CONTACT LENSES TODAY

August 24, 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.

Corneoplasty Now Uses Eye Drop
Advanced Corneal Systems has developed the next best alternative to LASIK -- Corneaplasty, a non-surgical procedure that changes the shape of the cornea in a three-step process using modern ortho-k lenses as corneal molds, in conjunction with certain enzymes to prepare and final-set the cornea. First the cornea is prepared by applying a proprietary concentration of hyaluronidase, which absorbs into the cornea, making it softer and more malleable. Then the prepared cornea is molded into the desired shape with custom-fitted accelerated orthokeratology contact lenses, which the patient wears during the treatment period. Finally, a proprietary cross-linking agent "fixative" drop is administered to "set" the cornea in its optimum shape. Currently pharmaceutical giant Sandoz is helping Advanced Corneal Systems through FDA clinicals. Advanced Corneal Systems expects approval of its non-surgical, reversible procedure within one to two years.

Addressing the Color Lens Issue
CIBA Vision conducted a recent e-survey of 130 eyecare practitioners that revealed that only one third of practitioners initiate discussions with their patients about color contact lenses. Of those who fit higher percentages of color lenses, many more reported initiating discussions than did those who had lower color lens fitting rates. Says Richard E. Weisbarth, OD, FAAO, vice president of Professional Services for CIBA Vision North America, "The survey results demonstrate that there is significant potential for eyecare professionals to grow their color lens business simply by approaching patients with the option."

Opti-Free Express MPDS is proven to be compatible with Silicone Hydrogel Lenses. Silicone hydrogel lenses have unique surface and matrix properties unlike other soft lenses. In a recent independent study with 50 lens wearers, Opti-Free Express was shown to be compatible with silicone hydrogel lenses worn on a daily wear basis.*
*Reference: Jones, L; MacDougall, N; Sorbara, L.G. Asymptomatic Corneal Staining Associated with the Use of Balafilcon Silicone-Hydrogel Contact Lenses Disinfected With a Polyaminopropyl Biguanide-Preserved Care Regimen. Optom Vis Sci 2002 Dec;79(12):753-61.
--ADVERTISING

Most Eye Injuries Don't Have to Happen
According to Prevent Blindness America (PBA), people could avoid 90% of eye injuries by following proper precautions. In celebration of Sports Eye Health Safety Month, PBA is offering several free materials. Call (800) 331-2020 to receive Impact Protection and Polycarbonate Lenses, Recommended Sports Protectors and Don't Play Games with Your Eyes. Or, visit http://www.preventblindness.org for more information on a variety of sports and home eye safety topics.

AMO Launches New MPS
Advanced Medical Optics (AMO) is launching Complete MoisturePLUS multi-purpose solution (MPS) in North America and European markets. Complete MoisturePLUS contains specially formulated tear technology ingredients such as the dual lubricants hydroxypropyl methylcellulose and propylene glycol, electrolytes including potassium chloride and sodium phosphate, and the amino acid taurine to create a moisture shield in and around the lens. The moisture is time released to maintain comfort throughout the day, AMO says. Complete MoisturePLUS is a no-rub formulation and requires only a four-hour soak time. It's now available in retail and drug stores nationwide.

Abstract: Methods Fail to Accurately Verify Asphericity
Researchers set out to suggest a tolerance level for the degree of asphericity of aspheric GP lenses and to find a simple method for its verification. Using existing tolerances for the vertex radius, the researchers calculated tolerance limits for eccentricity and p values. They also used a keratometer-based method as well as a method based on sag measurements to measure the vertex radius and eccentricity of eight concave progressively aspheric surfaces and six other concave ellipsoidal surfaces. The researchers compared their results with a gold standard measurement made using a high-precision mechanical instrument and concluded that neither method was precise enough to verify the asphericity within the suggested tolerance. They did, however, find that you can efficiently use the keratometer to verify the back vertex radius within its International Organization for Standardization tolerance and the back surface asphericity within an eccentricity/p value tolerance of +/- 0.1.
Dietze, HH; Cox, MJ; Douthwaite, WA. Verification of Aspheric Contact Lens Back Surfaces. Optom Vis Sci. 2003 Aug;80(8):596-605.

Editor's Commentary: You've Got to Have an Attitude
I got a kick out of our fitting tip comments this week. Imagine how simple this is. The practitioner has a positive attitude about proactive contact lens prescribing and more contact lenses get fitted. Like Brien Holden says (with more flowery language than I) regarding continuous wear lenses (or any contact lenses for that matter), "You gotta have an attitude." Every large, successful contact lens practice I have ever seen has a positive attitude -- starting with the leader all the way through the staff -- about presenting contact lenses in a proactive fashion.

Fitting Tip: Patients Appreciate Your Time and Effort
This is in response to Dr. Barr's August 10, 2003 CLToday commentary:
I'm a high myope (-8.00D OU) with slight astigmatism. PMMA lenses worked perfectly for me for 28 years, as did GP lenses for 10 years, with no adjustments or corneal problems. Because I've moved around the United States, I've consulted eight MDs, six ODs and two dispensing opticians for contact lens prescriptions.

In all that time, and with all of these professionals, only three (two ODs and one dispensing optician) expressed a positive, supportive attitude about contact lenses to me, their patient. These three individuals were all contact lens wearers. All of the neutral or negatively opinioned doctors wore glasses. Two actively tried to discourage me from continuing to wear contact lenses, even though my corneas were healthy and I've never had a corneal abrasion, infection or any other negative consequence from wearing contact lenses. Their reasoning seemed to be based in part on my advancing age (I'm a 58-year-old female who uses monovision correction). One of the negative ophthalmologists told me, "No one older than 60 wears contact lenses," while one of the positive optometrists told me he had a 90-year-old patient wearing contact lenses. I asked one of the negative doctors if he's ever used contact lenses and he replied, "briefly," with an expression of distaste. Apparently he found contact lenses uncomfortable or not practical. I attribute my early success with PMMA lenses to a talented dispensing optician who worked in tandem with an ophthalmologist. He took careful measurements, instructed me on how to insert, remove and clean the lenses and commented, "It's not like natural 20/20 vision, but it's the next best thing." That was 38 years ago, and I've never looked back.

From all this, I postulate that the attitude of the doctor is extremely important and can make or break a novice contact lens wearer's chance of success.
-- Cathy Bigley, via e-mail

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