In Contact - February 2006
Wassup?
Here?s hoping you all had a good break over the now almost forgotten festive season. Some feedback from readers tells me some of you enjoyed and found December?s ?Best of the Web? sites useful.
It looks like 2006 is going to be eventful with a number of exciting new technologies coming on stream in the first and second quarters with more to follow in the latter half of the year.
I understand CooperVision?s long awaited sooperdupersoftertwetter Biofinity silicone hydrogel will be launched in NZ in the second quarter. we've been aware of this lens for the past two years so I reckon It's about time it saw the light of day.
I also expect we will see J&J?s ?wetter? 1 Day Acuvue Moist make its appearance as I would the new Oasys lens. When I was visiting South Africa during November ?05 I was having a bit of shop talk with my former colleagues. I was telling them how impressed I was with Acuvue Advance and Advance for Astigmatism [provided one avoids MPS solutions!]. They looked at me like I was crazy and promptly told me ?Oasys is way better?. Here I was telling my ?third world? colleagues about a great new lens and they were already way ahead with the next generation Oasys. So based on the fact they?ve had Oasys in Africa for a good six months I expect us ?first world? Australasians should get it soon?.
we're also due to get the extended range 02 Optix of as well as the 02 Optix toric early in ?06?
Around mid year I am also told we will possibly have early access to trial lenses in the hybrid Synergeyes range for standard ametropia/topography as well as a keratoconic version. The hybrid lens [a Rigid centre of around 100 to 150 Dk units] with a HEMA-type 30% water peripheral ?donut? has been FDA approved and colleagues doing trials tell me they have had good success refitting complex cases and contact lens dropouts. Register on the website to learn more.
This could be a breakthrough contact lens product?
Safe as, Bro
Generally we are fortunate to have a growing armamentarium of silicone hydrogels at our disposal. Oxygen is really no longer an issue and the future is likely to centre around biocompatibility, wetting, surface quality, modulus, aberration controlled optics and so on. Since I was a student, around a quarter century ago, I was told that ?Extended Wear? lenses were the ?future?. Time and again since, we've been told that the ?future is here?. This was especially so when the 1st generation silicone-hydrogels hit the market in 1999. Well known and respected contact lens gurus were telling us ?the future is here, oxygen issues have been solved? and it was implied that now oxygen was no longer an issue the dreaded MKs that killed the former EW ?revolution? in the 80s would no longer be an issue. Unfortunately studies and monitoring over the past 6 years have shown that in fact MK rates with si-hy EW are not really much better than with conventional hydrogels and EW. In addition higher than desired rates of CLPC and CLPU are also issues that are not very pleasing.
On that other hand these same studies show that MK incidence is practically zero in RGP EW and MK in DW Daily Disposables is also insignificant. That pleases me greatly as you know I have long espoused Daily Disposables and RGPs as the safest best CL options. Silicone hydrogels are great lenses but I prefer to use them for Daily Wear and have not significantly increased my Extended Wear prescribing habits since 1999. In fact I am even less inclined to advise EW now that I was five years ago?
Use this link to educate you, your staff and patients on ways to minimise MK risk and what to do if it strikes!
Tradition?
Although the majority of practitioners are si-hy savvy I am still surprised by the number of HEMA lenses we see prescribed both locally and overseas. I can?t think of many, if any good reasons to Rx HEMA!
On the other hand there are still some very good performers in the higher water/higher Dk range of non si-hy disposables. Take a look at this article as it is certainly one perspective and food for thought. I'd have to agree that there are many excellent results to be seen in Proclear disposables and as I have said before Actifresh 400 with its high Dk, good fit, comfort and extended Rx range with UV 400 protection, still has to be one of the best disposable soft lenses ever.
For a person wearing these lens types: - with no neovascularisation or endothelial changes and a nice white eye, clear tarsal plates, good vision, wear and comfort, why change?
Why indeed.
There will be many other exciting developments in 2006 and I sincerely hope that the over the top, polarising, politicised regulatory nonsense that spoiled 2005 for many does not rear up this year. It would be great to see conciliatory, team building, profession enhancing developments instead. We will see how TPA optoms find their new prescribing powers ? a first for NZ Optometrists.
I have some interesting overseas travel ahead of me early in ?06.
I?ll let you know some of the outcomes of these meetings as soon as I can.
Have a good one!