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Sunday, September 4, 2011  
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Editor's Commentary - Jason J. Nichols, OD, MPH, PhD, FAAO

These last few months have led to substantial personal and professional changes in my life and that of my wife and close collaborator, Kelly K. Nichols, OD, MPH, PhD. I'd like to make you aware of these new ventures as they will be associated with tremendous growth opportunities.

Kelly and I have recently transitioned from The Ohio State University College of Optometry to the University of Houston College of Optometry (UHCO). With Dean Earl Smith's leadership at UHCO, we have embarked on the process of creating an Ocular Surface Translational Research Center. Our desire is that this will become the leading center for ocular surface research and clinical care, with contact lenses making up a big part of this venture. We look forward to working with our old friends and new colleagues at UHCO to help grow the journal so that we continue to provide cutting edge, clinical materials in the years to come. The Ohio State University served the editors of Contact Lens Spectrum well since the publication's inception in 1986 and our Buckeye friends and colleagues will always hold a dear place in our hearts. However, big things are happening at UHCO. As always, please feel free to drop me a note at jnichols@optometry.uh.edu.

Menicon Announces New Management Team for its International Business

Menicon Company Ltd. announced a major reorganization of its international operations and a creation of a new global management team. All Menicon Group companies outside Japan will be unified under one entity, Menicon Holdings B.V. in Emmen, the Netherlands. Menicon Holdings will serve as Menicon's international headquarters and oversee all commercial operations outside Japan.

Menicon Holdings will build new headquarters and a manufacturing plant in Emmen. The plant, slated to open in early 2013, will initially produce custom contact lenses for the European market, and house Menicon's European R&D center.

Toshio Matsushima serves concurrently as President of Menicon Holdings and Executive Officer, Global Strategies and Operations, in the parent company. The company announced the following appointments within Menicon Holdings: Jonathan Jacobson is Chief Executive Officer (CEO) reporting to Mr. Matsushima; Pierre Monteil is Chief Operating Officer reporting to the CEO; Manuel Martin Tamargo is Chief Financial Officer; Anatole Diep is Chief Manufacturing Officer; Rainer Hassenstab is QA/RA Director. The new Menicon Holdings will have an R&D Team to work with the company's global chief technology officer, Mr. Steve Newman, based in Singapore, to focus on bringing newly developed innovative products and services to the global markets.

Facebook "Likes" of AllAboutVision.com Provide Eye Exams and Glasses

With the click of a button, eyecare professionals can provide an eye exam and a pair of glasses to someone in a developing country. Each new "Like" of AllAboutVision.com's Facebook page will generate a $5 donation to Optometry Giving Sight, now through the end of November.

Just $5 can provide an eye exam and glasses to one person through Optometry Giving Sight funded programs, according to Clive Miller, CEO for Optometry Giving Sight.

Eyecare professionals who "Like" the company's Facebook page will also be the first to hear about eyecare news and new articles on AllAboutVision.com. To "Like" AllAboutVision.com on Facebook, go to www.facebook.com/allaboutvision. For information about the site and practice-building services, visit www.allaboutvision.com/ecp/.

Soflex Eni-Eye Contact Lenses Cleared for Sale in the US

Soflex has been granted FDA marketing approval for the following lenses manufactured in the Definitive silicone hydrogel material from Contamac: Eni-Eye SH Toric contact lens for daily wear; Eni-Eye Q SH Multi and Eni-Eye Q SH Multi Toric, multifocal contact lenses for daily wear; and Eni-Eye SH Soft K and Eni-Eye SH Soft K Toric, daily wear lenses for keratoconus and irregular corneas,

Soflex Contact Lenses is a contact lens manufacturer based in Israel with over 30 years CL manufacturing experience. The Eni-Eye lenses, which have been available in Europe for several years, will be sold through distributors within the US. To learn more about the products, visit www.soflexcontacts.com. Please fill out the Contact Form if you are interested in more information and the company will contact you.

Acculens Licenses Mediphacos

Acculens announced that an agreement has been reached for the licensing of their Maxim and Comfort SL branded scleral lens designs to Brazilian company Mediphacos. The agreement will open the Brazilian market to the Acculens scleral designs during the fourth quarter of 2011 and is optioned to expand into all of South America, Central America and Mexico.

Comfort SL is an alternative to soft lenses for the correction of non-distorted ametropic eyes, which requires only a patient Rx and K readings for the lens to be designed. The MAXIM Scleral lens is indicated for the management of corneal distortion and dry eyes. Both designs are available in custom parameters manufactured in Boston XO2. Twenty lens Maxim trial lens sets are available free of charge. For more information visit www.acculens.com.

