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Sunday, September 29, 2013  
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Last question:
What is your estimate of the number of daily disposable lens wearers who re-use their lenses rather than discard them after use?



Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

The digital world around us expands exponentially with time in terms of advances in technology. We live in a high definition world, and we expect our cameras, televisions, computer screens and many other electronic devices to perform in this regard. So, why is it that we sometimes do not fully correct our contact lens patients, in terms of their full refractive error (e.g., low cylinder) or in terms of the entire range of working distances we use—near to far—with multifocal designs? Give your patients the best you can using the latest technologies in contact lenses to optimize vision so that they can enjoy the high definition world around them.

Laura Angelini Named President, North America, Johnson & Johnson Vision Care

Johnson & Johnson Vision Care, Inc. announced the appointment of Laura Angelini to the role of President, North America, Johnson & Johnson Vision Care, Inc. In her new role, Ms. Angelini will be responsible for the Vistakon U.S. and Canadian businesses.

Ms. Angelini has over twenty years of experience building business and brands at Johnson & Johnson. She has served in various sales and marketing leadership roles across the company's Medical Device and Diagnostics segment. Early in her Johnson & Johnson career, she was responsible for introducing 1-Day Acuvue brand contact lenses to the Italian market.

Most recently, Ms. Angelini was challenged with the task of creating a global enterprise strategy for three previously separate businesses that came together to form Ethicon Surgical Care. Impacting almost all commercial areas of the business, she and her team were ultimately responsible for launching new products in each of the company's strategic growth categories.

ABB Optical Group Becomes Authorized Manufacturer of Rose K

ABB Optical Group has been a distributor of Rose K lenses over the past 15 years, and has now become an authorized manufacturer of the complete line of Rose K lenses, including the new Rose K2 XL. Being able to manufacture Rose K lenses in their state-of-the-art facility will allow the company to provide the product line to customers faster than ever before. Additionally, their highly trained certified Contact Lens Consultants continue to be available to assist customers with fitting their patients in Rose K lenses.

Dr. Paul Rose, designer of the Rose K family of lenses, was a guest speaker at recent evening seminars co-sponsored by ABB Optical Group and Menicon. He introduced the newest member of the Rose K family: the Rose K2 XL, a semi-scleral lens which is indicated for Keratoconus, PMD, Post Graft, Post-Lasik ectasia and other irregular cornea conditions that cannot be successfully fitted within the limbus. The Rose K2 XL allows eye care practitioners to provide their patients with the exceptional visual acuity and improved comfort that large diameter GPs are known for having. Experienced specialty lens fitters will appreciate the familiarity of fitting the Rose K2 XL design when using the 5-step fitting method that is commonly used with the proven Rose K product line.

New fitting guides featuring Rose K family of lenses, including a new Rose K2 XL fitting guide, and diagnostic fitting sets for the Rose K2 and Rose K2 XL lenses will soon be available from ABB Optical Group. For more details, contact your ABB Optical Group Sales Executive.

Register Now for Optometric Management Symposium
Plan now to attend the Optometric Management Symposium on Contemporary Eye Care, December 6‑8, 2013 at Disney's Contemporary Resort in Lake Buena Vista, Florida. This popular annual symposium provides the perfect balance of timely, disease management courses and practice-building courses with plentiful networking and leisure time to enjoy all that Disney resorts and theme parks have to offer.

The educational program is presented by the Pennsylvania College of Optometry, Salus University. For agenda, more information and to register, visit www.OMConference.com.
J&J Vision Care Accepting Research Proposals Related to Ultraviolet Radiation and the Human Eye

Johnson & Johnson Vision Care, Inc. (JJVCI) is now accepting research proposals related to ultraviolet (UV) radiation and the human eye. Specific areas of interest include the following topics:

  • Eye health including photoageing (cataractogenesis, presbyopia, corneal, retinal, conjunctival/limbal changes)
  • Epidemiology of UV induced ocular disease including geographic, ethnic, and occupational study. Proposals may include the study of indoor and outdoor UV radiation. Increased risk associated with UV exposure in youth.
  • Assessing the protective effect of UV blocking contact lenses on human ocular tissues including methodology, measurement techniques and clinical endpoints. Comparative protective effects of contact lenses and spectacles/sunglasses.
Research proposals must be submitted through the JJVCI Investigator Initiated Study (IIS) application process by contacting the Clinical Research Administrator by email at RA-VISUS-IISRequests@its.jnj.com, or by calling at 1-904-443-1525. All research proposals must be submitted in English.

For additional information on JJVCI's IIS process and policy, please go to the following link: http://www.acuvueprofessional.com/investigator-initiated-studies.

BCLA Launches New Industry Award

The British Contact Lens Association (BCLA) plans to reward individuals working within industry for their outstanding contribution to the contact lens profession with a new Industry Award. The award aims to honor and recognize the entrepreneurial work being carried out by individuals working in contact lens science, and research and technology, within the industry in the UK or overseas.

Nominations are now being sought, by the November 29 deadline, for the inaugural BCLA Industry Award. Nominations may be made by registered 2013 and 2014 exhibitors for one individual, who they believe has:

  • Demonstrated and applied new products, concepts and/or technology that have significantly contributed to the growth of the contact lens industry;
  • Developed existing (standard) technology in a new, creative manner; or
  • Significantly impacted the health of the global contact lens wearing community and contact lens profession.
For more information about the 2014 BCLA Industry Award, and how to nominate, visit www.bcla.org.uk/en/about-us/what-we-do/industry-award-2014.cfm.

