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Care Solution Corner
Susan J. Gromacki, OD, MS, FAAO |
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| In my last column, I recommended actions that can improve contact lens wear in dry eye patients: changing the lens material and/or replacement schedule and applying rewetting drops/artificial tears BEFORE, during, and AFTER contact lens wear. Another overlooked action: changing the care system and regimen.
First, take a thorough history: ask not only the name of the solution, but more importantly, HOW the patient is using it. With dry eye patients, prescribing a daily digital rub after lens removal (to dislodge all debris prior to the disinfection process) is a must. In addition, prescribe a care system with good wetting or lubricating agents. Most private label (generic) solutions are older formulations that do not include the latest technology in these agents. If you surmise that the solution preservatives are contributing to the dry eye — and they can -- eliminate them completely and prescribe a hydrogen peroxide solution or daily disposables. And, yes, patients can utilize a digital rub with a one-step H2O2 system. I will describe this in my next column. |
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CLToday Quick Poll
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Last week's question: Relative to this week's Editorial, are you in favor of increased oversight and regulation of continuing education?
Yes
 27%
No
73% |
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Ocular Surface Update
Kelly K. Nichols, OD, MPH, PhD, FAAO |
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I recently wrote a dry eye column in Optometric Management about an article I wrote called "Rhinestone Cowgirl," in which I discussed the importance of patient symptoms (Click here for article). The OM article was about two amazing women, one a patient, the other the host of a patient-based website for dry eye. Both live with pain daily, and have been the neglected voice. Anyone who has managed a severe dry eye patient that has bounced from practice to practice seeking help understands how challenging dry eye management can be - as I have been saying for years, it is a symptom-based disease. It is perhaps our best opportunity to really care for a patient by listening, rather than ignoring or downplaying their complaints.
In 2005, Chalmers et al. published a paper entitled "The agreement between self-assessment and clinician assessment of dry eye severity" (Cornea, 2005 Oct; 24(7):804-10), and the topic remains pertinent today. The authors concluded that clinicians often underestimated the severity of the subjects' self-assessment of dry eye, especially among the elderly and in women. I would hope clinicians and patients alike would read columns like this, discuss ocular pain and discomfort, and keep trying to find an effective management plan. There are resources, like www.dryeyezone.com , to help the patient and the clinician. |
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SynergEyes Receives FDA Clearance for Silicone Hydrogel Hybrid Contact Lenses
SynergEyes, Inc. announced that the Food and Drug Administration (FDA) has approved the company ’s application for a next generation silicone hydrogel hybrid contact lens. SynergEyes will market the new technology as two products: Duette hybrid contact lens for astigmatism and Duette Multifocal for presbyopia.
The new hybrid platform is cleared for use in the correction of hyperopic, myopic and astigmatic refractive error including presbyopia, in aphakic and non-aphakic non-diseased eyes. The lenses are indicated for daily wear for the correction of up to +20.00 and -20.00D in eyes with astigmatism up to +6.00D.
The Duette hybrid contact lens products feature a new SynergEyes-developed GP material, MaxVu and a proprietary Flex2O silicone hydrogel skirt.
“The high modulus MaxVu RGP has a Dk of 130 and class II UV blocker incorporated, while the high DK, low modulus silicone hydrogel skirt has a Dk of 84 and is 32% water. A patent-pending surface treatment, HealthyEyes, increases wettability and resists protein deposits to maximize comfort,” says Dr. Ramazan Benrashid, Vice President of Research and Development.
Duette hybrid contact lenses for astigmatism are currently available in limited release in select practices in the U.S. A nationwide launch is planned for early 2011. In addition, Duette Multifocal will be available in limited release in early 2011.
TearLab Enters into Cooperative Marketing Agreement with AMO Canadian Subsidiary
TearLab Corporation announced that it has entered into a cooperative marketing agreement with Abbott Medical Optics Inc.'s subsidiary, AMO Canada Company. Under the agreement, AMO Canada's sales force will directly sell the TearLab Osmolarity System in Canada while TearLab will help promote AMO Canada's products for the relief of dry eye symptoms, including Blink Moisturizing Eye Drops. Financial terms were not disclosed.
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AMO Solution Limited Recall in Europe and Middle East
Abbott Medical Optics (AMO) recalled a very small number of lots of its Complete Multipurpose Solution and Total Care Contact Lens Solution due to the potential for the bottle's flip top cap to leak. This is a limited recall and affects a handful of countries in Europe and the Middle East only.
According to the company, this is a packaging issue and is not related to the solution itself. AMO is taking this step as a precautionary measure. There are no reported adverse events, illnesses or injuries and no other products or additional lots are affected by this recall.
Improved Packaging and Extended Warranty Period for Paragon CRT SureFit
Paragon Vision Sciences announced an improved packaging system for Paragon CRT SureFit, which comes with an enhanced 90-day extended warranty period.
