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Sunday, November 18, 2012  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

Each January, we publish our Annual Report in Contact Lens Spectrum (http://www.clspectrum.com/articleviewer.aspx?articleid=106550) that summarizes the contact lens market as best we can for the prior year. Similarly, we also publish a "Contact Lens Event" of the prior year—something that we think stands out in the field of contact lenses and should be noted as such. It's traditional for us to solicit for nomination for this event from our readership. If you have any such nomination—something you think is substantial in the contact lens field and occurred in 2012—please let us know by emailing me directly at jnichols@optometry.uh.edu.

In Memoriam: Hikaru Hamano, MD

Hikaru Hamano, MD passed away on October 26, 2012. He was eighty-eight years old.

A legend in his home country of Japan, he founded the largest contact lens practice in the country, but Dr. Hamano's contributions to contact lens research were global in impact and scope. He co-authored the book Corneal Physiology and Disposable Contact Lenses, which supports the use of daily disposable contact lenses, and authored numerous other research publications which contributed to the development of contact lenses as we know them today.

Beginning in the early 1970s, Dr. Hamano focused research on the importance of oxygen to the cornea and on how contact lens wear affects the corneal epithelium, corneal nerves and tear composition.1 He was among the first in the world to demonstrate the partial oxygen pressure on the cornea under PMMA lenses.1 The size of his practice enabled him conduct large scale clinical studies to validate basic findings on the importance of oxygen transmission to the cornea and examine the properties of new lenses. A study he performed in 19942 comparing complication rates of various contact lens modalities in 23,000 patients, helped to establish the improved benefits of the daily disposable modality.1

1. Schaeffer J, Beiting J. Key Developments in Contact Lens Materials and Design, 1975-2000. Contact Lens Pioneers, a supplement to Review of Optometry, September 2007
2. Hamano H, Watanabe K, Hamano T, et al. A study of the complications induced by conventional and disposable contact lenses. CLAO J 1994;20(2):103-8.

New Email Address for Contact Lenses Today

The email address for contacting us at Contact Lenses Today has changed. Whether you are submitting news, fitting tips or commentary, please contact us at cltoday@pentavisionmedia.com. Company representatives and readers, please update your address book and keep us posted.

CooperVision Renews Its Support of U.S. Military Personnel
CooperVision, Inc. plans to launch a new website in partnership with the Armed Forces Optometric Society (AFOS), reinforcing the global contact lens manufacturer's commitment to serving the U.S. military community. With this new website, military personnel and their families can learn more about CooperVision's extensive product portfolio, purchase CooperVision's contact lenses affordably, and be assured guaranteed delivery wherever they are located around the world.

In addition, CooperVision plans to offer patients the option to support the Wounded Warrior Project (WWP) by donating $1 per carton for each purchase of CooperVision contact lenses. The Wounded Warrior Project takes a holistic approach when serving the military community and their families to nurture the mind and body, and encourage economic empowerment and engagement.
AFOS was created in 1970 to advance the science of eye care throughout the world. Today the society has more than 1,200 military and federal doctors of optometry across the country and internationally. AFOS has the largest group of Vision Scientists worldwide, and strives to elevate the standards of eye care for the benefit of men, women and children everywhere.

For more information please visit www.afos2020.org.
Plan Now to Attend GSLS 2013 in January

Plan now to attend the Global Specialty Lens Symposium January 24-27, 2013, at the Rio All Suites Hotel and Casino, Las Vegas, Nevada. With an expert international faculty and a CE-accredited agenda, the 2013 GSLS will include a fundamentals pre-conference, insightful presentations by experts in the field, hands-on demonstrations of cutting-edge products, as well as scientific papers and posters and networking opportunities with your colleagues from over 30 different countries.

Look for more detailed information in future issues of Contact Lens Spectrum and online at www.GSLSymposium.com.

ABB CONCISE Offers Free Training on Custom Specialty Lenses

With Bausch + Lomb's KeraSoft IC silicone hydrogel contact lenses and Paragon Vision Sciences' ICD (irregular corneal design) 16.5mm scleral lens now available through ABB CONCISE, the company is supporting its customers by providing the opportunities to participate in active learning on the fitting of these lenses.

Accounts can complete the necessary training to become a certified KeraSoft IC professional by going to abbconcise.com and clicking on the KeraSoft IC banner advertisement. That will lead to a page with information about the lens and the link to the certification tutorial. Upon completion of the online training, accounts can contact ABB CONCISE's Contact Lens Consultation for trial set information and to place KeraSoft IC orders.

Due the interest in the ICD 16.5 scleral lens, ABB CONCISE, with the support of Paragon Vision Sciences, will be offering a second exclusive one and a half hour training webinar on Wednesday, November 21st, at 6:00pm PST (9:00pm EST) with Patrick Caroline, FAAO of Pacific University, called Contemporary Scleral Lens Design and Fitting.

ABB CONCISE accounts can register for the webinar online at www2.gotomeeting.com/register/591257546. To obtain further information about the webinar, accounts can email gpcustomsoftlenssupport@abbconcise.com with their account information. Accounts interested in learning more about the lens or placing orders can contact ABB CONCISE's Contact Lens Consultation at 800-772-3911 CA or 800-225-1812 MA, choose option 4.

