CONTACT LENSES TODAY

September 14, 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.

Wise to Distribute Punctal Plug
Wise Optical has entered into an agreement with Surgical Specialties Corporation to distribute Surgical Specialties' UltraPlug line of punctal plug products. The UltraPlug is designed to relieve dry eye syndrome and limits tear drainage when inserted into the punctum. According to the companies, the plug is made of medical-grade silicone and is engineered to provide a high degree of patient comfort.

Examining Affects of Carboxymethylcellulose
Allergan researchers investigated the potential for carboxymethylcellulose (CMC) to chemically complex residual disinfectants found in current multipurpose solutions (MPSs) in situ. The results of the study, in which the researchers examined the chemical availability of the MPS disinfectant polyhexamethylene biguanide (PHMB) using a spectrophotometric assay, appear in the July 2003 issue of Eye & Contact Lens. After finding that the chemical availability of PHMB in water or MPS was reduced within 10 minutes of adding CMC, the researchers concluded that CMC rapidly binds PHMB and reduces its chemical availability and bioactivity. They also stated that their results suggest a potential cytoprotective effect of CMC on the ocular surface when used before lens insertion.

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Paracon Helps Soderberg Expand CL Services
Soderberg, Inc. has announced that Paracon, Inc. will assist Soderberg in its distribution of exclusive GP contact lens products such as Crystal-Vue, Sharp-Vue, Apogee and S-10. To see Soderberg's complete contact lens product offerings, visit http://www.soseyes.com.

CIBA Doubles Production of Night & Day
CIBA Vision says that trial Night & Day lenses are readily available because it has doubled production of the lenses. Now, according to the company, eyecare practitioners can refit patients in the lenses more aggressively. The manufacturing expansion responsible for the ample supply of trial lenses is part of a multi-million dollar investment that CIBA announced in June 2002 to nearly quintuple production of the lenses by 2004. To obtain a 70-lens trial set of the lenses, contact your CIBA sales rep or distributor.

Abstract: Managing CLACI
This literature review article points out numerous important factors and guidelines for diagnosing and managing contact lens associated corneal infiltrates (CLACI). Although the exact prevalence and incidence are uncertain, CLACI is far more common in extended wear. The authors state that with symptoms, and an overlying epithelial defect, even in the absence of an anterior chamber reaction or discharge, lens wear should be discontinued, a culture taken and aggressive antibiotic therapy initiated. Though in some definitive cases where infection is ruled out, no medical therapy may be necessary, but progress should be monitored. Prevention of CLACI includes good lens fit and movement, compliance, avoiding toxic substances including possible lens care products, regular lens replacement, high oxygen flux and consideration switching to daily disposable or GP lenses if CLACI recurs in an extended wear patient.
Robboy, MW; Comstock, TL; Kalsow, CM. Contact Lens-Associated Corneal Infiltrates. Eye & Contact Lens July 2003 29(3):146-154.

Editor's Commentary: Residual Astigmatism -- Just Correct It
Tom Quinn, OD, MS, wrote an excellent column in the August issue of Contact Lens Spectrum about when to use spherical lenses versus aspheric lenses versus toric lenses for astigmats depending on how much spherical component they have. He also points out how as little as 0.50D of residual astigmatism can make a difference. It sure does. It's interesting to teach young students about residual astigmatism. They never say it, but you can see the looks on their faces and imagine them thinking, "So why not just correct it?" Great question! Sometimes the naive can lead you to the best answer. Why not just correct it?

Fitting Tip: Three-Lens Dispensing for Presbyopes
I've been wearing "hard" contact lenses for 44 years (first PMMA and GP lenses for the past 15 years or more). As I approached middle age and reading became difficult, I added a 1.00D undercorrection in my nondominant eye for when I'm in the office. I am 61 years old now and this still works for me. My myopia has gradually decreased over the years from -4.00D OU to -2.00D OU. Whenever I have a patient in the presbyopic age, I demonstrate my own contact lenses and suggest a three-lens solution. I prefer 20/20 OU outside of the office and wear the full prescription. I have converted many soft lens wearers to GP lenses and the vast majority love them. Sharper vision, ease of care and longevity of the lenses are the benefits these patient obtain.
--Edmund J. Samuels, OD
Port Washington, Ind.

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