Wow! We received a tremendous response from the readership about issues with growth in the contact lens market. Unfortunately we are not able to print all of them, but we will be printing several of them this and next week. Some great things to think about in the weeks to come.

Menicon Co., Ltd. will introduce "Magic," a daily disposable contact lens packaged in a wafer-thin, hygienic flat-pack, at the company's Magic Store concept shop in Tokyo, Japan on November 7. Nationwide marketing in Japan will begin next spring.

Per the company's news release, Magic's novel flat pack, created with Menicon's proprietary technology, measures 12.5% of the thickness and just 40% of the volume of a conventional CL storage pack. The Magic flat pack sandwiches the contact lenses lightly between two specially designed foil sheets. The compact lens pack offers convenience for storage and carrying and its unique design also is highly hygienic. Besides ensuring easy lens removal, it always exposes the outer surface of the lens first, reducing the likelihood of touching the inner surface of the lens.

The Magic contact lens utilizes HEMA-GMA (2-Hydroxyethyl Methacrylate-Glycerol Methacrylate), a lens material offering superior water retention. The chemistry of GMA attracts water molecules for high wettability and all-day comfort, according to the company. The lens has a base curve of 8.60 mm and a diameter of 14.2 mm. Initially Magic will come in powers ranging from -0.50 to -6.00.

Also this week, Menicon Holdings BV and Eye Shelter SA, a wholly owned subsidiary of Laboratoires Thea, a France-based independent ophthalmic group, announced that Menicon is to become Eye Shelter's exclusive partner to market the SOLO-care contact lens solutions range in member states of the European Economic Area and Canada.

Menicon will take over distribution of the SOLO-care and AQuify brands as soon as all regulatory assignments have been completed between CIBA Vision (former owner of the SOLO-care and AQuify products in territories included in the scope of this partnership) and Eye Shelter, which is expected on March 31, 2012, at the latest.

The ODLean program at The Vision Care Institute, LLC has launched the ODLean Facebook page. The site provides commentary, key learnings and industry trends from ODLean experts on the topics of productivity, marketing, and patient experience. It also features weekly practice management and marketing tips, and serves as a forum for discussion among optometrists, ophthalmologists, and their staff.

The ODLean Consulting program at The Vision Care Institute applies lean principles for eye care practitioners to grow a practice's patient base, increase foot traffic, and manage patient flow for optimal retention, referral and revenue. ODLean offers customized solutions to any-sized eye care practice that will increase efficiency, improve patient experience, and boost profits immediately and sustainably.

For more information, visit www.facebook.com/odlean or www.thevisioncareinstitute.com/odlean.

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.
--ADVERTISING

GP Lens Institute (GPLI) has rescheduled its GP Lens Practice...Today and Tomorrow symposium for December 11, 2011. The event was postponed from October. This in-depth clinical symposium features the latest advancements in the GP lens industry. Ten of the foremost experts and practitioners in the GP field will share important clinical pearls as well as practical applications for your practice to increase your comfort level in fitting spherical and specialty design lenses. Participants may earn up to seven hours of COPE educational credit (Illinois approval pending).

The symposium will still be held at Hamburger University, adjacent to the Hyatt Lodge in Oakbrook, Illinois, a suburb of Chicago. The symposium's unique program structure allows attendees the flexibility to customize their learning experience based on their practice needs. The day will begin with a general session on the topic of "Advancements in GP Lens Applications and Materials." Then each hour, attendees can select any course presented in Track One or Track Two. The symposium will conclude with a special two-hour case grand rounds program, with the management of representative cases pertaining to spherical and specialty GP lens applications.

For more information or to register, visit www.GPLI.info.

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As Professor Gary Pisano from the Harvard Business School, quoted in The Economist October 29th 2011, says, "The answer goes to the heart of what ails drug companies. Large pharmaceutical firms used to be engines of innovation, but a big fall in share prices, the onslaught of generic drugs and bureaucracy from recent mega-mergers has tripped them up. Research productivity and approval rates for mass-market drugs aimed at rich consumers are falling. Big firms have grown risk averse, developing lots of imitations of blockbuster drugs and fewer novel ones. The squeeze will get worse as a dozen top-selling drugs lose patent protection over the next two years." Sound familiar?

In the pharmaceutical industry, increasingly, the big guys are moribund. Risk aversion, back watching, safe incremental advances are the norm. Ideas don't survive the committees, adventure and breakthrough have to come from outside. Sound familiar? And sadly in our industry, when funds are made available internally, it's for cutting cost of goods, manufacturing economies margin chasing. A few exceptions — but very few.

Unless our majors find some 'bottle' and creativity, some people with intellectual flair to tackle the great advances needed in 'comfort and biocompatibility', 'optics vision and myopia control — a game changer that languishes for lack of investment' and 'eliminating inflammation and infection', selling cardboard boxes will not make it. Where are matches for the genius of 'Witcherle and the soft lens'; 'Danalens and disposables', 'Adrian Hunter and SiHy'; breakthroughs that we desperately need repeated.

Thirty million dropouts a year from the industry — in some countries more dropouts than recruits — and yet no serious scientific and research industry effort in this field. Why? Because in-house doesn't attract the scientists needed and out-house is unattractive if you are royalty-averse.

