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Materials & Designs
Ronald K. Watanabe, OD, FAAO
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Myopia control is in the news again. The upcoming issue of Optometry and Vision Science has a paper on novel spectacle designs with varying amounts and designs of peripheral plus power designed to reduce peripheral hyperopic defocus, which is thought to slow myopia progression (1). Though the results were not significant for the overall study population, they did find significant reduction in myopia progression in a subset of patients.
This got me excited again about the possibility of using various contact lens designs for myopia control in children. Scanning the recent literature, orthokeratology and multifocal lenses have shown promising trends in slowing down the rate of myopia progression (2, 3). Reverse geometry orthokeratology designs create a mid-peripheral steep zone on the cornea that presumably results in peripheral myopic defocus. Center-distance multifocal soft contact lenses may do the same. As research continues to bring the myopia control picture into better focus, contact lens designs specifically for this purpose will hopefully be developed. Until then, orthokeratology or multifocal contact lenses are promising options that we can offer our younger myopic patients.
References:
1. Sankaridurg P, Donovan L, Varnas S, et al. Spectacle lenses designed to reduce progression of myopia: 12 month results. Optom Vis Sci 2010; 87(9).
2. Walline JJ, Jones LA, Sinnott LT. Corneal reshaping and myopia progression. Br J Ophthalmol 2009; 93: 1181-1185.
3. Aller TA, Wildsoet C. Bifocal soft contact lenses as a possible myopia control treatment: a case report involving identical twins. Clin Exp Optom 2008; 91(4): 394-399.
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CLToday Quick Poll
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Research Review
Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO |
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Microbial keratitis continues to be our most dreaded complication of contact lens wear and further research is needed to help us better understand this horrible complication. The August issue of Contact Lens Spectrum has a great review article on this topic, A Closer Look at Microbial Keratitis. A recent article by Chalmers and coworkers made me think that although modalities and lens types have changed in the last decade, risk factors for microbial keratitis have not.
In their work, Chalmers and coworkers examined charts from 1,276 soft contact lens wearers comprising 120 visits and 1,454 years of soft lens wear. They reported that the risk factors for inflammatory and infectious events among soft lens wearers in clinical practice are similar to those reported in previous prospective clinical trials. High ametropia and an age less than 25 years continue to pose risks for most events, including microbial keratitis and inflammatory complications. The lessons I take from this paper include: 1) make sure your high ametropes have reasonable spectacles to wear to give them a break from lens wear, and 2) find ways to make lens wear and care convenient yet safe and effective for the younger population. Daily disposables are also great option, as in the paper this modality was associated with lid irritation, but no other events.
Reference:
Chalmers RL, Keay L, Long B, Bergenske P, Giles T, Bullimore MA. Risk Factors for Contact Lens Complications in US Clinical Practices. Optom Vis Sci. 2010 Aug 19. [Epub ahead of print]
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B+L Names Wechsler as Global President, Pharmaceuticals
Bausch + Lomb (B+L) named Daniel M. Wechsler as Corporate Vice President and Global President of its Pharmaceuticals business.
Mr. Wechsler was most recently head of U.S. Strategy, Commercial Model Innovation and Business Development for Merck & Co., a role to which he was appointed following the company’s acquisition of Schering-Plough Corporation in 2009. From 2005 to 2009, he was Group Vice President, Global Business Operations and Selling Excellence, for Schering-Plough.
In 2003, Mr. Wechsler joined Pfizer Inc. as Vice President for its multibillion-dollar U.S. Specialty Sales organization. He began his career in 1991 with The Upjohn Company (later Pharmacia Corporation), holding a variety of positions with increasing responsibilities for sales and sales training, culminating in his role as Vice President, Sales, Institutional Division.
Mr. Wechsler earned his master’s degree from the University of Rochester and holds a bachelor’s degree from the State University of New York at Brockport.
Can-Fite BioPharma Announces Phase 3 Study in Dry Eye Syndrome
Can-Fite BioPharma Ltd. announced that it has opened an Investigational New Drug application (IND) with the US FDA for a Phase 3 study of its lead drug, CF101, in patients with moderate to severe dry eye syndrome.
According to the company, in an earlier Phase 2 study, in which CF101 was taken orally as a monotherapy for 12 weeks, a statistically significant benefit in the clearing of fluorescein staining in the nasal, temporal, pupillary and inferior parts of the cornea was documented. CF101 was found to be safe and well tolerated during this study period.
The randomized, double-masked trial will compare two doses of CF101 to placebo. Approximately 240 patients will be enrolled at multiple centers; they will be treated for 24 weeks. The main outcome assessments (clinical endpoints) are improvement of corneal fluorescein staining (which is a measure of ocular surface inflammation), tear production, and dry eye symptom score.
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GLPI Presents 2010 GP Clinical Excellence Awards
The GP Lens Institute (GPLI) and the Contact Lens Manufacturers Association (CLMA) recently announced the recipients of the 2010 GP Clinical Excellence Awards. The award is bestowed upon the 4th year student from each of the optometric colleges and universities in North America that showed interest and enthusiasm in the fitting of GP contact lenses in their clinical environments. Honorees are selected by the faculty at each school. The award includes a diagnostic set manufactured by a CLMA member laboratory.