CRT SureFit lenses are clearly identified and the simplified fitting instructions direct the practitioner to begin the fitting process with the lens labeled "OD-1 and/or OS-1." Based upon a patient's "K" Readings and Spectacle Rx, the first lens in the CRT SureFit 3-Pack Fitting and Dispensing System is the lens that has the highest probability of first fit success. Should the first lens not be dispensable, the second and third lenses are predetermined parameters and one of them should provide a successful CRT fit for the patient. According to the company, by providing the possible CRT lens exchanges up front, CRT SureFit will save the practitioner up to 75% chair time and administrative resources by not having to see the patient for multiple lens exchange refits.
The inside of the CRT SureFit 3-Pack box shows an oversized fluorescein pattern of a perfectly fit CRT lens and simplified fitting instructions along with a reminder notice to return the two, non-dispensed lenses back to Paragon in a prepaid Federal Express envelope within 90-days. For additional information, visit www.paragoncrt.com/surefit.
B+L Launches New Alaway Television Ads
Bausch + Lomb (B+L) recently launched its advertising campaign for Alaway (ketotifen fumarate ophthalmic solution) antihistamine eye drops. Television ads are currently airing across major U.S. broadcast and cable networks and will continue through September. The brand will also be supported in store with shelf talkers, feature ads, pharmacist displays, free-standing inserts and doctor detailing.
The campaign targets allergy sufferers using the slogan: It's not just your allergies, it's your eyes. The ads highlight that consumers don't need to wait for systemic allergy medications to take effect before they can get relief for their itchy eyes.
Yong Joins Menicon as Chief of Special Projects
Menicon Co., Ltd. announced the appointment of Chew Hwee Yong as Chief of Special Projects at the company's head office in Nagoya, Japan. Chew will be responsible for updating and expanding Menicon's internal processes as well as external relations to support the company's globalization.
Chew started his career with the Singapore Economic Development Board (EDB). During his nine-year tenure with the EDB, Chew was responsible for overseeing significant projects in different high-tech industries. Chew also spent three years in Osaka, Japan, as the EDB's Centre Director covering western Japan and attracted investments from diverse fields. From 2006 to 2009, Chew also served as a Consul at the Consulate-General Office of the Republic of Singapore, Osaka. During his term, he was the representative for Singaporeans in western Japan and fostered strong relationships with the western Japan industrial community.
Chew has a Bachelor of Engineering degree in Precision Engineering from the University of Tokyo and a Master of Engineering degree in Optics & Optoelectronics, Electrical Engineering, from Princeton University.
This month at www.siliconehydrogels.org: the results of the 2009 International Contact Lens Prescribing Survey, the impact of UV-absorbing silicone hydrogel lenses, fitting silicone hydrogels for patients with sub-optimal endothelial cell function, and our synopsis of silicone hydrogels at the 2009 American Academy of Optometry meeting.
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Editor's Commentary
Jason J. Nichols, OD, MPH, PhD, FAAO
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I find the results of this last week's CLToday Quick Poll quite interesting (see the Results in left column). In summary, the majority of those responding feel the increased oversight or regulation of continuing education is unnecessary. I've heard a few comments from readers about the topic. One viewpoint is that increased regulation makes continuing education more challenging to obtain, by limiting those who can provide and/or sponsor it. Additionally, eyecare practitioners feel confident in their ability to determine the quality of the content relative to the issue of "promotional" materials. Of course, a main viewpoint supporting increased regulation is that high standards are important for any profession, particularly relative to public perceptions. If you have any additional thoughts or views on the subject, please email me directly at jnichols@optometry.osu.edu. |
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In Vitro Lipid Deposition on Hydrogel and Silicone Hydrogel Contact Lenses
Researchers wanted to understand various soft contact lens materials' ability to adsorb common tear lipids.
Ten unworn polymers of nine types were individually soaked in 1.0 mL of 1.75 microg/mL cholesterol oleate or 1.0 mL of 0.5 microg/mL phosphatidylcholine solutions for 1 or 14 days. The adsorbed lipids were extracted with chloroform-methanol, which underwent assay quantification for cholesterol oleate and inorganic phosphate.
For phosphatidylcholine, only lotrafilcon B, balafilcon A, and enfilcon A had more extracted after 14 days than 1 day (all p < 0.005). After 1 day of incubation in phosphatidylcholine, 0.54 to 4.17 microg/lens of phosphatidylcholine was recovered from the polymers, and after 14 days of incubation in phosphatidylcholine, 0.58 to 5.77 microg/lens of phosphatidylcholine was recovered from the polymers. For cholesterol oleate, etafilcon A had significantly more at 1 day than 14 days and lotrafilcon A, lotrafilcon B, and balafilcon A had significantly more at 14 days than 1 day (p < 0.005). After 1 day of incubation in cholesterol oleate, 0.14 to 4.80 microg/lens of cholesterol oleate was recovered from the polymers and after 14 days of incubation in cholesterol oleate, 1.40 to 6.84 microg/lens of cholesterol oleate was recovered from the polymers.
The researchers concluded that hydrogel and most silicone hydrogels appear to adsorb lipids relatively quickly (i.e., within the first day). While there is some variability in the amounts recovered across materials, it is uncertain whether or not these differences have any clinical significance.
Pucker AD, Thangavelu M, Nichols JJ. In Vitro Lipid Deposition on Hydrogel and Silicone Hydrogel Contact Lenses. Invest Ophthalmol Vis Sci 2010. |
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