How do we grow the contact lens market you ask? The new paradigm is an entrepreneurial research group alliance with a forward thinking, risk taking visionary individual or company or Government with money and attitude. This is, far more likely to arise in China and India than the U.S., Europe or Australia — and this goes to the heart of many problems for our economies and societies.

As Professor Gary Pissano says, "Nimble biotech firms, however, have a good record of innovation. But the bursting of the biotech bubble has left them starved of cash." However, "The good news is that new business models and cash are coming. Three former executives from SmithKline Beecham, Novartis and Aventis have founded Care Capital, a $175m investment fund that favors novel drugs over 'me too' bets" and "Charities and government agencies are getting cleverer too."

That is why we have opened in the last month major new Institutes and Alliances in both China (Brien Holden Vision Institute — China, in a new purpose built research, education and public health facility) and India (the India Vision Institute — a partnership between BHVI and LVPEI to raise hundreds of millions to kick-start the Indian Vision Industry).

We believe that tapping into the genius among these 2.5 billion people with knowledge partnerships will feed the future breakthroughs both for the billion people in these mega-countries that need vision correction and from there, with the right alliances, the rest of the world.

Professor Brien Holden, PhD, DSc, OAM, FAAO.
CEO, Brien Holden Vision Institute

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Ask Yourself: Why Not Daily Disposables?

Lately the world seems a-buzz about daily disposables. With impending future launches of new daily disposables with new technologies, and recent American Academy of Optometry and American Academy of Ophthalmology meetings discussing dry eye in contact lens wearers, daily disposable lenses are indeed a viable option to ease discomfort, placing them center stage. This concept became "clear" to me on a recent overnight international flight. As I reached for the laminated pamphlet describing how my chair worked, I noticed a light blue "deposit" on my instructions. It was a shriveled contact lens. Good reminder, I thought. Time to remove my contact lenses—but I will at minimum, for politeness, wrap them in a napkin as I dispose my daily lenses.

Contact Lens Spectrum and Contact Lenses Today research data regarding the market penetration of daily disposable lenses demonstrates that North America lags behind many other markets in terms of daily disposable usage. Some practitioners and patients regard disposing of contact lenses on a daily basis as wasteful and expensive—yet consider, if it is leads to improved safety or comfort, perhaps it should be considered more often. In terms their use in patients with CL related dry eye (CLDE), refitting to daily disposable lenses is moderately high on the list of options considered by practitioners, but not the leading option. (CL Today Quick Poll results 10/9/2011). Many are aware that industry has yet to fund a large clinical trial to address the impact of modern daily disposables in CLDE, so it seems the opportune time to take this vital next step in confirming our beliefs about this important modality.

Menicon Introduces New GP Care System and Sales Model

Menicon has recently introduced its new "Deluxe Care System" for GP lenses. It includes:

• Menicon Unique pH (formerly Alcon Unique pH): daily multipurpose solution for cleaning, conditioning, and disinfecting; uses Polyquad (polyquaternium-1) (0.0011%), and edetate disodium (0.01%) as its active ingredients/preservatives. Menicon recommends daily digital rubbing and rinsing.
• Menicon PROGENT: biweekly intensive cleaner, used without digital rub, to remove protein deposition and provide disinfection. Previously available in the United States for in-office use only, it is now FDA-cleared for patients to use at home.
• Menicon Rewetting Drops: for use before and during lens wear; rebranded and available in a 10 ml bottle.
• Lens case

Menicon Solutions are not available through traditional drug, food or mass merchandisers. The novel e-commerce system, WebStore, allows patients to register online and receive their solutions through the mail. Menicon states that this model provides convenience for patients and revenue for practices, while giving practitioners the ability to monitor patient compliance. Practitioners also have the option to stock and sell the care system themselves.

It is well documented that contact lens wearers have much higher incidences of corneal infections as compared to non-contact lens wearers, though the exact cause(s) of this increased susceptibility has not been identified. A distinct subset of mucins (MUCs) is present on the ocular surface and act to protect the integrity of the corneal epithelium. This study was performed to determine if multi-purpose contact lens solutions (MPCLSs) can cause increased infections in the cornea by destroying the protective cell-bound mucin layer.

An immortalized human corneal limbal epithelial cell line (HCLE) was treated in the presence of four commonly used MPCLSs or PBS and the expression and release of MUC-16 was assessed. Cells were also cultured with P. aerugenosa following MPCLS treatment and internalization of bacteria was assessed by quantitative genomic PCR. Loss of MUC-16 was then correlated with infection rates.

Each of the four commonly used MPCLSs examined in this study differentially affected mucin release. The relative affect was correlated with an increase in infection of corneal epithelial cells by P. aerugenosa.

The researchers concluded that the results of this study are consistent with the hypothesis that (MPCLSs) cause increased infections in the cornea by destroying the protective cell-bound mucin layer.

Gordon GM, Moradshahi N, Jeong S, Lane C, Fini ME. A Novel Mechanism of Increased Infections in Contact Lens Wearers. Invest Ophthalmol Vis Sci. 2011 Oct 28. [Epub ahead of print]

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