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Lattice Corneal Dystrophy
By Gregory W. DeNaeyer, OD

This is a photograph of Lattice Corneal Dystrophy. This relatively rare stromal dystrophy is autosomal dominant and presents as refractile lines in the anterior stroma during the first decade of life. The lesions that create this lattice pattern consist of amyloid. As this dystrophy progresses, recurrent corneal erosions and scarring of the cornea are common. Treatments consist of bandage contact lenses or penetrating keratoplasty, depending on severity.

For more on this patient, see http://www.clspectrum.com/article.aspx?article=&loc=archive\2009\august\cls_august_a02.html .

We welcome photo submissions from our 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.

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

Nystagmus and Contact Lenses

I came across a study performed predominantly at my institution on the effect of a topical carbonic anhydrase inhibitor (CAI) brinzolamide (Azopt) on measures of nystagmus foveation quality in a subject with infantile nystagmus syndrome. Dell'Osso et al (2011) concluded that the improvements in the Nystagmus Acuity Function after topical brinzolamide were equivalent to systemic acetazolamide or eye muscle surgery and were intermediate between those of soft contact lenses or convergence. In fact, topical brinzolamide and contact lenses had equivalent longest foveation domain improvements.

I wondered how contact lenses dampen infantile nystagmus syndrome? Taibbi et al (2008) noted that contact lenses allow fixation through the optical sweet spot at all times, thereby preventing distortion. They state that "contact-lenses broaden the range of high-foveation-quality gaze angles in addition to any improvement in primary-position visual acuity they may provide. This suggests that contact lenses do far more to improve visual function than has been previously appreciated and is a potentially important therapeutic option for infantile nystagmus syndrome patients." (Taibbi et al 2008)

Taibbi G, Wang ZI, Dell'Osso LF. Infantile nystagmus syndrome: Broadening the high-foveation-quality field with contact lenses. Clin Ophthalmol. 2008 Sep;2(3):585-9. Dell'Osso LF, Hertle RW, Leigh RJ, Jacobs JB, King S, Yaniglos S. Effects of Topical Brinzolamide on Infantile Nystagmus Syndrome Waveforms: Eyedrops for Nystagmus. J Neuroophthalmol. 2011 Sep;31(3):228-233.

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Ronald K. Watanabe, OD, FAAO

Multifocal Soft Lens Update

In the realm of two-week and monthly replacement multifocal soft lenses, we have had several good silicone hydrogel products introduced in the past several years, including Acuvue Oasys for Presbyopia, Air Optix Multifocal, and PureVision Multi-Focal. These products have increased success rates when fitting presbyopes, resulting in happier patients and practitioners.

A new silicone hydrogel product recently introduced is the Biofinity Multifocal. This lens combines a successful silicone hydrogel material (comfilcon A) with a refined Proclear/Frequency 55 Multifocal design. The difference between this new lens and its predecessors is that the intermediate aspheric zone transitions into a spherical peripheral power zone such that the "D" lens has a spherical ring of near power in the periphery of the optic zone, and the "N" lens has a spherical distance zone in the periphery. This reportedly improves near vision in the "D" lens and distance vision in the "N" lens without compromising overall vision. The fitting guide also now recommends using two "D" lenses when the patient's add requirement is +1.75 D or less. This new product shows promise to further improve our fitting success with presbyopes.

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An International Analysis of Contact Lens Compliance

The purpose of this study was to evaluate compliance to contact lens use in 14 countries, and to identify wearer attributes which indicate lower compliance levels.

A web-based survey was undertaken by 4021 contact lens wearers, revealing information about demographics, and lens and solution information including daily handling details, case care and aftercare frequency. Particular attention was paid to eight modifiable compliance-related behaviors which are associated with an increased risk of microbial keratitis.

Full compliance was very rare for most lens users, although better (15% of wearers) for daily disposable lenses. Reduced compliance was demonstrated in South Korea, and for young male full-time contact lens users, especially those who have not consulted their eyecare practitioner for some time. The behaviors associated with the lowest levels of compliance were rubbing and rinsing, handwashing, correct lens replacement and case cleaning.

Given other recent literature, which suggests improved contact lens compliance with regular self-review exercises, the authors encourage clinical colleagues to particularly examine case cleaning, handwashing and rubbing and rinsing at aftercare examinations, especially in young male wearers.

Morgan PB, Efron N, Toshida H, Nichols JJ. An international analysis of contact lens compliance. Cont Lens Anterior Eye: The journal of the British Contact Lens Association. 2011 Aug 23. [Epub ahead of print]

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Important Links:
To report adverse contact lens reactions visit: http://www.accessdata.fda.gov/scripts/medwatch/ or call (800) FDA-1088.
To report possible grievances related to the Fairness to Contact Lens Consumers Act or associated Contact Lens Rule visit: https://www.ftccomplaintassistant.gov/.

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For more information on Contact Lenses Today including archives of previous issues, please visit our website at www.cltoday.com. For the latest articles on contact lenses, important clinical information and helpful tools related to the contact lens practice visit the Contact Lens Spectrum website at www.clspectrum.com.

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