of either biofilm. "Rub, rinse, tissue-wipe and air-dry" was the most effective cleaning regimen (p < 0.001), capable of removing 4 to 6 log CFU of bacteria. Higher levels of biofilm were removed by mechanical friction from non-ridged cases than that of ridged cases (p < 0.001). Biofilm removal varied with multipurpose solution tested.

The researchers concluded that current manufacturers' guidelines are not adequate in eliminating microbial contamination. Simply incorporating rubbing/wiping steps in daily case hygiene reduces viable organism recovery. Factors such as the cleaning regimen, anti-microbial potency of multipurpose solution and the interior topography of a lens case may impact the surface detachment of biofilm during the cleaning process.

Wu YT, Zhu H, Willcox M, Stapleton F. The effectiveness of various cleaning regimens and current guidelines in contact lens case biofilm removal. Invest Ophthalmol Vis Sci. 2011 Apr 7. [Epub ahead of print]