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Sunday, October 23, 2011  
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Last week's question:
What is the primary reason why you DO NOT prescribe daily disposable lenses to patients?

 1. Limited parameter selection (e.g., high torics, not enough base curves)

 2. Cost

 3. Patient resistance

 4. I am reluctant due to perceived patient non-acceptance

 5. I don't believe that they offer any true benefits to the patient (e.g., ocular health or comfort)

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

Hopefully you've followed our recent Quick Polls on the daily disposable modality. To summarize, the primary reason why practitioners indicated they fit patients into this modality is to "optimize ocular health" while the primary reason why practitioners do not fit this modality is "cost." I've done my own cost analysis relative to one of the fastest growing, disposable consumer products which will appear in my Editor's Perspective column in Contact Lens Spectrum in November, so please stay tuned.

WebMD, B+L Join Forces to Help Consumers and Doctors Improve Eye Health

WebMD Health Corp. and Bausch + Lomb (B+L) introduced a first-of-its-kind suite of online resources to help improve the care of eye health in America. The new resources on WebMD and Medscape will educate consumers about the importance of maintaining good eye health, as well as its connection with other prevalent health conditions, to encourage them to connect with an eyecare professional to discuss how they can protect and enhance their vision.

The consumer resources at WebMD (www.webmd.com/eye-health) feature assessments to improve eye health knowledge, editorial features, and expert-led videos regarding common eye concerns, as well as steps preserve healthy vision through every stage of life.

On Medscape, www.medscape.com, eye health professionals can engage in a clinician challenge, and explore clinical topics, imagery and new information about overall eye health. The medical destination also allows professionals to engage in peer-to-peer discussions with their colleagues in a registration-based eye health community. Initial discussion board topics include: breakthrough platforms for cataract surgery, ocular nutrition, visual acuity and bio-inspired eye health products. Medical professionals also will be able to explore related resources and information in the Bausch + Lomb Eye Health Center, which can be found on the site.

Medscape's online resources will reach optometrists and ophthalmologists and will also reach health care professionals in related fields who play a primary role in the prevention and treatment of eye-related conditions or treat systemic conditions commonly associated with co-morbidities of the eye.

WebMD and Medscape editorial content is independently created, balanced and unbiased. Any content sponsored or contributed by B+L will be clearly labeled as such.

AOA Launches New Contact Lens Safety Web Site

The American Optometric Association (AOA) launched www.ContactLensSafety.org, a new, easy-to-use website to help answer consumer questions about contact lens safety. The AOA Contact Lens and Cornea Section (CLCS) created the site with the assistance of the American Academy of Optometry (AAO).

A wide range of information can be found on the site. Topics covered include lens replacement schedules, purchasing contact lenses and contact lens wear in various environments. Also included is the "Ask the Expert" section where consumers can submit their contact lens question to a panel of experts.

Thomas Quinn, Jr., OD, AOA CLCS Council Member, stated that this site has been created to become a one-stop resource for questions regarding contact lens safety. He also cautioned in an AOA media release, that the site offers only information on contact lens safety and is not a substitute for an annual comprehensive eye examination.

Global Specialty Lens Symposium, January 26 - 29, 2012, Paris Hotel & Casino in Las Vegas

Plan now to attend the Global Specialty Lens Symposium in January 2012. With an expert international faculty and a CE-accredited agenda, the 2012 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.

AVT Added as Authorized Menicon Z Laboratory

Menicon America, Inc. announced that Advanced Vision Technologies (AVT) has become an Authorized Menicon Z (tisilfocon A) finished contact lens manufacturer. AVT of Golden, Colorado, specializes in innovative designs of premium GP contact lenses. With the addition of Menicon Z to the company's product portfolio, AVT now offers lens design with the highest level of oxygen permeability in a gas permeable lens material available today. Menicon Z is approved for extended wear up to 7 days, and the only GP material approved for up to 30 days of continuous wear.

For more information on AVT and the company's lens designs, visit http://www.avtlens.com.

Ocusoft Names Shelton Vice President of Sales

Ocusoft, Inc., an ophthalmic research, development and supply company, announced a strategic shift in their executive team with the appointment of Ed Shelton as Vice President of Sales.

Mr. Shelton, based in Collierville, Tennessee, has over 25 years of experience in the ophthalmic pharmaceutical and device industry including sales of contact lenses and surgical products, as well as pharmaceuticals. He most recently served as Ocusoft's Vice President of Special Projects assisting the President and Chairman on a variety of industry issues.

During this transition, Rose Mary Martinez will relinquish many of her duties as the former Vice President of Sales to assume her new role as Vice President of Sales Operations. She will focus on improving efficiencies and productivity in company's day-to-day sales operations while continuing to oversee the Inside Sales/Customer Service Department.

R-Tech Ueno Reaches Agreement on the Supply of Recombinant Human Serum Albumin for Dry Eye Treatment Solution

R-Tech Ueno, a drug discovery venture company in Japan, and Novozymes Biopharma DK A/S, a leading company in the field of bioinnovation, reached a basic agreement on the supply of recombinant human serum albumin for use in an ophthalmic solution for the treatment of dry eye which the company is developing. R-Tech Ueno has been searching for a new raw material supplier so that they could restart development of the solution, which was halted last year with the dissolution of the license with the previous supplier.

