CONTACT LENSES TODAY

December 19, 2004

Contact Lenses Today® is edited by Dr. Joseph T. Barr and the staff of Contact Lens Spectrum. This week CLToday® reaches more than 10,000 readers in 74 countries.


1-800 and ClearLab Grant CL Rights to Menicon
1-800 Contacts, Inc. and its international manufacturing business, ClearLab, have signed an agreement that grants Menicon Co., Ltd. exclusive rights to develop, manufacture and market certain disposable contact lenses and related intellectual property (including contact lens material, manufacturing technology and related knowledge) in Japan.

CLAMP Study Shows That GPs Slightly Effect Myopia Progression
In comparing the effects of GP contact lenses and soft contact lenses on myopia progression in children (aged eight to 11 years), researchers randomly assigned 116 subjects (who had 20/20 visual acuity or better OU) to wear GPs or soft contact lenses during a three-year study. Subjects underwent cycloplegic autorefraction, keratometry and A-scan ultrasonographic axial length measurements at each annual visit and researchers conducted all analyses according to the original randomization assignment. The mean ± SD spherical equivalent cycloplegic refractive error progressed -1.56 ± 0.95D for GP wearers and -2.19 ± 0.89D for the soft lens wearers during the study (analysis of covariance [ANCOVA], P<.001). The axial growth of the eyes wasn't significantly different between treatment groups (ANCOVA, P = .57). The step corneal meridian of the GP wearers steepened 0.62 ± 0.06D, and that of the soft lens wearers steepened 0.88 ± 0.57 during the three years (ANCOVA, P = .01). In the December issue of Archives of Ophthalmology, the researchers concluded that although the GP wearers' myopia progressed less than that of the soft lens wearers, the results of the study don't indicate that GPs should be prescribed primarily for myopia control.

ACHIEVE Study Underway
The three-year Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study is now underway and will examine the effect of eyeglasses and contact lenses on the self-perception of myopic children ages eight to 11 years. The study, which the Vision Care Institute of Johnson & Johnson Vision Care Inc. is sponsoring, will also examine how each vision correction choice influences children's academic and athletic competence, social acceptance, behavior and overall self-perception. The study is based at The Ohio State University College of Optometry with other schools and colleges of optometry participating as clinical sites.

Set-up Your Patients for CL Success: Teach them the proper care system for their Silicone Hydrogels
Because of the hydrophobic nature of silicone, silicone hydrogels are more prone to lipid deposits than traditional hydrogel contact lenses. However, issues with lipid deposits can easily be resolved with a reasonable care and handling procedure. Advise your patients to wash their hands before handling the lenses and institute a rub step even if the solution says that it's a "no-rub" solution. Clinical research has shown that lipid deposits affect less than 10% of patients who wear ACUVUE ADVANCE Brand Contact Lenses with HYDRACLEAR and, even among those patients, changes in vision and comfort are rarely experienced.
Offer your patients the opportunity to experience all day comfort with ACUVUE ADVANCE Brand Contact Lenses with HYDRACLEAR and set them up for success by ensuring a proper handling and care system.
http://www.ecp.acuvue.com

--ADVERTISING

New GP Lenses Available From ABB Optical
ABB Optical is introducing a new generation of GP contact lenses, which consists of Versare, Everyday, E-cone and E-Corneal, made with Boston XO Super Dk material. The lenses feature a proprietary technology, Controlled Zone Technology. Call the company's Exclusive Customer Service at (800) 225-1812 to take advantage of a limited time special introductory offer including a FREE programmed Palm Zire for simplified fitting.

FDA Gives Green Light to B&L Products
The FDA has accepted for review Bausch & Lomb's New Drug Application for its patented Retisert intravitreal implant for noninfectious posterior uveitis. The Application has FDA Fast Track status, designed to allow for quicker, priority review of novel therapies for serious diseases for which an unmet medical need exists. The implant also has received FDA Orphan Drug designation for this indication. B&L expects to receive FDA notification of the application status by spring 2005 and is targeting commercialization of Retisert in 2005.
In other company news, the FDA has approved the New Drug Application for its combination product, Zylet (loteprednol etabonate 0.5% and tobramycin 0.3% ophthalmic suspension), which is indicated for the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of infection exists.