Thread in Eye
By Bo Lauenborg, OD, Aarhus, Denmark

This patient slept in her daily disposable toric lenses, which resulted in a textile thread being stuck in the epithelial layer in both the right and left eye. In fact, it had grown into the epithelia. The textile fibers were removed without injury to the cornea. We prescribed a subsequent 14-day break from contact lens wear. After that we expect to restart the patient with contact lenses, however not in a daily disposable but rather a silicone hydrogel alternative, and with additional training in compliance and hygiene.

We thank Dr. Lauenborg for sending this image and welcome photo submissions from our readers. It is easy to submit a photo for consideration for publishing in Contact Lenses Today. Simply visit http://www.cltoday.com/upload/upload.aspx to upload your image. Please include an explanation of the photo and your full name, degree or title and city/state/country.

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Ronald K. Watanabe, OD, FAAO

Multifocal Sclerals

Scleral lenses are becoming increasingly popular, not only for irregular corneas, but also for "normal" eyes. They have been great for patients with astigmatism and contact lens dryness. One additional area that has a lot of potential is presbyopia. Compared to soft multifocals, sclerals have crisper optics. Compared to corneal GP multifocals, they are easier to adapt to.

Multifocal scleral lenses are becoming more common. Most, like the One-Fit, Maxim, and Custom Stable, are center-near designs with the multifocal optics cut onto the front surface of the lens. Each has their own unique optical design, with varying zone sizes, eccentricity values, and transition zones. Most take pupil size and add power into consideration when determining these parameters. One, the AVT Scleral, is a center-distance design with the multifocal optics cut into the back surface of the lens. The design has an aspheric zone that transitions from distance to intermediate to near, and a peripheral distance zone for low light distance vision. Whichever design you select, all are simultaneous vision designs due to the immobile nature of scleral lenses. But with their crisp GP optics, multifocal sclerals can be a fantastic choice for the appropriate patient.

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Loretta B. Szczotka-Flynn, OD, PhD, MS, FAAO

What is the best treatment for recurrent corneal erosions?

There is no international agreement on the best interventions for recurrent corneal erosion. A Cochrane Review was published on this topic last year and highlighted a variety of treatment approaches in eight published trials around the world, with no consensus on what was the most effective treatment.1 In the Cochrane Review, treatment approaches ranged from excimer laser ablation in addition to mechanical debridement, therapeutic contact lens wear, lubricant drops and ointment, diamond burr polishing and oral tetracycline or topical prednisolone drops in addition to standard treatments. However, the review concluded that international consensus is needed to progress research efforts towards evaluation of the major effective treatments for recurrent corneal erosions.

In a recent study just published in Cornea, Ahad and colleagues investigated the efficacy of bandage contact lenses in comparison to ocular lubricants in the initial management of recurrent corneal erosion syndrome in a randomized controlled trial with 29 patients. The patients wore bandage contact lenses for a 3-month duration, replaced every 30 days or used ocular lubricants four times per day, with ointment at night for 3 months.2

Interestingly, bandage lenses did not increase the likelihood of complete resolution, but some patients experience earlier relief from symptoms. Specifically, patients on bandage lens treatment had earlier resolution of symptoms, with a mean time of 5 weeks compared with 9 weeks for ocular lubricants. None of the patients with BCLs developed adverse side effects.

Clinically, I am agreement with these findings, and usually prescribe silicone hydrogel bandage lenses in a continuous wear modality for approximately 3 months with good results.

1. Watson SL, Lee MH, Barker NH. Interventions for recurrent corneal erosions. Cochrane Database Syst Rev. 2012 Sep 12;9:CD001861. doi: 10.1002/14651858.CD001861.pub3.
2. Ahad MA, Anandan M, Tah V, Dhingra S, Leyland M. Cornea. Randomized Controlled Study of Ocular Lubrication Versus Bandage Contact Lens in the Primary Treatment of Recurrent Corneal Erosion Syndrome. 2013 Aug 22. [Epub ahead of print]

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Bitoric Rigid Gas Permeable Contact Lenses in the Optical Management of PKP

The purpose of this study was to evaluate the complexity and effectiveness of fitting bitoric rigid gas permeable contact lenses (RGPCLs), compared to spherical RGPCLs, when used in the correction of high amounts of post-penetrating keratoplasty astigmatism.

Records of post-penetrating keratoplasty (PKP) patients being managed with bitoric RGPCLs were compared to controls (post-PKP patients managed with spherical RGPCLs). Factors that were analyzed included the number of diagnostic RGPCLs used to assess the initial fit, the number of RGPCLs ordered to finalize the fit and the number of total doctor visits to finalize the fit.

Fourteen eyes of 14 patients satisfied the study criteria. The average amount of total astigmatism in this study group was 10.0D±5.0 compared to the control group which was 3.3D±2.6. The number of diagnostic RGPCLs used for the study group was 1.2±0.4 compared to 1.0±0.0 for the control group. The mean number of contact lenses ordered to complete the fitting for the study group was 1.9±0.7 compared to the control which was 2.1±0.8. The study group presented for an average of 6.3±1.6 visits whereas the control group presented for 4.9±1.1 visits. Contact lens corrected acuity for the study group was 0.101±0.11 (20/25) compared to the control group 0.08±0.12 (20/24).

The researchers concluded that the complexity of fitting bitoric RGPCLs was found to be similar to fitting spherical RGPCLs on post-PKP eyes and the visual outcomes were not different.

Phan VA, Kim YH, Yang C, Weissman BA. Bitoric rigid gas permeable contact lenses in the optical management of penetrating keratoplasty. Cont Lens Anterior Eye. 2013 Aug 27. pii: S1367-0484(13)00099-4. doi: 10.1016/j.clae.2013.07.015. [Epub ahead of print]
Source: Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7003, United States. Electronic address: vphan@jsei.ucla.edu.

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