Recipients of the awards for 2010 are: Nathaniel Graham, OD, New England College of Optometry; Melissa Kim Le, OD, Pennsylvania College of Optometry at Salus University; Jessica Ellis, OD, Southern College of Optometry; William Chadwick Henson, OD, University of Alabama at Birmingham-College of Optometry; Tony Bisotti, OD, Indiana University School of Optometry; Joann Paczwa, OD, Illinois College of Optometry; Erin Michele Theut, OD, Ferris State University-Michigan College of Optometry; James Scherman, OD, University of Missouri-St. Louis College of Optometry; Stephanie D. Mendell, OD, Northeastern State University-Oklahoma College of Optometry; Tara Vacharkulksemsuk, OD, Southern California College of Optometry; Derek B. Ames, OD, Pacific University College of Optometry; Jessica Unruh, OD, University of Houston College of Optometry; Anny Pi-ning Chen, OD, SUNY; Adam Sweeney, OD, NOVA Southeastern College of Optometry; Michael Parolini, OD, Ohio State College of Optometry; Esther Nakagawara, OD, University of California - Berkeley College of Optometry; Anh-Ton Tran, OD, University of Montreal; and Simon Reid, OD, University of Waterloo.
Global Specialty Lens Symposium, January 27-30, 2011, Paris Hotel & Casino in Las Vegas
Plan now to attend the Global Specialty Lens Symposium in January 2011. With an expert international faculty and a CE-accredited agenda, the 2011 GSLS will include insightful presentations by experts in the field, hands-on demonstrations of cutting-edge products as well as scientific papers and posters. Look for more detailed information in future issues of Contact Lens Spectrum and online at www.GSLSymposium.com.
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Pediatric Cataract Initiative Seeking Applicants for Inaugural Research Grant
The Pediatric Cataract Initiative is now accepting applicants for its inaugural single small research grant. US$75,000 will be awarded to a qualified individual, institution or organization investigating the causes of pediatric cataract and/or improved treatment tools and protocols. The submission deadline is November 15, 2010.
The grant is intended to support innovative research that can be carried out in 12 months with limited resources. Applicants may submit more than one proposal provided that each is scientifically distinct. Visit www.pediatriccataract.org/grant_funding.html to the download request information.
The Pediatric Cataract Initiative is a partnership between the Bausch + Lomb Early Vision Institute and Lions Clubs International Foundation to identify, fund and promote innovative methods of overcoming pediatric cataract. For additional information, visit www.PediatricCataract.org.
ZeaVision Announces New President and Director of Marketing
ZeaVision, LLC, an eye care nutraceutical company, announced two promotions. Chris Barber has been promoted to President from his previous role of Vice President Sales and Marketing and appointed to the Executive Board.
Prior to joining ZeaVision, Barber worked as a commercial leader for GE Healthcare and legacy companies for 27 years. Barber received a Bachelor of Business Administration degree from the University of Central Arkansas and executive training at The University of Chicago, University of Michigan, and the GE Executive development center.
The company also announced the promotion of Betsy Ley to Director of Marketing and Customer Service. Ley has managed ZeaVision Customer Service since joining the company in 2005, and has more than 25 years of experience in a variety of roles at Com-Link21, LDDS, MCI WorldCom, Maritz Inc., and CallForceOne Consulting Group.
Keratoconus Group named BCLA Charity of the Year
The British Contact Lens Association (BCLA) has chosen the Keratoconus Group to be its Charity of the Year for 2010-11. The Keratoconus Group works to raise awareness of keratoconus in the UK, providing support and information to people with the condition and supports research into keratoconus as well.
BCLA Secretary General, Vivien Freeman, commented: “We are delighted to support the Keratoconus Group in this way, and would encourage our members to do what they can to get involved.”
For more information about the Keratoconus Group, and to find out how to donate, visit www.keratoconus-group.org.uk
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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Many of the pediatric contact lens experts recommend avoiding age as the primary criteria for fitting children and/or teens in contact lenses. These experts often recommend evaluating more subtle aspects such as perceived maturity, dexterity, and motivation. However, as clinicians it's often easy to fall back on black-and-white criteria that can be used in many cases, even outside of the topic of fitting children in contact lenses. We'd like to get your feedback on this. Please see this week's CL Today Quick Poll and let us know your thoughts. |
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Epidemiology of Ulcerative Keratitis in Northern California
Researchers wanted to determine the incidence and associated risk factors for ulcerative keratitis in northern California. In this large-population, retrospective, cohort study, all medical records with diagnosis coding for corneal ulcers during a consecutive 12-month period were reviewed. Incidence rates were calculated using a dynamic population model. Multivariate relative risk regression was conducted to evaluate potential risk factors for ulcerative keratitis.
Within the target population of 1,093,210 patients, 302 developed ulcerative keratitis. The incidence of ulcerative keratitis was 27.6 per 100,000 person-years (95% confidence interval, 24.6-30.9). The incidence of corneal ulceration in contact lens wearers was 130.4 per 100,000 person-years (95% confidence interval, 111.3-151.7), with an adjusted relative risk of 9.31 (7.42-11.7; P < .001) compared with non-contact lens wearers, who had an incidence of ulcerative keratitis of 14.0 per 100,000 person-years (11.7-16.6).
Seven of 2,944 people known to be infected with human immunodeficiency virus developed ulcerative keratitis, with five being contact lens wearers. The incidence of ulcerative keratitis in human immunodeficiency virus-positive patients was 238.1 per 100,000 person-years (95% confidence interval, 95.7-490.5), with an odds ratio of 9.31 (7.42-11.7; P < .001) compared with human immunodeficiency virus-negative patients, who had an incidence of ulcerative keratitis of 27.1 per 100,000 person-years (24.1-30.3).
The researchers concluded that the incidence of ulcerative keratitis in this population is higher than previously reported. This may be owing to the increasing prevalence of contact lens wear.
Jeng BH, Gritz DC, Kumar AB, Holsclaw DS, Porco TC, Smith SD, et al. Epidemiology of ulcerative keratitis in Northern California. Arch Ophthalmol. 2010 Aug;128(8):1022-8.
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