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

We've known about issues with deposits on contact lenses for many years. It's been thought that a layer of organic deposits begins to form on a contact lens within minutes of application to the eye, and today we have the capability to develop a much deeper understanding of the composition of contact lens-related deposits with newer analytical technologies. One thing that I always remind practitioners, when presented data on deposits, is to pay attention to the method of analysis used, even in terms of the basics (e.g., clinic or lab based measures). While methods and approaches can often turn people off, I really believe that the devil is in the details.

CooperVision Introduces Proclear 1 Day Multifocal Lenses

CooperVision Inc. announced the launch of Proclear 1 day multifocal daily disposable contact lenses, which provide presbyopic patients with excellent vision at all distances and address age-related dryness, all in the convenience of a daily disposable lens.

According to the company, Proclear 1 day multifocal, appeals to both daily and occasional wearers due to its healthier modality, ability to provide excellent vision at all distances, and CooperVision's PC Technology, known for its comfort. Proclear is the only lens material cleared by U.S. Food and Drug Administration to claim that it: "May provide improved comfort for those who experience dryness or mild discomfort during lens wear."

The center-near aspheric design and simplified fitting approach make it easier to select the right lens for patients in all stages of presbyopia, whether they are emerging or existing presbyopes. Proclear 1 day multifocal lenses are offered in a broad power range and are designed with a single power profile. With the use of a near boost in the non-dominant eye, the lens can accommodate patients up to +2.50 ADD. As a result, the company states that practitioners will be able to more easily adjust prescriptions, even as they change, contributing to less chair time, more profitable visits, and improved patient satisfaction.

Proclear 1 day multifocal lenses are manufactured with PC Technology, a unique lens material that attracts and maintains moisture, thus reducing dryness. The lenses feature sphere powers from +6.00 to –10.00 (0.50 steps after –6.00); a base curve of 8.7 mm; and a diameter of 14.2 mm. The lens is designed with a single power profile that can accommodate patients up to +2.50 ADD power.

The lens will be launched initially in the U.S., Canada, Australia, New Zealand, and in a number of European countries. For more information on CooperVision's comprehensive line of multifocal contact lenses, visit www.coopervision.com/multifocal.

Mazzo to Retire from AMO
Abbott Medical Optics (AMO) announced that James Mazzo, President of Abbott Medical Optics and Senior Vice President, Medical Optics for Abbott corporate, will retire from AMO at the end of this year. After leading the organization for the past 10 years through a spin-off, initial public offering, numerous acquisitions, sale and integration into Abbott, and most recently, his term completion as Chairman of AdvaMed, Mazzo believes it is the right time for him to move on to the next phase of his career.

Murthy Simhambhatla will assume the role of President of AMO at year end. Mazzo will continue as President of AMO for the remainder of the year, while working with Simhambhatla to ensure a smooth transition.
Prior to joining Abbott upon the acquisition of Advanced Medical Optics, Mazzo served as its chairman and CEO. He also held various senior executive-level positions for Allergan prior to its spin-off of Advanced Medical Optics, including president of Allergan's Europe/Africa/Middle East region.

Murthy Simhambhatla, PhD, currently heads Abbott's Ibis Biosciences business. An engineer by training, he held a succession of management positions at Guidant and joined Abbott through the acquisition of that business. Before leading Ibis, Simhambhatla served as General Manager of the Vascular business in Australia and as Divisional Vice President and General Manager of Abbott's drug-eluting stent business.
U.S. Optometrists Invited to Share Their Expertise at International Conference

American optometrists are invited to register for the World Council of Optometry's next conference and join professionals from around the world who are gathering in Chicago to discuss ways to improve eye and vision care globally. This conference, Advancing Optometry Worldwide, will be an opportunity for North American optometrists to share their experiences with professionals from over 20 countries.

Advancing Optometry Worldwide is taking place at the Renaissance Blackstone Hotel, Chicago, June 24-26 and is conveniently timed to coincide with the American Optometric Association's Optometry's Meeting, allowing delegates to attend two influential events in one city.

Included in the registration fee is an opportunity to attend clinical workshops, or a lecture by Dr. Leonard Messner on the eye in neurological disease, at the Illinois College of Optometry. Delegates will also hear from speakers such as Professor Kovin Naidoo, African Chair of the International Agency for the Prevention of Blindness and Global Programs Director of the International Centre for Eyecare Education; Dr. Pete Kehoe, Past President of the American Optometric Association; and Clive Miller, CEO of Optometry Giving Sight.

For more information or to register, visit www.worldoptometry.org/chicago.

TearScience Promotes Wicker to CFO

TearScience, Inc. announced the promotion of Nicole Wicker to Chief Financial Officer (CFO). Nicole has served as TearScience's Vice President of Finance since joining the company in December, 2008.

Wicker served as CFO for several companies and has led the successful transition of companies from the startup stage through acquisition or initial public offering (IPO) including SmartPath and Motricity. She started her career with Ernst & Young in the Entrepreneurial Services group, where she worked 11 years and swiftly became lead financial executive in numerous SEC filings, IPOs, mergers and acquisitions.