Save on CLES 2005
Any eyecare professional planning on attending the Contact Lens and Eyecare Symposium (CLES) 2005 (January 19 to 22, 2005 in San Diego) can save up to 25% by pre-registering before December 31 by calling (866) 515-2537 or by visiting http://www.cles.info

Abstract: Bacterial Contamination in CLs and in Human Corneal Epithelial Cells
Researchers in Australia investigated non-steroidal anti-inflammatory drugs (NSAIDs), salicylic acid, sodium diclofenac and ketorolac for inhibition of bacterial colonization of contact lenses and human corneal epithelial cells (HCE). They exposed contact lenses pre-colonized with Pseudomonas aeruginosa, Haemophilus influenzae, Staphylococcus epidermidis and Streptococcus pneumoniae to NSAIDs overnight and then calculated the number of viable bacteria on the contact lenses. They also evaluated cytotoxicity of NSAIDs to HCE cells with the MTT essay and used the viable counts to measure the adhesion of P. aeruginosa and S. epidermidis to HCE cells in the presence of the least cytotoxic NSAID. After reviewing their results, the researchers concluded that salicylic acid demonstrated potential as a compound for incorporation into anti-bacterial strategies to prevent bacterial contamination of contact lenses.
Bandara BM, Sankaridurg PR, Willcox MD. Non-steroidal Anti-Inflammatory Agents Decrease Bacterial Colonization of Contact Lenses and Prevent Adhesion to Human Corneal Epithelial Cells. Current Eye Research 2004 Oct-Nov;29(4-5):245-251.


Editor's Commentary: CLAMP Study is Conclusive
Jeff Walline and Karla Zadnik, of The Ohio State University College of Optometry, have established that GP lenses do not alter the axial length change of the eye in children (Archives of Ophthalmology, December). This is a landmark study, which allows us to tell our young patient's parents that they benefit somewhat from GP lenses for less myopia progression, they will still progress. This well-done study shouldn't lead us to conclude that GP lenses are the answer for myopia control, nor are they to be rejected. There are many positive reasons to prescribe them. There are also many positive reasons to prescribe our other numerous options for children. I encourage you to read this paper in detail so you can make informed recommendations to your patients and their parents.

Fitting Tip: Recommending the "New Stuff"
Also in regard to Dr. Anderson's tip ("Fitting Tip," CLToday November 28), I think we have to consider four things:
1. Oxygen without compliance is better than almost no oxygen without compliance.
2. As far as GPC is concerned, I maybe see one or two a year, compared to just four or five years ago. I attribute that to more and more disposable and less and less of "I want the one that lasts one year."
3. We should be concerned about causing myopia creep. Most of us have seen this for years and have believed that in some part, it's caused by lack of oxygen. We owe it to our patients to try and prevent increases in myopia -- unless we happen to be greedy and are only interested in making money.
4. For the most part, we hate planned obsolescence. We complain about our computers getting outdated, or our XYZ product falling apart after so many uses or so many months. From an eye health issue, these new lenses are coated to keep them wetter and to lubricate better, but these coatings come off in three to four weeks and the lenses go from great to "I feel the lenses after two to three weeks." In this case, planned obsolescence is in our favor and is certainly in the patients' best interests. We need to do the right thing and recommend the "new stuff."
--Robert D. Bard, O.D., F.A.A.O.
Whitesboro, Texas

This month at http://www.siliconehydrogels.org, read about the hyperopic shift that occurs with silicone hydrogel lenses, GP-silicone hydrogel piggyback systems and a study testing the presumption that wearing inverted contact lenses decreases comfort and vision.
Report adverse contact lens reactions here: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.

Access a reporting form for complications you've seen that were a result of contact lenses dispensed without a valid prescription at the Association of Regulatory Boards of Optometry's (ARBO's) Web site: http://www.arbo.org/arbo.asp?dt=R&doc=Complications. Complete and send the form online or print it out and fax it to (866) 886-6164.

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