CONTACT LENSES TODAY

June 25, 2006

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.

AOA, AAO Object to S. 2480
The American Optometric Association (AOA) and American Academy of Optometry (AAO) object to Senate Bill 2480. Similar to Utah legislation passed earlier this year, the bill, promoted by 1-800 Contacts, would amend the Fairness to Contact Lens Consumers Act (FCLCA). The amendment requires manufacturers to make lenses available “in a commercially reasonable and non-discriminatory manner,” to alternate channels of distribution including mail order and Internet retailers.
    The Senate Finance Committee is set to consider S. 2480 on June 30th, despite a recent Federal Trade Commission report that found no major problem with consumer access. In a joint letter, the AOA and AAO say the biggest problem with the new law is passive verification that allows distributors to dispense lenses if the practitioner doesn’t respond to prescription verification requests within eight hours. The American Medical Association (AMA) House of Delegates recently passed a resolution that calls on Congress to remove the existing passive verification subsection of the law altogether.
    Kevin McCallum, Senior Vice President of Marketing and Sales for 1-800 Contacts, says “The AAO and AOA are seeking an unprecedented doctor-pharmacy system where the doctor is allowed to own their own pharmacy and compete with anyone else attempting to fill the prescription.” He further explains that Congress adopted the passive verification system to address that conflict of interests, while still allowing eye doctors to sell to patients. Mr. McCallum also notes the Committee reported an, “unusually high number of consumer complaints in states that rely on active verification schemes,” and that, the “passive verification system ensures that consumers are not caught in the competitive tug-of-war between doctors and third party sellers for the sale of contact lenses.”
Acuvue Gets AOA Seal for UV Protection
The AOA’s Commission on Ophthalmic Standards has given its Seal of Acceptance for Ultraviolet Absorbing contact lenses to Vistakon’s Acuvue Advance and Oasys brand contact lenses. The AOA specifications are in line with the standards of the American National Standards Institute (ANSI) and International Standards Organization (ISO). The ANSI and ISO classify UV blocking contact lenses into two groups based on the lens’ absorptive capacity at minimum thickness. Vistakon says the Acuvue brands are the only lenses to achieve Class I UV-blocking status, which indicates they absorb a minimum of 90% of UVA and at least 99% of UVB radiation.
Calif. Court says Pearle Vision Broke the Law
The California Supreme Court ruled unanimously that Pearle Vision, a unit of Luxottica, violated a state law that limits relationships between the providers of eye wear and those who provide eye exams. Pearle Vision had argued that the Knox-Keene Act of 1976 allowed its optometry company, Pearle VisionCare, to operate as an HMO free of any such restrictions. The VisionCare optometrists work in the same stores as opticians employed by Pearle Vision.
    The court ruled that the Knox-Keene Act allowed optometrists and other health professionals to work for HMOs, but did not repeal earlier laws that prohibit opticians from employing optometrists, maintaining them on or near the premises, or having landlord-tenant relationships with O.D.s. The ruling upholds an injunction by state Attourney General Bill Lockyer that prohibits Pearle Vision from advertising eye exams. Mr. Lockyer sued the company in 2002 in San Diego, claiming it falsely advertised that optometrists located in or near its retail outlets were independent of the company. This latest ruling was a result of Pearle Vision’s appeal and allows the lawsuit to proceed towards trial.
Wet Lens, Patient Satisfaction
Among those ages 35-49, 65% of patients who consider dropping out of contact lens wear cite dryness sensation as a key reason. ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ Plus are made from senofilcon A, a next generation silicone hydrogel material. The proprietary formulation includes a remarkable moisture-rich wetting agent and no surface coating. The senofilcon A material balances properties to meet the demands of contact lens wearers in environments that can make eyes feel tired and dry. This breakthrough material creates a lens so moist and smooth that an eyelid glides effortlessly over it. ACUVUE® OASYS™ Brand Contact Lenses can help keep your patients in contact lenses by increasing their comfort and also giving them crisp vision and healthy lens wear.
--ADVERTISING
CIBA Launches Antimicrobial Lens Case
At last week’s annual AOA meeting in Las Vegas, CIBA Vision introduced the Pro-Guard lens case. It features an antimicrobial agent clinically proven to reduce lens case contamination, which occurs in up to 80% of contact lens wearers. The case is infused with silver ions, which are released gradually as the case is exposed to moisture, to kill bacteria and help minimize contamination on the lens case surface. In a one month clinical trial, the company found a 38% contamination rate for Pro-Guard lens cases vs. 63% for controls. CIBA will provide wearers with a new Pro-Guard case with every purchase of AQuify MPS.
B&L Gets Plasma Coat Approval
The U.S. Food and Drug Administration (FDA) has granted Bausch & Lomb approval to add a cold oxygen plasma treatment to the manufacturing process of GP lenses made with Boston materials. The treatment is a process that bombards the lens surface with ions in a vacuum. B&L says it may reduce lens hydration time by reducing the wetting angle of the lens and improving comfort without changing the finished lens properties.
Global Keratoconus Congress 2007
Mark your calendars for the first-ever Global Keratoconus Congress to be held January 26-28, 2007 in Las Vegas. The Global Keratoconus Congress is an assembly of experts in the field of patient care, teaching and research. They will share the latest information on this chronic sight-threatening condition that affects one in 2,000 people. Attendees will learn about the latest approaches to contact lens fitting, surgical techniques, clinical research and appropriate third-party reimbursement for medically necessary contact lens care. Manufacturers and laboratories that support the care of these patients will assist in demonstrating the usefulness of their latest products and treatments. More information will be coming soon.
Abstract: Blepharoptosis and Hard Lens Wear
Researchers at the Kyoto Prefectural University of Medicine’s Department of Ophthalmology conducted a retrospective case review to clarify histopathologically the structural features of blepharoptosis in prolonged, hard contact lens wear. They examined biopsy specimens from identical sites at the levator aponeurosis and Mueller muscle from 15 long-term hard contact lens wearers. Participants ranged in age from 26 to 59 with bilateral blepharoptosis; two men and 13 women. The average length of hard lens wear for participants was 25.4 years and average spherical equivalent was -9.10D. They also examined specimens from 15 patients with involutional blepharoptosis who underwent levator resection. Participants were between 64 and 79 years of age; 3 were men, 12 were women.
    Investigators found that all patients in the first group manifested fibrosis and negligible fatty degeneration in the Mueller muscle. In the latter group, they detected mild fibrosis in the Mueller muscle and fatty degeneration in the aponeurosis and Mueller muscle. They conclude that prolonged hard contact lens wear induces fibrosis in the Mueller muscle and may result in contact lens-induced blepharoptosis.
Watanabe A, Araki B, Noso K, Kakizaki H, Kinoshita S. Histopathology of blepharoptosis induced by prolonged hard contact lens wear. Am J Ophthalmol. 2006 Jun;141(6):1092-96.e1.
Editor's Commentary: CL Field Appeals to Investment Community
I judge the contact lens field by how busy practitioners are, how many wearers there are, and whether practitioners want to prescribe contact lenses. Based on office visits, the field has done well over the past years. But I have been curious about why the investment community has been so interested in our field over the past couple of years. I met with a friend at the AOA meeting who explained what should have been obvious to me. He's an O.D. who is now a financial research analyst. The investment community is interested in the contact lens field, and in fact, the eye care field in general, because of growth. Growth in sales dollars, in new products and in the need for eye care creates interest in numerous eye care companies, including those that make new contact lenses. We are very fortunate to work in such a vital field that offers new and better opportunities for O.D.s and our patients.
Fitting Tip: Eliminate GP Lens Binding
Regarding Dr. Barr's comments in his Editor's Commentary (see CLToday, June 11th), you can make several modifications to reduce or eliminate GP lens binding:
 
