CONTACT LENSES TODAY

November 16, 2003

Contact Lenses TodayŽ is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLTodayŽ reaches nearly 10,000 readers in 74 countries.

Time to Think About CLES Registration
According to Contact Lens and Eyecare Symposium (CLES) organizers, attendee registration for this year's meeting is already running well ahead of last year's pace. This year's CLES meeting (the 2nd annual) will take place January 21 - 25 in Orlando. Register by December 31, and you'll save 20% off of the registration fee. Prospective attendees can receive a free CLES Education Brochure or register by calling (866) 515-CLES or e-mailing CLES@cles.info. You'll also find a listing and descriptions of all courses at http://www.cles.info.

FDA Accepts B&L NDA for Combination Therapeutic
The FDA has accepted for review Bausch & Lomb's and Pharmos Corporation's new drug application (NDA) for loteprednol etabonate and tobramycin ophthalmic suspension (0.5% and 0.3%). Once approved, the anti-inflammatory/antibiotic combination product will treat patients who have steroid-responsive inflammatory ocular conditions and who have or are at risk of developing superficial bacterial ocular infections. According to Bausch & Lomb, pending FDA review, it expects to introduce the new medication in 2004.

The Importance of a Care Solution Recommendation! Contact lens patients get the best care you provide, so why not update them to the most advanced lens solution, Opti-Free Express MPDS? A solution recommendation is vital to retain your patients as happy, satisfied lens wearers. Without it, patients may think that all solutions are the same and may be more apt to purchase a generic brand. Generic brands may be older-generation products and may contain PHMB preservatives.
Keep your patients in comfortable lens wear every day by recommending Opti-Free Express MPDS Lasting Comfort No Rub formula! http://www.norub.com
--ADVERTISING

CIBA Gains New Solution Clearance
Based on results from a large-scale clinical study of Clear Care versus ReNu Multiplus, Opti-Free Express and Complete Comfort Plus, the FDA has given CIBA Vision clearance to add two comfort claims to its packaging of Clear Care. The company also reports that in a recent consumer study, 64% of the subjects said that Clear Care is easier to use than their current multipurpose solution.

Europe Approves Intacs for Keratoconus
Addition Technology, Inc. has received European regulatory approval (CE Mark) for the use of Intacs prescription inserts for surgical vision correction to treat keratoconus. Data from the European study show that 74% of keratoconus patients achieve best corrected visual acuity of 20/40 or better after Intacs insertion. Intacs are approved for distribution in the United States, Europe, Asia, Canada, Mexico and Latin America.

Retaane to Enter Safety and Efficacy Trials
Alcon plans to initiate two new phase III studies of anecortave acetate for depot suspension (Retaane) to treat AMD. The trials will evaluate the safety and efficacy of treatment every six months with Retaane versus placebo in a group of patients who have advanced dry AMD and are at risk of progressing to wet AMD. Enrollment will begin in January 2004, after which a four-year study will follow, involving approximately 2,500 patients at 100 sites worldwide. According to Alcon, the FDA has given "Fast Track" designation to the development of Retaane for the treatment of AMD.

Abstract: Managing Stevens-Johnson Syndrome with CLs
Researchers in Israel recently shared their case report of a 69-year-old man who had Stevens-Johnson syndrome in the October issue of Optometry . The syndrome developed in the man as a result of a hypersensitivity reaction to allopurinol. The researchers fit him with GP sealed scleral contact lenses of high oxygen permeability, which produced a remarkable improvement of his signs and symptoms and allowed him to completely stop his frequent use of artificial tears. According to the researchers, their report shows that you can successfully manage Stevens-Johnson syndrome with GP sealed scleral lenses of high permeability.
Fine, P; Savrinski, B; Millodot, M. Contact Lens Management of a Case of Stevens-Johnson Syndrome: A Case Report. Optometry 2003 74(10): 659-664.

Letters to the Editor: Response to Dr. Noel Brennan
I'm writing in response to Dr. Noel Brennan's recent letter (Readers Write Back, "How Much Oxygen?" Oct. 26) regarding Night & Day silicone hydrogel lenses and oxygen transmissibility. As Dr. Brennan knows and is indeed trying to emphasize, the response to lenses is more complex than just the oxygen flow at the center of a -3.00D lens or than that which can be expressed in any advertisement. Even Night & Day, with the highest Dk/t of any soft lens currently on the market, will not have sufficient oxygen for all corneas and all refractive errors under all conditions. But the fact that it has the highest Dk/t allows the oxygen to flow more readily as required by the varied physiological demands of individual corneas, or as influenced by the periphery of minus lenses or the center of plus lenses where extra thickness is inherent in the lens designs. Numerous studies have been published showing improved corneal physiological response to higher oxygen transmissibility including such simple measures as edema as well as other indicators. Yes, we must be aware of the simplifications that are inherent in any advertisement of any technical product. But we must also be aware of oversimplifying and confusing the decisions we need to make as practitioners. The bottom line is that higher oxygen permeability means less resistance to the flow of oxygen through the material, which means a higher probability of meeting the oxygen demands of more wearers under more conditions.
--John McNally, OD, head of Continuous Wear, R&D, CIBA Vision

Editor's Commentary: Long-Term Contact Lens Wear
The long-term soft contact lens wearer I saw this past week (22 years of wear) had about 1mm of limbal neovascularization. He was happy with his lenses and not interested in changing to higher Dk/t lenses, so the normal procedure is to discuss wearing time and reduce it by one half hour at each end of the daily wearing period. You should ask these patients how often they sleep in their lenses so you can deal with overnight wear as you see fit. I often wonder what concerns my colleagues more: droopy eyelids on successful long-term GP lens wearers with healthy corneas or neovascularization from soft lenses.

Fitting Tip: Lens Insertion -- Keeping it Clean
If a new or established soft contact lens wearers is having problems with lint getting on the contact lens or if she's having problems with the lens "sticking to her finger" upon insertion, then have her follow this tip:
After removing the contact lens from the case, set it on the backside of your hand. Next dry your finger on the backside of your hand to remove extra water from the finger that holds the lens. This will also eliminate towel lint. Now hold the newly dried finger (fingerprint side down) next to the contact lens. Slide and roll your finger (fingerprint side up) underneath the contact lens. Now the lens will center on your finger, ready for insertion.
--Michelle Till, OD
Omaha, Nebr.

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