June 13, 2004

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.

The FDA has granted approval to Euclid Systems Corporation for the overnight wear of its Emerald Orthokeratology lens. For more information, call Euclid Systems at (800) 477-9396 x1. According to Euclid, its Emerald ortho-k lens boasts predictable fitting, precise replacements for patients and no trial set is required, which reduces fitting time.

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ASCRT Meeting Filled With Information
The American Society of Corneal and Refractive Technologies' (ASCRT's) mission is to advocate and provide a forum for the discussion and development of corneal and refractive technologies. Nearly 100 eyecare practitioners heard presentations at the June 4 - 6 meeting. Professor Desmond Fonn, from the University of Waterloo, Canada, described the fairly constant epithelial thickness with soft contact lenses and PMMA contact lenses with eye closure while the corneal stroma swells. In CRT treatment, there is an average 7% midperipheral corneal swelling while the central corneal epithelium thins according to the treatment. He also reported the increased light scattering associated with thick soft contact lens wear.

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CONTINUOUS WEAR LENSES WERE FASTEST GROWING MAJOR CATEGORY IN 2003
For the year 2003, manufacturer sales of commodity 1-2 week clear, spherical disposable lenses grew just 3%, as prices declined 2%.
Sales of Focus NIGHT & DAY lenses increased 123% in 2003, and new patient fittings rose 112%, according to Health Products Research. The momentum continues in 2004.
Focus NIGHT & DAY -- There's Only One Best (http://www.mycibavision.com)
--ADVERTISING

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FDA Approves Istalol for Treating Glaucoma
The FDA has approved Ista Pharmaceuticals, Inc.'s NDA for Istalol for the treatment of glaucoma. Istalol, which is a topical solution of timolol, is a once-daily, beta-blocking agent. In clinical trials, Istalol showed efficacy and safety comparable to twice-daily timolol maleate ophthalmic solution.

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Study Shows Patient Interest in Overnight Wear of CLs
CIBA Vision recently asked a random sample of 196 soft contact lens wearers throughout the United States what contact lens wearing schedule they ideally preferred, assuming their doctors assured them it was safe. Nearly three of every four survey participants preferred a schedule allowing some overnight wear. Thirty-five percent preferred a 30-day continuous wear schedule, 14% preferred a one- to two-week continuous wear regimen, 20% preferred occasional overnight wear and 27% preferred to remove lenses daily with no overnight wear. CIBA Vision found in an earlier study that 61% of participants admitted to occasionally sleeping with their lenses on.

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Vistakon Launches New Consumer Campaign
In conjunction with the national launch of Acuvue Advance contact lenses with Hydraclear, Vistakon has launched the Acuvue Get Fit for Eye Comfort campaign. Vistakon launched the campaign with American Idol Kelly Clarkson and New York City-based optometrist Susan Resnick. Kelly is encouraging consumers to log on to http://www.GetFitForEyeComfort.com to participate in a self-assessment questionnaire that will help them evaluate how well they're taking care of their eyes and their egos. After completing the questionnaire, consumers will receive an evaluation and tips for getting their eyes and egos in even better shape.

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B&L to Sell Generic Ciprofloxacin
The FDA has approved Bausch & Lomb's Abbreviated New Drug Application to manufacture and sell ciprofloxacin ophthalmic solution USP, 0.3% to treat bacterial eye infections including conjunctivitis. The company's generic equivalent of the prescription eye drops is available immediately in 2.5mL, 5mL and 10mL. Alcon, Inc. sells the branded form of the medication as Ciloxan.

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Abstract: Linking Comfort to GP Wear in Keratoconics
Investigators from the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study group analyzed baseline data from the 16 CLEK Study clinical sites for all patients (751 eyes) wearing a GP lens in their more severely keratoconic eye (as determined by steep keratometry). The group's goal was to identify factors associated with GP lens comfort in keratoconus. The investigators asked patients, "In general, how comfortable are your contact lenses?" looking for a response of 1 (very comfortable) through 5 (very irritating). They found no apparent association between decreasing patient-reported rigid lens comfort and increasing disease severity as measured by steep keratometry or first definite apical clearance lens. They also noted that the apical fitting relationship (flat vs. steep) doesn't appear to be associated with patient-reported comfort. Minimal peripheral clearance may contribute to decreased rigid contact lens comfort in keratoconus.
The CLEK Study Group, Variables Affecting Rigid Contact Lens Comfort in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study. Optometry & Vision Science 2004 Mar;81(3):182-188.

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Editor's Commentary: Corneal Reshaping Reaches its Pinnacle?
With the past American Society of Corneal and Refractive Technologies meeting in Scottsdale, Arizona, and the Global Orthokeratology meeting staged for July 22 to 25 in Toronto (see http://www.clspectrum.com), hundreds of North American and international eyecare practitioners will be up to date on the latest in how to perform overnight corneal reshaping and the latest research in this exciting area.
Although this procedure is more mainstream than it was years ago, growth is still slow. I believe that despite generally safe results and high professional fees, many contact lens practitioners are reluctant to present this high fee (unlike their LASIK counterparts) and that the chair time associated with CRT treatment is inhibiting.
Work by Walline and Rah has shown that myopic children are successfully treated with CRT, resulting in adequate all-day vision. As more laboratories obtain FDA approval for overnight corneal reshaping with high-Dk GP lenses and as Paragon continues to mature its marketing strategy for CRT corneal reshaping (especially for myopia and eventually for hyperopia and presbyopia), the market will grow.

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Fitting Tip: Setting Patients Straight on CL Terms
I have a lot of patients who are confused about our terms describing contact lenses. I have to admit that "daily wear," "extended wear" and "disposable" are confusing terms. Literally most of my patients think that "extended wear" soft contact lenses are lenses that they can wear for one, two or even three years! They are confusing "extended wear" with "daily wear/nondisposable." For some strange reason, every soft contact lens wearer knows that their two-week disposable contact lens is approved for "sleeping in," yet magically, they all think that they can sleep in their lenses until they feel uncomfortable or until their vision gets bad -- usually months at a time. Be specific when you describe contact lens modalities and thoroughly explain what the lenses you describe are designed/approved for. Don't assume that patients know or understand what they're wearing -- especially when you find signs of contact lens overwear.
--R. Michael Prince, O.D.
Bryan, Texas

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Time's Running Out to Plan for the Global Orthokeratology Symposium (July 22-25, 2004 Toronto, Canada) Get the tools to implement orthokeratology in your practice. http://www.gos2004.com

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Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.