CONTACT LENSES TODAY

September 5, 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.


Ophthalmology Continues Battle to Limit OD Scope
On July 22, 2004, Senators Peter Fitzgerald (R-IL), Maria Cantwell (D-WA), Dianne Feinstein (D-CA), Ernest Hollings (D-SC) and Jeff Sessions (R-AL) proposed bill S. 2743, which questions the scope of practice, competency and credentials of the entire optometric profession and seeks to inject Congress into a state-licensing issue. The title: A bill to amend title 38, United States Code, to provide that only licensed medical doctors, licensed doctors of osteopathy and certain licensed dentists may perform eye surgery at Department of Veterans' Affairs facilities or under contract with the Department. The language of this bill is the same as S.A. 3323, which the same lawmakers proposed in June. According to the American Optometric Association, the Department of Veterans' Affairs issued a VA policy directive on July 30, 2004 that upholds its right to offer privileges to qualified optometrists to perform certain laser surgeries, as long as an ophthalmologist supervises them. The status of S. 2743, as listed on the U.S. Senate's Web site, is that it's been read twice and referred to the Committee on Veterans' Affairs.

CLES Plans 2005 Education Program
The Education Task Force of the Contact Lens and Eyecare Symposium (CLES), which is composed of educators from the American Optometric Association, the Contact Lens Association of Ophthalmologists and the Contact Lens Society of America, has released the CLES 2005 Preliminary Education Program. More than 90 hours of approved CE have been developed. To see the preliminary program, or to get more information, visit http://www.cles.info. CLES 2005 is scheduled for January 19 to 22, 2005 in San Diego.

NEW FROM CIBA VISION -- Introducing O2OPTIX The Healthy Choice for Daily Wear
Maximizing oxygen transmissibility helps protect patients from the signs and symptoms of corneal oxygen deficiency.
With a remarkable Dk/t of 138, new O2OPTIX provides more oxygen to the cornea than any other two-week soft contact lens -- more than five times the oxygen transmissibility of ACUVUE®2 and 62% higher than ACUVUE® ADVANCE. Ideal for daily wear patients who want to wear their lenses for a full day -- however long that may be.

New O2OPTIX -- Breathable Lenses Designed for Healthy Eyes
http://www.cibavision.com
ACUVUE® , ACUVUE® 2 AND ADVANCE>™ are trademarks of Johnson & Johnson Vision Care, Inc.

--ADVERTISING

Restasis in the Consumer Spotlight
Allergan has launched the first direct-to-consumer advertising campaign (in the form of TV spots and print advertising) for Restasis, its chronic dry eye therapy. The commercial, which airs on both network and cable shows, directs viewers who are interested in more education and information to the Restasis Web site (http://www.Restasis.com) and a toll-free phone number to get more information about chronic dry eye and therapy with Restasis.

Vistakon Launches Hydraclear Campaign
Vistakon recently launched a campaign, which has the slogan "Hydraclear for All!" to convey to eyecare professionals attending the American Optometric Association (AOA) meeting that Acuvue Advance Brand Contact Lenses with Hydraclear are ideal for all types of contact lens candidates, including new and satisfied wearers, dropouts and patients who experience end-of-day irritation, discomfort and/or redness. Of the 395 attending eyecare practitioners who placed their votes at the Hydraclear for All! voting booth at the AOA, 95% believe that all-day comfort is an essential contact lens feature. Increased oxygen to the eye (83%) and excellent visual acuity (76%) came in second and their, respectively. The company will continue its campaign at Vision Expo West this week.

Cooper Adds to Line of CLs
CooperVision has introduced a new addition to its Vertex Toric line of contact lenses: The Vertex Toric XR, which features extended range cylinder parameters to fit a wider population of astigmatic patients in a disposable modality. The lenses are available in a six-lens pack configuration and are made to order in five working days to meet specific patient needs. They are now available from CooperVision and its authorized distributors. Visit http://www.coopervision.com/us/patient_aboutus_news.asp for more information.

Abstract: Bacterial Adhesion and Contact Lenses
Australian researchers conducted a study to determine whether secretory phospholipase A(2) (sPLA(2)) deposition is associated with contact lens type, if sPLA(2) remains active on contact lenses and if this has an effect on bacterial adhesion. Patients wore soft contact lenses (ionic [etafilcon A] and nonionic [polymacon] high-water) for six hours (daily wear, n=39) or six nights on an extended wear schedule (n=25). The researchers collected tears from patients and extracted protein and active enzymes from lenses once patients removed them. They recovered significantly less sPLA(2) from polymacon lenses for both daily and extended wear compared with etafilcon A lenses (daily wear: 3 vs. 5ng/lens; extended wear: 3 vs. 6ng/lens; P <0.05). The researchers found that sPLA(2) reduced adhesion of Staphylococcus to contact lenses in vivo. They concluded that etafilcon A lenses absorb more active sPLA(2) than do polymacon lenses, which increases with length of contact lens wear. Also, that sPLA(2) adsorbed to a contact lens can reduce the viable Staphylococcus adhering to the lens, which may protect the eye from colonization by this pathogen. Hume EB, Cole N, Parmar A, Tan ME, Aliwarga Y, Schubert T, Holden BA, Willcox MD. Secretory Phospholipase A2 Deposition on Contact Lenses and its Effect on Bacterial Adhesion. Investigative Ophthalmology & Visual Science 2004 Sep;45(9):3161-3164.

Editor's Commentary: Special Lenses for Special People
We all have a few patients from time to time (or too many) who require very special, custom-designed lenses. Of course, they think they should have easy access to the simple prescription disposable lenses that their friends and/or family have. It's not always easy to explain why their lenses are more difficult to replace, take longer to receive and cost significantly more than their loved one's or neighbor's. Ongoing patient education, showing them the dials, showing them the numbers, explaining the careful measurements and observations (measure twice, cut once) is of great importance in these cases. These are ultimately loyal patients, but at first they may need a lot of hand holding. We welcome your comments on how you explain these difficult situations.

Fitting Tip: Best Lenses for Kids
I respectfully disagree with Dr. Murray's suggestion of monthly replacement for youngsters (CLToday Editor's Commentary, August 29, 2004). They are notorious for not replacing their lenses, and they rarely rub them. They overwear their lenses and after a month of contact lens misuse, their eyes look pretty bad. I have often seen cases of GPC in these youngsters, which, of course, they are stuck with forever.
It's much better to use a silicone hydrogel with its exceptional Dk value to counteract the overwear and to get them into a routine to replace their lenses. Better for the patient and also for the parent who has to keep track of things.
--Dennis W. Siemsen, O.D., MHPE
Rochester, Minn.

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.

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