1. Increase the lens diameter.
2. Increase the back surface optic zone.
3. Modify the edge. Several new lens designs allow different edge lifts in different quadrants. This is especially useful in bitoric and keratoconic lens designs.
4. Choose a material with a high Dk/t. Menicon and Paragon HDS 100 are good choices for high myopes. Both are available with plasma treatment to increase wettability.
5. Make sure the patient's lenses are free of lipid and protein deposits. Cleaning with MiraFlow every few days will help remove lipids. A monthly treatment with Progent will remove protein and any other surface deposits.

    One or more of these tricks should promote lens centration, increase comfort and reduce binding. Order these lenses warranted so the lab can do the modifications.
Dianne Anderson, O.D.,
Batavia, Ill.
This month at http://www.siliconehydrogels.org, review a study investigating epithelial barrier function and learn more about the appearance and significance of ‘conjunctival epithelial flaps’ – including a case study with video footage.
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 golf 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.
CLToday Services: Subscribe; Change or Remove your e-mail address; submit news to news@cltoday.com; or, fax 1-215-643-3902.
Contact Lenses Today and CLToday are registered trademarks of Lippincott, Williams and Wilkins, Inc. ©2006 Lippincott, Williams and Wilkins, Inc.
This has been a BCI e-mail communication. If you prefer not to receive e-mail from us, please use the following link
to remove your e-mail address from our list: Removal Request | View our Privacy Policy

You are receiving this e-mail because you have agreed to receive e-mail communications from Lippincott, Williams and Wilkins, Inc.
Lippincott, Williams and Wilkins, Inc. - 1300 Virginia Drive Suite 400 Fort Washington PA 19034 | 215-643-8000
Lippincott, Williams and Wilkins, Inc. e-mail program complies with the Federal Can-Spam Act of 2003

Please take a moment to make sure your newsletters don't get marked as spam.
Add cltoday@bci-media.com to your 'approved senders' list or address book.