Post-Graft GP Fit
By Marco Tovaglia, Vittuone, Italy

A post-graft is a great challenge for a contact lens practitioner. This patient was managed with a back surface toric GP contact lens with a special reverse progression in the peripheral area. The result is excellent vision quality and contact lens-cornea relationship.

We thank Marco Tovaglia for his photo 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.

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Ronald K. Watanabe, OD, FAAO

New Sclerals

I ran across a couple of new products at this year's Academy Meeting: Paragon NormalEyes 15.5 and X-Cel Atlantis scleral lenses. The NormalEyes 15.5 lens has the Proximity Control and Dual Axis features found in their CRT design. Proximity Control consists of a sigmoid return zone and an aspheric landing zone that work together to create a tangent landing on the conjunctiva with predictable conjunctival compression. The Dual Axis feature helps control lens flexure and centration for those toric scleras. The parameters are laser marked to make lens identification easier.

The Atlantis lens has three zones with proprietary radii of curvature that can be independently controlled. The Central Zone is designed to clear the cornea, but may have the least impact on the lens fit. The Limbal Zone is designed to vault the limbus and is available in 5 radii that alter the overall sagittal depth in 25 micron steps. The Scleral Zone aligns with the sclera and comes in 4 radii that alter the sag in 50 micron steps. Atlantis is available in 15.0, 16.0 and 16.5 mm diameters.

No one scleral design can fit every patient, so it is great to see new unique designs being developed.

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

Contact Lenses for Color Deficiency

A few weeks ago I wrote about one little known therapeutic application of tinted contact lenses for photosensitive epilepsy patients, which spurred some questions: what about tinted contact lenses for color deficiency?

The concept of assisting color perception in color deficient individuals with tinted contact lenses is not new, as it was first proposed in 1837. One of the historically most widely used lenses was the X-Chrom lens, a red-tinted (historically rigid) contact lens, typically worn in the non-dominant eye.1 Dating back to 1974, studies have shown that in systems where a red or magenta lens is fit on the non-dominant eye, performance on pseudoisochromatic plate testing can almost instantly be improved.2

More recent literature on this topic comes from Swarbrick and colleagues3 who studied the ChromaGen system in 14 color deficient patients in which all were fit with either a pink or magenta tint in the non-dominant eye (plus often a different colored lens in the dominant eye). They found that the tinted lenses significantly reduced Ishihara error rates and subjectively, patients reported enhanced color perception. They concluded that such tinted lenses can indeed enhance subjective color experience and assist in certain color-related tasks. However, they caution that color vision is not normalized with use of tinted lenses and this form of correction is not indicated as a treatment for color deficiency in occupations with color vision-related restrictions.

More about this in the December issue of Contact Lens Spectrum.

1. Zeltzer, H. The X-Chrom lens. J. Am. Optom. Assoc. 1971; 42, 933±939.
2. La Bissoniere, PE. The X-Chrom lens. Int. Contact Lens Clin. 1974; 1 (4), 48±55.
3. Swarbrick HA, Nguyen P, Nguyen T, Pham p. The ChromaGen contact lens system: colour vision test results and subjective responses. Ophthalmic Physiol Opt. 2001 May;21(3):182-96.

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Effect of CL Materials on Disinfection Activity of Polyquaternium-1 and Myristamidopropyl Dimethylamine MPS Against Staphylococcus Aureus

This study examined the interaction of seven different lens materials with a multipurpose solution (MPS) containing the disinfectants polyquaternium-1 (0.001%) and myristamidopropyl dimethylamine (0.0005%). The objective of this study was to determine whether the different lens materials affect the concentration of a disinfectant in this commercially available MPS and the efficacy of the disinfectant against Staphylococcus aureus.

Silicone hydrogel lenses (galyfilcon A, senofilcon A, comfilcon A, enfilcon A, balafilcon A, and lotrafilcon B) and a conventional hydrogel lens (etafilcon A) were soaked in polypropylene lens cases filled with commercially available MPS containing 0.001% polyquaternium-1 and 0.0005% myristamidopropyl dimethylamine for 6, 12, 24, 72, and 168 hours. Empty lens cases were also filled with MPS. After each time point, solutions from cases containing the seven types of lenses and controls were assayed for activity against S. aureus according to International Standards Organization 14729 standard with modifications. Test solutions were analyzed for polyquaternium-1 and myristamidopropyl dimethylamine concentration at each time point.

The concentration of polyquaternium-1 and myristamidopropyl dimethylamine remaining in the lens cases was reduced only slightly over time. Storage with the lenses did not adversely affect biocidal efficacy of the solution, and in some cases, it was significantly better (P=0.0029).

The efficacy of this polyquaternium-1 and myristamidopropyl dimethylamine MPS to kill S. aureus was not adversely affected by the presence of lens materials soaking in the cases. Thus, current methods for performing solution antimicrobial testing should be reevaluated.

Shoff ME, Lucas AD, Phillips KS, Brown JN, Hitchins VM, Eydelman MB. The Effect of Contact Lens Materials on Disinfection Activity of Polyquaternium-1 and Myristamidopropyl Dimethylamine Multipurpose Solution Against Staphylococcus aureus. Eye Contact Lens. 2012 Nov;38(6):374-8.
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