CONTACT LENSES TODAY

August 17, 2003

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches nearly 10,000 readers in 74 countries.

Artificial Alternative to Human Cornea Transplant
Australia-based Argus Biomedical developed the AlphaCor artificial cornea, a one-piece, soft, flexible hydrogel polymer that offers promise for transplant patients who reject human tissue. A surgeon at Minnesota Eye Consultants recently performed a three-hour Stage I surgery to implant the AlphaCor in a patient who had previously rejected conventional donor grafts. A Stage II procedure is set for November and will involve removal of a small section of the patient's cornea to make vision possible. AlphaCor, which has undergone 14 years of research and four years of extensive clinical trials internationally, has enabled many patients in the clinical trials to experience visual improvement that led to their being re-classified from legally blind to functionally sighted.

Women and Dry Eye
A national study of 39,876 women participating in the Women's Health Study shows that more than 3.2 million women over the age of 50 in the United States have dry eye syndrome (DES). The researchers defined DES as the presence of clinically diagnosed DES or severe symptoms (both dryness and irritation constantly or often). They found that the prevalence of DES increased with age and that compared with whites, hispanic and asian women were more likely to report severe symptoms, but not clinically diagnosed DES. They also noted that women from the south had the highest prevalence of DES. The researchers reported the results of their study in a recent issue of the American Journal of Ophthalmology and concluded that further research is needed to better understand DES and its impact on public health and quality of life.

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CIBA Gives Awards, Offers New Product
For the seventh year, CIBA Vision again recognizes corporate optometrists for their commitment to quality and innovations in the care they provide to contact lens patients. The Corporate Optometry Professional Advisory Panel selected the 12 winners of this year's CIBA Vision Innovation in Contact Lens Care Awards. The winners are: Paul Collins, OD; Brenda Conner, OD; Patrick M. Dooley, OD; Greg Jellenek, OD; Bill Opferman, OD; Carol Rickards, OD; Howard Rosner, OD; Rajiv Trivedi; Linda Zanas, OD; and Michael J. Wojciak, OD.

Also, CIBA Vision has created an eductional toolkit that is now available to eyecare professionals in the United States and Canada. The company's kit includes a reference guide card designed to help practitioners quickly and easily determine which CIBA contact lens is best for a patient based on his astigmatic prescription. It also includes a poster that identifies the features and fitting characteristics of each CIBA Vision lens used to correct astigmatism. To learn more about the toolkit call (800) 241-5999.

Abstract: If It Ain't Broke, You Can Improve It
Researchers fit 50 current monovision contact lens wearers with Acuvue Bifocal contact lenses and assessed their visual function and subjective vision ratings with habitual monovision lenses at the first visit and then again at the end of the six-month study while wearing bifocal lenses. At the end of the study, researchers determined the subjects' lens preferences and then called the subjects one year later to repeat the lens preference questionnaire. All subjective ratings, except for near vision in poor lighting, were significantly greater with bifocal lenses. Of the 50 subjects, 40 (80%) completed the six-month study and 68% of them preferred bifocal lenses. Thus, the researchers concluded that it is possible to refit successful monovision lens wearers with simultaneous vision bifocal lenses and these lenses should be considered as an alternative method for the correction of presbyopia.

Situ, P; Du Toit, R; Fonn, D; Simpson, T. Successful Monovision Contact Lens Wearers Refitted with Bifocal Contact Lenses. Eye Contact Lens 2003 Jul;29(3):181-4.

Editor's Commentary: Sun, Fun and My Contact Lenses
This past week on vacation my bifocal contact lenses were great. I didn't have my usual dry eye sensation because I only wore them at the beach and at the golf course and the humidity was quite high. I didn't even need many drops at the windy beach and having my contact lenses in while in the ocean is great for good vision. My modified bifocal prescription worked just fine with more add in the left eye to help me read, which I do at the beach when I'm not swimming, walking, running or riding my bike. With less add in my right eye my distance vision was superb even while wearing my really cool-looking sunglasses. And using an easy, no-rub care system makes life easy on vacation.

Fitting Tip: Help New CL Wearers Adapt with Drops
Many years ago, one of the pioneer contact lens fitters increased the acceptance of hard contact lenses by new contact lens wearers by instilling a small drop of a mild topical anesthetic in the eye a few moments before trying on the first diagnostic lens. He told the patient that the drop would reduce his awareness to the lens and that he only used it for the first time so he could show patients how well their vision can become right away. This pioneer also explained that later, the patient would be able to rapidly adapt without the drops because he'd be custom making the lens just for that patient to fit his eyes even better than the trial lenses fit.

It worked with hard lenses, so it might also work even better with soft diagnostic lenses. Once a patient experiences the vision without glasses, it's easier to convince him to try contact lenses. One reason why some practitioners hesitate to let more spectacle wearers try contact lenses is that generally, a fitter will get greater income from multiple pairs of spectacles than for contact lenses at today's lens prices, which are discounted by so many retailers. We have been able to show all contact lens wearers the many benefits of also having a current prescription in their spectacles in addition to their contact lenses.

I personally don't use any topical anesthetic when demonstrating soft lens comfort. I have several technicians, who all wear contact lenses, and when they show prospective patients that they are wearing contact lenses, it's easier. I also let patients who are just curious try on a pair of lenses without any cost or obligation, right there while they're in the office. I have also done this with patients who have a high Rx before doing a frame selection so they can actually see what they're trying on.
-- Erwin Jay, OD
Richmond Heights, Ohio

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