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Sunday, October 27, 2013  
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Last question:
How frequently do you encounter defects in soft lenses when you remove a new one from a blister pack?
Almost never

Infrequently (< 1/100)
Sometimes (~1/25)
Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

Are large diameter lenses the way of the future? Without question, we have seen growth in this category over the last several years. We know the benefits in terms of vision, comfort and vaulting a diseased cornea. However, there are still some questions that remain. One of the great mysteries to date remains the issue of lens fogging or clouding. Hopefully we will see more work on this topic in the year to come to help us avoid or prevent this annoying problem.

The TFOS International Workshop Report on Contact Lens Discomfort Now Available

Contact lens discomfort (CLD) may be the leading cause of patient dissatisfaction with, and discontinuation of, contact lens wear throughout the world — but there is little agreement among vision researchers and eye care professionals about how to define and manage its causes.

To lay the groundwork for defining and treating this widespread issue, the Tear Film & Ocular Surface Society (TFOS) organized the TFOS International Workshop on Contact Lens Discomfort, which was chaired by Jason J. Nichols, OD, MPH, PhD, Professor at the University of Houston College of Optometry. The findings are now available online in the journal Investigative Ophthalmology & Visual Science.

The CLD Workshop took 18 months to complete and involved 79 experts from around the world. Workshop participants used an evidence-based approach and a process of open communication, dialogue, and transparency in order to achieve a global consensus concerning multiple aspects of CLD. It is hoped that the TFOS report will significantly increase awareness of factors that may, and may not, contribute to the generation of CLD. Ideally, this report will stimulate innovative research in this very important field.

The TFOS International Workshop on Contact Lens Discomfort Report is freely available to scientists and clinicians worldwide online at http://www.iovs.org/content/current. Complete or partial translations of the report will be offered in numerous languages.

CooperVision Launches Biofinity XR Contact Lenses Extending Sphere Range

CooperVision, Inc. announced the launch of its Biofinity XR lens brand. The extension to its silicone hydrogel (comfilcon A) lens significantly expands Biofinity's range of sphere powers, allowing practitioners to fit a greater number of monthly replacement lens patients. This includes wearers with significant hyperopia or myopia currently using other lens brands or spectacles.

Biofinity XR lenses will be available in powers from +8.50 to +15.00 (0.50 steps) and -12.50 to -20.00 (0.50 steps). The existing Biofinity line will continue to be available in +8.00 to -12.00 powers.

With this launch, the Biofinity and Biofinity XR sphere lines now represent the widest available range of silicone hydrogel contact lenses from any major manufacturer, according to the company.

B+L Introduces PureVision2 Multi-Focal Contact Lenses

Bausch + Lomb (B+L) announced the introduction of PureVision2 Multi-Focal (balafilcon A) visibility tinted contact lenses for presbyopia, a monthly silicone hydrogel multifocal contact lens packaged in borate buffered saline. Featuring a next generation 3-Zone Progressive design, these innovative lenses are designed to improve near and intermediate vision while providing excellent distance clarity1.

According to the company, the innovative lens design allows for a predictable2, quick fit for the eye care professional.

PureVision2 for presbyopia contact lenses are available for daily or extended wear up to 30 days. Featuring multifocal lens technology licensed from Unilens Vision, Inc., these lenses are now available in the U.S. in a full range of parameters, and will be introduced in other markets throughout 2013.

1 Analysis based on use of Hartmann-Shack wavefront sensing instruments applying high lateral resolution to map lens power across a contact lens. More than 6000 unique measurements over the central 6mm of a contact lens were plotted to determine local power measurement as a function of radial distance from the center of the lens.
2 Thirty-nine ECPs (from 10 countries) refitted 422 existing soft contact lens wearing presbyopes into PureVision2 for Presbyopia. Patients returned for follow-up visits after 1-2 weeks. ECP assessment of lens performance including ease of fit, and patient satisfaction with lenses in real world conditions, were measured using a 6-point agreement survey.

Don't Miss the 2013 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.
Art Optical Initiates New Technical Training Center

Art Optical initiated their new onsite Technical Training Center on October 15, 2013, by hosting members of the West Michigan Optometric Association.

The practitioners in attendance learned about the capabilities of the new training facility, which features the latest diagnostic assessment equipment, custom sound and lighting, and seating capacity for up to 75. The Training Center will be used for customer-focused events like educational lectures and focus groups, as well as hands-on specialty lens fitting workshops for individuals and small to medium-sized practitioner groups. The additional capabilities in the new Technical Training Center will further aid the company's internal research and development efforts, and enhance associate training experiences as well.

The next practitioner event scheduled at the Art Optical Technical Training Center will be December 5, 2013, when Dr. Paul Rose, inventor of the ROSE K family of GP lens designs presents an interactive workshop on his latest design, the ROSE K2 XL Semi-Scleral lens. Registration information is available at http://artoptical.com/register.

Kerasoft IC Launched in Italy

In a partnership between UltraVision CLPL, Bausch + Lomb and Sanalens, KeraSoft IC was launched in Italy at the 'Congresso di Monopoli' on October 13-14, 2013.

