contact lens management
New Choices for Comfort
Give patients the end-of-day comfort they are
looking for.
TOM
KISLAN, O.D.
In
my practice, as in many others, dry eyes are a common problem associated with contact
lenses. According to Fonn in 1996, an estimated 34% of contact lens wearers drop
out each year, and a survey from 2002 (Young, et al.) indicates that contact lens
wearers identify dryness as one of the primary reasons they discontinue use (40%
of participants). In addition, contact lens patients encounter issues such as ocular
allergies, side effects to systemic medications and lid disease such as meibomian
gland dysfunction and posterior blepharitis.
Taking
this into account, we clearly must evaluate our lens selection carefully to increase
wearer satisfaction. I was looking for a lens that was easy to fit and would stand
up to the product's claim of superior end-of-day comfort. I've found that contact
lenses specially designed for dry eye fit the bill.
 |
|
Extreme
H2O 54% Xtra |
LENS
POWERS: 13.6mm: +6.00D to
-12.00; 14.2mm: +6.00D to -10.00D; both in 0.50D steps above -6.00D
MATERIAL: Hioxifilcon D (46%); water
(54%)
DK/T: 29
BASE CURVES: 13.6mm, 14.2mm
COST: Tier pricing: $11.00 to $17.00
per six pack. |
Specialty lenses hit the spot
While lecturing across the country, I always receive
questions about whether silicone hydrogels are the lens of choice for dry eye patients.
I've always felt this was incorrect, so I conducted an investigative masked study
comparing the performance of a popular silicone hydrogel contact lens with a specialty
dry eye contact lens, Extreme H2O 59% Xtra (Hydrogel Vision Corp.) and an omafilcon
lens, also designed for dry eye patients. Data from 105 patients shows that the
above lenses outperformed their previous lens materials. Further, the "dry eye"
contact lenses, Extreme H20 and omafilcon, provided significantly more comfort,
longer wear time, better Schirmer scores and TBUT (see page 97). Also, the performance
of each lens significantly improved with the concomitant use of Restasis (cyclosporine,
Allergan). I will present this study at the American Academy of Optometry meeting
in Denver next month.
More options, better comfort
I was pleased that my results confirmed that I
have been fitting a truly beneficial lens for the past five years — the Extreme
H2O. Manufactured with a GMA/HEMA material called hioxifilcon A, Extreme H2O is
a non-ionic lens with a water content of 59%. Both components hold very tightly
to their hydrogen bonds, enabling hydration levels to remain almost unchanged during
the wearing period.
Extreme H2O 54% is made with a new
material called hioxifilcon D and has a water content of 54% (indicated in the name).
It's available in two diameter designs. In addition to the advanced moisture retention
properties, the new material offers improved durability. Not only has the lens worked
very well on many of my patients who experience dryness and discomfort, but the
greater durability is an upgrade from older, Group 4 lenses.
Precise fits
|
Performance of Extreme H2O 54% Xtra |
|
|
WITH
PREVIOUS CONTACT LENS |
AT INITIAL
FITTING |
AT ONE
MONTH |
AT SIX
MONTHS |
|
Wear time(hours) |
4.5 |
5.12 |
6.65 |
7.85 |
Comfort
(subjective, scale of 1 to 5) |
2.08 |
2.23 |
2.77 |
3.42 |
Schirmer
(mm) |
5.19 |
5.27 |
6.96 |
7.5 |
TBUT
(seconds) |
6.65 |
6.81 |
7.77 |
8.65 |
The two sizes (13.6mm and 14.2mm) enable me to
get a more precise fit on my patients, which definitely contributes to the comfort
they experience when wearing the lens. Over the past couple of months, I've fit
an increased number of children in the 13.6mm lens. The smaller size lens enables
me to get full corneal coverage with the least amount of material on the eye. It's
great for my patients with tight lids and small fissures. I'd say that approximately
75% of my dry eye patients wear the Extreme line of lenses, and 25% of my new fits
wear the new 54% lens.
It's a classic win-win
The new 54% is my first choice for first time-contact
lens wearers, and for patients who are simply looking for a lens that gives them
end-of-day comfort. Providing my patients with the comfort they want has brought
great success to my practice. In addition to patient retention, I have received
many referrals — between three and five a week — from patients wearing
the lens. I am confident your success rate with Extreme H2O 54% will be as positive
as mine.
DR. KISLAN IS OWNER AND MEDICAL
DIRECTOR OF STROUDSBURG EYE SPECIALISTS, HAZLETON
EYE SPECIALISTS AND THE DRY EYE CLINIC OF NORTHEAST
PA. HE LECTURES ON DRY EYE DISEASE AND GLAUCOMA
AND HAS NO FINANCIAL INTEREST IN THE PRODUCTS
MENTIONED.
Optometric Management, Issue: November 2006