The project, RU-101, is aimed at the development of ophthalmic solutions for the treatment of corneal epithelial diseases including dry eye, focusing on serum component albumin. The company reports that they have confirmed that serum albumin enhances the production of mucin, one of the components of tears, in an experiment in conjunctival epithelial cells, and the company also has intellectual property rights concerning the treatment of dry eye with albumin. The company plans to promote the development RU-101 eye drops as a therapeutic agent for moderate to severe dry eye and prepare to start clinical trials in the United States as soon as possible.

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Keratoconus with Stromal Rings
By Augusto Rossé, Catholic University of Valparaiso, Chile

This photo represents a keratoconus patient with stromal rings. The patient was fitted with mini scleral lens (16.5 diameter) and one can see clearance with fluorescein pooling between lens and cornea in the optic section.

We thank Augusto Rossé for his image and welcome photo submissions from our other 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.

Susan J. Gromacki, OD, MS, FAAO

Position Papers from the American Academy of Optometry

Hello from Boston! Yesterday, I participated in the leadership meeting of the Cornea, Contact Lenses, and Refractive Technologies (CCLRT) Section of the American Academy of Optometry (AAO). One of our agenda items addressed the maintenance and development of our section's position papers. Written by CCLRT Diplomates and reviewed by the section leadership, they are wonderful resources for patients, practitioners, staff and the press.

There are currently eight position papers (including one with information on contact lens care, Healthy Eyes: Responsibilities of the Contact Lens Patient) with more on the way. The Academy does provide the caveat, "This report is furnished for general information purposes only. It does not constitute the practice of optometry or medicine, nor should it be relied upon for dealing with a specific, individual medical or health condition. Please consult a qualified eye care professional for advice about a specific condition."

I have found the AAO position papers to be well-written and quite helpful in patient communication, both oral and written.

To view these position papers, visit: http://www.aaopt.org/section/cl/position/index.asp.

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Kelly K. Nichols, OD, MPH, PhD, FAAO

Changing Places and New Faces

Having just returned from the American Academy of Optometry meeting in Boston, I have been reflecting on the most compelling tidbit of ocular surface information that I heard or saw at the meeting. On a bragging note, my husband and Contact Lenses Today editor, Jason Nichols, was recipient of the AAO Borish award for his career work in the dry eye and contact lens fields, but more important was his acceptance acknowledgement of me as his "lifetime sweetheart" (awh...).

On a more serious note, certainly, the meeting was a-buzz with the Alcon/Ciba merger under the name Alcon, a Novartis company. It was interesting and in some cases mind-bending to see leadership from both legacy Alcon and Ciba working together for a common goal. Also, with Merck's acquisition of Inspire, it was nice to see some new faces at AAO, as well as friends relocated within the eye care community. In addition to support from familiar friends at Allergan and other companies interested in drug approval for dry eye and/or MGD/blepharitis, some rumors still circulate of venture capital divestment of dry eye pipeline products.

However, given all of this, for me, the big news in OSD was the continued optimism in the continued pursuit of new artificial tear formulations, contact lens care solutions and ocular surface therapeutics by big and small companies alike—as well as the enthusiasm and perceived value in involving optometry in this process.

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Finite Element Analysis of Blunt Foreign Body Impact on the Cornea after PRK and LASIK

Researchers wanted to investigate the effect of blunt foreign body impact on a human cornea after photorefractive keratectomy (PRK) and LASIK using a simulation model.

Computational simulations were performed using a finite element analysis program (LS-Dyna, (Livermore Software Technology Corp). The blunt foreign body was set to impact at the center of the corneal surface models (after PRK and LASIK) with thicknesses of 500, 450, 400, 350, and 300 μm. Corneal rupture was assumed to occur at a peak stress of 9.45 MPa and at a strain of 18%. The foreign body projectile was blunt in shape, made from aluminum, contained plastic-kinematic properties, and had a density of 2700 kg/m(3).

The projectile was launched at the center of the cornea with velocities ranging from 20 to 60 m/s. The threshold of impact velocities creating rupture in corneal thicknesses of 500, 450, 400, 350, and 300 μm were 33, 32.8, 30.7, 27.9, and 22.8 m/s, respectively, in the PRK model. In the LASIK model, the thresholds creating rupture in the stromal bed of the corneas with thicknesses of 500, 450, 400, 350, and 300 μm were 40, 38.1, 35.6, 31.5, and 26.7 m/s, respectively. The 110-μm corneal flap in the LASIK model ruptured at all velocities.

The researchers concluded that ruptures occurred at lower velocities in the PRK cornea model than in the corneal stromal bed of the LASIK model following blunt foreign body impact.

Mousavi SJ, Nassiri N, Masoumi N, Majdi NM, Farzaneh S, Djalilian AR, et al. Finite Element Analysis of Blunt Foreign Body Impact on the Cornea After PRK and LASIK. Journal of Refractive Surgery. 2011 Sep 12:1-6.

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Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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For more information on Contact Lenses Today including archives of previous issues, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

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