Article Date: 2/1/2004

In Search of Long-Lasting Contact Lens Comfort
The new ACUVUE® ADVANCE™ Brand Contact Lenses with HYDRACLEAR™ from VISTAKON®  combines the best qualities of traditional hydrogels and silicone hydrogels with a unique internal wetting agent that is branded HYDRACLEAR™.

Kim Castleberry, O.D., Plano, Texas

Kirk Smick, O.D., Morrow, Ga. Mary Jo Stiegemeier, O.D., Beachwood, Ohio

Discomfort was the primary reason why 2.7 million patients stopped wearing their contact lenses last year, bringing the number of contact lens dropouts in the United States to 24 million. These patients aren't necessarily lost for good; 68% say they're willing to reconsider contact lens wear, according to a VISTAKON® survey. Additionally, five of six current and potential contact lens wearers indicated that all-day comfort was critical to lens wear; but a separate study shows that less than half of current lens wearers are satisfied with their comfort at the end of the day. Thus, any effort to lure patients back to the fold while retaining current patients and recruiting new lens wearers must address comfort, especially long-lasting, all-day comfort.

Eye care professionals may be missing this message. "What [researchers] found was there was a big disconnect between what patients were telling the research people and what doctors were hearing in the exam room," says Kim Castleberry, O.D., of Plano, Texas. With a fresh lens on the eye, patients say they feel fine. Only later in the day do they feel the discomfort that makes them quick to remove their lenses or ready to quit contact lens wear altogether.

To satisfy these patients and provide long-lasting comfort, VISTAKON® has developed a contact lens that combines the softness and hydrophilic quality of a traditional hydrogel lens with the high oxygen transmissibility of a silicone hydrogel. Also incorporated into the mix is a proprietary technology with a wetting agent that permeates the lens. The result is the ACUVUE® ADVANCE™ Brand Contact Lens.

Best of both worlds

Traditional daily wear hydrogel and traditional silicone hydrogel contact lenses each have their tradeoffs. Daily wear hydrogel lenses feature a soft, flexible material with exceptional wettability and a proven track record. Their disadvantages include a low Dk/t compared with silicone hydrogels, as well as end-of-day dryness and dehydration.

Silicone hydrogels, on the other hand, offer high oxygen transmissibility (three times that of the leading hydrogel brand), less dehydration and lower protein deposits. Their drawbacks include a stiffness that creates initial discomfort, plus they require a surface coating, they're expensive, and they invite increased lipid deposits.

Conjoining the two modalities accentuates their positive qualities while diminishing their drawbacks. The ACUVUE® ADVANCE™ Brand Contact Lens features the fit and feel of a traditional hydrogel plus the oxygen-rich nature of a silicone hydrogel. It offers exceptional wettability and low dehydration in a soft, flexible material. Its Dk/t of 85 exceeds that of the leading hydrogel. It collects minimal protein deposits and requires no surface coating. And its average UV-A blocking is 90%, while its UV-B blocking is 99%.

The HYDRACLEAR™ difference

The critical component that makes this combination feasible is a long-chain, high-molecular-weight, hydrophilic molecule called HYDRACLEAR™. HYDRACLEAR™ is a moisture-rich element that is present throughout the lens matrix helping to create a lubricious feel. "When I picked up the ACUVUE® ADVANCE™ with HYDRACLEAR™ lens, I could not believe how silky smooth it really felt. HYDRACLEAR™ is really helping to impart some remarkable properties to ACUVUE® ADVANCE™," says Kirk Smick, O.D., of Morrow, Ga.

HYDRACLEAR™ readily binds to water, so the eye feels moist and comfortable even at the end of the day. And ACUVUE® ADVANCE™ with HYDRACLEAR™ enhances comfort in other ways. "It incorporates silicone into the lens without having the stiffness problem," says Mary Jo Stiegemeier, O.D., of Beachwood, Ohio. "Silicone is one of the least wettable of materials, but [HYDRACLEAR™] keeps that lens more wettable and seems to limit protein deposits as well." A recent clinical trial showed that, thanks to the lens's oxygen-rich environment and flexible nature, the eyes of patients fit with the ACUVUE® ADVANCE™ Brand Contact Lens remained whiter at the end of the day than those who had been fit with FOCUS® Night & Day™.

End-of-day comfort

A VISTAKON® survey found that 87% of ACUVUE® ADVANCE™ patients said their lenses remained comfortable throughout the day for 9 hours or more. "ACUVUE® ADVANCE™ provides exceptional long-lasting comfort," Dr. Castleberry says. "So, your patients will be comfortable at the beginning of the day and at the end of the day." Dr. Castleberry speaks from first-hand experience. "I put the lens on myself, and for the first time in my life, I can wear contact lenses all day and all evening," he says. With more than 60 of his patients now wearing the ACUVUE® ADVANCE™ Brand Contact Lens, not one reports dissatisfaction.

Two-week daily wear

The ACUVUE® ADVANCE™ Brand Contact Lens is cleared for daily wear with a recommended 2-week disposable schedule. Its design and parameters are similar to those of the ACUVUE® 2 Brand lens. It comes in base curves of 8.3 mm and 8.7 mm, with a 14.0-mm diameter and powers from +4.00D to ­6.00D. Fitting is straightforward. "For patients who are currently wearing a daily wear hydrogel material from any manufacturer, this really isn't a refitting concept," Dr. Smick says. "Chair time is not an issue."

Your recommendation counts

VISTAKON® polled patients who were fit successfully in the ACUVUE® ADVANCE™ Brand Contact Lens and after 1 week of lens wear, asked if they were interested in purchasing the lenses. Eighty-two percent said yes. If their doctor were to recommend it, 95% said they would likely obtain the lenses. "The power of the practitioner is really paramount in terms of giving patients the confidence they need in this technology," Dr. Castleberry says.

VISTAKON® hopes that this confidence extends not only to current contact lens wearers, but also to prospective lens wearers and contact lens dropouts.

*UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors, such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.

are trademarks of Johnson & Johnson Vision Care, Inc. 2004

VISTAKON® launched ACUVUE® ADVANCE™ Brand Contact Lenses at the 2003 American Academy of Optometry Annual Meeting. Kim Castleberry, O.D., Kirk Smick, O.D., and Mary Jo Stiegemeier, O.D., lectured there on the ACUVUE® ADVANCE™ Brand.


Optometric Management, Issue: February 2004