TearScience manufactures and sells a complete system for eye care physicians to assess and treat patients for evaporative dry eye disease. The system is comprised of the LipiFlow Thermal Pulsation System and the LipiView Ocular Surface Interferometer. For additional information, visit www.tearscience.com.

Keratoconus with Aspheric, Four-Curve GP
By Sergey Cusato, OD, FIACLE, São Paulo, Brazil

This shows a patient with keratoconus and a corresponding visual acuity of 20/400 in the affected eye. The lens shown is a high Dk aspheric GP with four peripheral curves. The patient, after adaptation, had an improvement in his VA (visual acuity) from 20/400 to 20/40

We thank Dr. Cusato for his image and 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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Ronald K. Watanabe, OD, FAAO

Bandage Lenses

There are times when a patient will need a bandage contact lens for therapeutic treatment of an ocular surface condition, such as a corneal abrasion, recurrent epithelial erosions, or filamentary keratitis. Three silicone hydrogel lenses are currently approved for therapeutic use: Acuvue Oasys, Air Optix Night and Day, and PureVision. These are available in their usual base curve/diameter options in plano power. Night and Day and PureVision are approved for up to 30 days of continuous wear while Oasys is approved for 7 days/6 nights of extended wear. All are wonderful options for those patients who may need to wear a bandage lens for several days or weeks.

Another bandage lens option for severe ocular surface disease is the scleral lens. When fitted to vault the cornea and capture a thick layer of saline solution, it is one of the best ways to provide corneal hydration and encourage healing of the ocular surface. Though fitting a scleral is a more involved process than fitting a soft bandage lens, for long-term treatment, it may be well worth the time and effort. Consider these options the next time a patient needs a bandage lens.
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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

Studies in Corneal Transplantation

The National Eye Institute (NEI) has sponsored three major clinical trials on corneal transplantation. Collectively, these studies have sought to answer questions surrounding the associations between graft success and tissue matching (the Collaborative Corneal Transplantation Studies), donor age (the Cornea Donor Study), and donor preservation time (the Cornea Preservation Time Study).

The Effect of Corneal Preservation Time on Long-Term Graft Success, or Cornea Preservation Time Study for short (CPTS), is the most recent study funded by the NEI. The goals of the CPTS are to determine if the 3-year graft failure rate following endothelial keratoplasty (EK) performed with donor corneas with a preservation time of 8 to 14 days is non-inferior to the failure rate when donor corneas with a preservation time of 7 or fewer days are used. It will also determine if the central corneal endothelial cell density 3 years after EK is related to preservation time.

Although other studies have been performed which indirectly examined the question of preservation time, the CPTS is the first prospective masked trial that is randomizing participant eyes on this basis. By and large, the previous studies on this topic have not found increasing preservation time to be associated with graft success or endothelial cell loss, although none of these studies were designed with preservation time as the primary variable of interest. A lack of well run studies on a preservation time over 7 days has contributed to a bias against using corneal tissue beyond this time. If the CPTS determines donor corneas preserved longer than 7 days are non-inferior to those preserved <=7days, this bias will be addressed which will facilitate an increase in the U.S. domestic donor supply.

The CPTS study is now enrolling up to 1,330 patients across about 35 sites in the U.S. Interested patients and doctors can visit www.clinicaltrials.gov (NCT 01537393) to find recruiting locations.

To learn more about these studies look for an upcoming Research Review article in Contact Lens Spectrum on this topic.
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A Method of Imaging Lipids on Silicone Hydrogel Contact Lenses

The objective of this study was to determine whether Nile Red and Oil Red O stains are able to detect tear film lipids deposited on silicone hydrogel contact lenses.

Eight unworn lotrafilcon A lenses were individually soaked in successively decreasing amounts of cholesterol oleate solution (5.6 to 0.00 mg/ml) for 1 day in triplicate for each staining procedure (etafilcon A lenses were also soaked as a control). The sets of lenses were then stained with Nile Red or Oil Red O. The lenses were then individually visualized with a Nikon Eclipse 80i florescent microscope at 100x magnification, and two representative photos were taken of each lens. Both staining procedures were repeated with human worn lotrafilcon A lenses.

The Nile Red stain detected variable yet decreasing amounts of lipids when lenses were incubated in lipid concentrations >/=0.09 mg/ml. Oil Red O detected decreasing amounts of lipids when lenses were soaked in lipid concentrations >/=0.35 mg/ml. The Nile Red stain produced considerably more background staining than Oil Red O, and approximately half of the negative control lenses stained with Nile Red while there was minimal staining of lenses stained with Oil Red O. Etafilcon A lenses yielded decreasing amounts of lipid when soaked in successively lower concentrations of lipid when stained with Nile Red. Human-worn lotrafilcon A lenses yielded similar lipid characteristics when compared with in vitro lenses, with variable amounts of lipid detection when comparing individual subjects.

The researchers concluded that Nile Red and Oil Red O are both able to detect lipids on soft lenses in both in vitro and ex vivo conditions. Oil Red O appears to be a better stain for silicone hydrogel lenses as it offers a higher signal to noise ratio.

Pucker AD, Nichols JJ. A method of imaging lipids on silicone hydrogel contact lenses. Optom Vis Sci. 2012 May;89(5):E777-87.
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