Article Date: 9/1/2011

Bye Bye Dry
contact lens focus

Bye Bye Dry

Daily contact lens offers relief from dry eye and higher-order aberrations.

Irwin Azman, O.D.

A 63-year-old, female presbyopic patient recently presented and explained that for the past seven years, she desired to wear contact lenses. She said she worked on a computer all day and wanted to be spectacle-free for close work. Her history revealed that three other eyecare practitioners had prescribed several lens types—including daily disposables—through these years, though she was unsuccessful in all of them. The reason: The patient experienced ocular dryness and subsequent vision degradation upon wear with each lens.

I diagnosed the patient as having marginal evaporative dry eye, for which she was asymptomatic sans contact lens wear. The patient's history showed no other health issues.

I explained to her that before trying another lens, we needed to quiet her evaporative dry eye with a lid cleanser and concomitant oral omega-3 fatty acid supplementation.

At follow-up, the patient's ocular surface appeared healthy, so I instructed her to continue with this treatment. I asked her: “If I could give you a daily disposable lens that would maintain a high-level of hydration but would require modified monovision and wearing glasses over the lens for night driving, would you be willing to try it?”

This lens is the Safigel 1 Day, from the company of the same name. Here, I explain why I offered it to this patient and explain why you should consider offering the lens in your practice.

Incorporated bio-polymer

The Safigel 1 Day lens contains sodium hyaluronate (HA)—a bio-polymer contained within many dry eye treatment drops. Specifically, the lens slowly releases HA into the tear film. In fact, every one molecule of HA attracts 3,000 molecules of water, allowing for natural tears on both sides of the lens, the company says. Therefore, with the moisturizing component included in the lens matrix, patients receive the benefits of a dry-eye treatment delivered from their contact lens every time they blink. (That said, without determining whether there is an underlying cause of the patient's ocular dryness first, the lens may not be of benefit. So, be sure to assess the patient's ocular surface prior to fitting, and prescribe an appropriate treatment if needed.)

The result of wearing the Safigel 1 Day lens: Patients predisposed to dry eye—due to environmental factors, allergies, systemic disease, medication use, etc.—or who have marginal-to-moderate dry eye undergo natural repair of the corneal epithelium and experience enhanced tear film stability, comfortable, long wearing times and clear, crisp vision all day—the latter of which can also be attributed to the lens design. I've personally seen these benefits in the patients to whom I've prescribed the lens.

Safigel 1 Day
MATERIAL: Methafilcon A
DK/T: −3.00D, 31
WATER CONTENT: 55%
WEARING SCHEDULE: Daily disposable
RECOMMENDED REPLACEMENT SCHEDULE: Daily
BASE CURVE: 8.6mm
DIAMETER: 14.1mm
PARAMETERS: −0.50D to −6.00D (0.25D steps), −6.00D to −8.00D (0.50D steps), +0.50D to +2.00D (0.25D steps), +2.50D to +4.00D (0.50D steps)

Aspheric design

Although the Safigel 1 Day lens can be successfully fit for a variety of corneal shapes, ranging from as flat as 38.00D to as steep as 50.00D, its aspheric front surface design makes it particularly beneficial for patients who have irregular corneas. This is because it can mask as much as 1.00D of with-the-rule astigmatism, against-the-rule astigmatism and can correct up to +.75 add. As a result, I've used it with success on patients who have higher-order aberrations, specifically spherical. These include post-radial keratotomy, post-photorefractive keratectomy, post-LASIK, early stage keratoconus, pellucid marginal degeneration and post-corneal transplant patients.

Here's something else to consider: My chair time with patients who have irregular corneas has decreased since I've started prescribing this lens. This is a big plus for practitioners who have shied away from fitting these patients in the past. In other words, I think you'll find that the return, in terms of both patient satisfaction and less chair time per patient, is well worth it when prescribing the Safigel 1 Day lens.

Exclusive distribution

In order to dispense the Safigel 1 Day lens, you must be an eyecare practitioner. In other words, online contact lens dispensaries do not carry these lenses. As a result, the patients to whom you choose to prescribe the lens will return to you and you alone for lens replenishment—something else that will increase your practice revenue.

My patient

The 63-year-old female patient mentioned above agreed to try the Safigel 1 Day lens. She returned for follow-up a few days later reporting both good close and distance vision (J1 and 20/25 respectively) and the comfort that had eluded her seven years prior. OM


DR. AZMAN HAS BEEN IN PRIVATE CONCIERGE PRACTICE SINCE 1980 IN TIMONIUM, MD. IN ADDITION, HE IS THE FOUNDER AND EDUCATIONAL DIRECTOR OF OPHTHALMIC PRACTICE TRANSFORMATIONS (WWW.FINDOPT.COM), WHERE HE TEACHES PRIVATE-PRACTICE OPTOMETRISTS THE ROADMAP TO A SUCCESSFUL DRY EYE AND CONTACT LENS PRACTICE. E-MAIL HIM AT EYEAZMAN@AOL.COM, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL. COM.

Optometric Management, Issue: September 2011