Essilor Contact Lens Specialists (Essilor CLS) announces the arrival of Expert Progressive Multifocal GP contact lenses now available within the United States. According to the company, the Expert contact lens is a vision advancement for contact lens patients with presbyopia; a progressive lens that is uniquely designed, allowing no compromise of near or distance vision while providing crisp, clear intermediate vision.

Per the company announcement, with a patented Slab Off Technology, this new lens is designed with a 360° uniform edge thickness making it the most comfortable translating gas permeable lens available. It is exclusively made with Bausch + Lomb Boston materials and is only available through Essilor CLS.

The lens is available with a base curve of 7.20mm to 8.60mm in 0.05mm steps and an overall diameter of 8.50mm to 10.00mm in 0.50mm steps in powers ranging from 15.00D to +10.00D in 0.25D steps with add powers of +1.00D to +3.50D in 0.25D steps.

Eyecare professionals are invited to a special celebration to launch this new lens design during the upcoming Global Specialty Lens Symposium at booth #303, January 23-26, 2014. Please visit www.gslsymposium.com for further information on attending this comprehensive international eyecare meeting.

X-Cel Contacts introduces the Flexlens ARC (Atypical Refractive Correction) custom soft lens as the latest addition to their toolbox of irregular cornea designs. This lens will be manufactured at X-Cel’s state-of-the-art manufacturing facility in Duluth, Georgia, allowing for quick turnaround time, superior quality and consistent reproducibility.

The Flexlens ARC is a custom soft lens design that fits like a regular toric contact lens. With no need to worry about peripheral curves or any other parameter that may complicate the fit, the Flexlens ARC is easy to fit, thus reducing chair time, according to the company. This lens utilizes a standard back surface fitting curve, precise axis, cylinder, and an enhanced center thickness to stabilize the correction over an aberrated cornea.

The Flexlens ARC is indicated for the correction of various ocular conditions including keratoconus, pellucid marginal degeneration, corneal transplants, post refractive surgery and/or any irregular cornea conditions. For additional information, contact an X-Cel Consultant at 1-800-241-9312 or xcelinfo@walman.com

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Excellent Candidates

I was recently emailed a question regarding boosting contact lens patient numbers. Although this sounds like a practice management tip, I think that now more than ever this is a material and designs topic. As we start the new year, I would challenge you to grow your contact lens practice by informing nearly every patient that "You are an excellent candidate for contact lenses." For the unsuspecting patient who has not thought of contact lenses as an option, this will yield a surprise: "I am?" Many times they elect to not make a switch to contact lenses, but surprisingly it opens up dialogue for us to tell our patients about the latest design and material innovations.

Patients who drop out of lenses often times do so because the lenses that they were wearing did not work, not because they do not want to wear them. With the innovations in materials, orthokeratology, scleral designs, the single use modality, and toric and multifocal designs we have a tool box that is full with pleasant surprises. The definition of a specialty patient is someone who either REALLY needs contact lenses (keratoconus, etc.) or someone who is a challenge (dry eye, astigmatic presbyope, etc.). With our stellar industry partners bringing new innovations, these specialty patients are more than ever “excellent candidates.”

Keratoplasty for Keratoconus – “Should we go all the way?”

Researchers in Australia retrospectively reviewed outcomes of 73 consecutive patients with keratoconus, managed with Deep Anterior Lamellar Keratoplasty (DALK) or Penetrating Keratoplasty (PK), between 2000 and 2010, by a single surgeon.¹ Data were collected on baseline parameters, best-corrected visual acuity (BCVA) in logarithm of the mean angle of resolution (logMAR), subjective refraction, graft survival, and complications.

Thirty-one (42.5%) eyes underwent a DALK, and 42 (57.5%) eyes underwent a PK. All PK-operated and 29 out of 31 (93.5%) DALK-operated eyes remained clear at the last review. Postoperative complications were significantly more frequent after PK (57.1%) than after DALK (26.5%; P = 0.0197). The mean BCVA was not significantly different for DALK (0.14 logMAR, SD 0.2) versus PK (0.05 logMAR, SD 0.11). Subjective refraction and method of visual correction (spectacles or contact lenses) were similar for each group.

The researchers’ conclusions were that DALK-operated patients in this study showed similar graft survival, fewer postoperative complications, and equivalent refractive outcomes. No significant difference in the mean BCVA was noted between DALK and PK cases.

These results are in agreement with numerous other recent studies^2,3 suggesting that DALK may be a preferred first surgical choice over PK for patients requiring keratoplasty for keratoconus. Although DALK is preferred over PK due to lower complication rates, it is still an invasive procedure and other less invasive treatments for keratoconus such as contact lenses, cross linking and intracorneal ring segments should be used unless contraindicated or ineffective.

1. Macintyre R, Chow SP, Chan E, Poon A. Long-term Outcomes of Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty in Australian Keratoconus Patients. Cornea. 2014 Jan; 33(1) 6-9.
2. Kim MD, Chung TY, Chung ES. A retrospective contralateral study comparing deep anterior lamellar keratoplasty with penetrating keratoplasty. Cornea. 2013 April; 32(4) 385-9.
3. Amayem AF, Hamdi IM, Hamdi MM. Refractive and visual outcomes of penetrating keratoplasty versus deep anterior lamellar keratoplasty with hydrodissection for treatment of keratoconus. Cornea. 2013 Apr;32(4):e2-5.