Over 250 practitioners from all over Italy attended the conference which had a focus on specialty contact lenses. Lynn White MSc FCOptom, Clinical Director of UltraVision CLPL, and Dr. Lynette Johns, Clinical & Educational Consultant for Bausch + Lomb, presented a joint workshop with 'live' patient fittings throughout the weekend. Post-graft and RGP wearing patients were fitted with KeraSoft IC.

Brien Holden Vision Launched

A new brand, a new website, Brien Holden Vision was officially launched at the 92nd annual meeting of the American Academy of Optometry (AAO) in Seattle. This new enterprise brings together the commercial subsidiaries of the Brien Holden Vision Institute.

Brien Holden Vision will develop pathways for advanced and beneficial products and services for those in need of vision correction and to detect signs of conditions that threaten vision, eye and general health. The new website, www.brienholdenvision.com, highlights the cutting-edge projects currently being undertaken.

The launch of Brien Holden Vision brings together a group of commercial subsidiaries whose products and services fall into strategic categories:

  1. Vision care products — such as contact lenses and lens care solutions that improve health and vision, control myopia and correct presbyopia;
  2. Enabling technology — technology and / or products that detect eye and health problems to deliver better health and vision care at affordable cost;
  3. Social entrepreneurship — innovative, sustainable vision care delivery systems and facilities based on best-practice affordable vision care.
According to Professor Holden, the Brien Holden Vision Institute has a clear mission. The core activities means the Institute can license technology developed by their teams to commercial organizations, and then reinvest funds back to sustain and expand work in their eye care programs around the world.

Your Interesting Case Photo Here

Have you seen an interesting case lately? Would you like to share it with your colleagues? An image from that case could appear in this column next week!

We 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

New Soft Multifocal Design

Bausch + Lomb has introduced the PureVision2 for Presbyopia contact lens. This is a new design based off of the original PureVision Multi-Focal. The multifocal design has been redesigned to deliver improved vision and more predictable fitting to try to improve patient success while reducing chair time. The design was dubbed "3-Zone Progressive." It has a 6 mm optic zone with a wide central near zone that transitions into a wide intermediate zone and an optimized distance zone. The power profile is also more consistent across lens powers than the original PureVision Multi-Focal, which gives more predictable results during the fitting process.

Other improvements include a decrease in thickness across the entire lens, which improves oxygen transmissibility (130 at -3.00 D) and comfort. The center and edge are more than 20% thinner than the original design. Otherwise, the material and lens parameters are the same. The lens is approved for continuous wear up to 30 days and nights. In a busy practice, a consistent design and streamlined fitting process can be a welcome addition to the array of soft multifocal lenses already available to us.

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

Drug-Eluting Contact Lens for Glaucoma Management

A non-industry sponsored study of a drug-eluting contact lens is showing promise for the treatment of glaucoma. Ciolino and colleagues from Massachusetts Eye and Ear Infirmary and Massachusetts Institute of Technology have developed a drug-eluting contact lens designed for prolonged delivery of latanoprost. Latanoprost-eluting contact lenses were created by encapsulating latanoprost-poly(lactic-co-glycolic acid) films in methafilcon by ultraviolet light polymerization. The drug-polymer film is located between the methafilcon hydrogel's outer surface and inner surface resulting in a clear central aperture surrounded by a translucent ring of drug-polymer film. In vitro and in vivo studies (animal) showed an early burst of drug release followed by sustained release for one month. In vivo (in rabbits), single contact lenses were able to achieve, for at least one month, latanoprost concentrations in the aqueous humor that were comparable to those achieved with topical latanoprost solution.

These lenses appeared safe in cell culture and animal studies. This contact lens design can potentially be used as a treatment for glaucoma and as a platform for other ocular drug delivery applications.

Ciolino JB, Stefanescu CF, Ross AE, Salvador-Culla B, Cortez P, Ford EM, Wymbs KA, Sprague SL, Mascoop DR, Rudina SS, Trauger SA, Cade F, Kohane DS. In vivo performance of a drug-eluting contact lens to treat glaucoma for a month. Biomaterials. 2013 Oct 3. [Epub ahead of print]

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Central Vault in Dry Eye Patients Successfully Wearing Scleral Lens

Scleral contact lenses are used to treat symptoms of severe dry eyes. Procedures for fitting scleral lenses have been vague because of lack of standardized guidelines. This retrospective case series sought to establish average vault over central cornea in successful scleral lens wearers with dry eyes.

Anterior segment optical coherence tomography was used to measure the distance between the posterior lens surface and cornea in 20 eyes of 12 consecutive patients successfully fit in the Vanderbilt Scleral Lens Clinic.

Mean vault was 380 ± 110 μm. There was no correlation between vault and corneal curvature or vault and visual acuity.

The authors concluded that with a large SD in average vault, precision in central vault does not seem to be important in scleral contact lenses for successful fit for dry eyes.

Sonsino J, Mathe DS. Central vault in dry eye patients successfully wearing scleral lens. Optom Vis Sci. 2013 Sep;90(9):e248-51. doi: 10.1097/OPX.0000000000000013.
Source: Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee.

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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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