Article Date: 2/1/2006

contact lens management
A Contact Lens for Astigmats
This new toric lens offers comfort and stability.
JUAWANA C. HALL, O.D.

Toric contact lens wearers are often silent sufferers due to discomfort and poor vision. They may not initially complain, but when probed, these patients frequently report lens instability, which leads to unstable vision. As a result, astigmats are often contact lens dropouts. But a new lens can provide both comfort and stable vision for these patients. When Vistakon introduced the Acuvue Advance for Astigmatism, I was skeptical. Previous toric contact lenses didn't stabilize well; I didn't expect this lens to, either.

An astigmat meets his match

The Acuvue Advance for Astigmatism features Class 1 UVA and UVB blocking.

I first tried the lens on my most challenging toric patient � my husband. He has low levels of astigmatism, but it's all corneal, which makes fitting more complicated. He also has mild dry eye symptoms that bother him only during allergy season and when wearing contacts. He cannot tolerate GP lenses, and after trying every soft toric lens

on the market with no success, he'd resigned himself to wearing glasses. 

His initial response to the new lenses was that they were "perfect." That seemed too good to be true, so I asked him to try wearing them all day. A few months later, he still loves them and can wear them for 16 hours at a time. His vision is 20/20 OU with no haze or fluctuating vision.

These lenses work just as well in other astigmats. The best candidates, I find, are patients with low to moderate amounts of astigmatism (0.75D to 2.00D), and those who've had issues with their current lenses. These patients often complain of some blurriness or fluctuation in vision because the lenses tend to rotate with the eyelids' movements.

Lens particulars

This lens uses an accelerated stabilization design that works with the eyelids to balance the lens in place when the eye is open and quickly re-align the lens if it rotates out of position. Additionally, the lenses stabilize in less than 60 seconds. This is a great time saver, because I'm now able to fit my patients in less than a minute, compared with the typical 15 minutes of chair time for older lens designs.

Acuvue Advance for Astigmatism

BASE CURVES 8.6mm
MATERIAL: galyfilcon A
DK VALUE: 60
PARAMETERS: plano to -6.00D in 0.25D steps (Cylinders: 0.75, -1.25, -1.75; Axis: 10� to 180� in 10� steps); -6.50D to -9.00D in .50D steps (Cylinders: -1.25, -1.75; Axis: 90� & 180�, + 20, no obliques); and +0.25D to +6.00D in 0.25 steps (Cylinders: -0.75, -1.25, -1.75; Axis: 90� & 180�, + 20, no obliques).
Spherical lens only.

COST: $100-$120 for a three-month supply
FDA-APPROVED WEARING TIME: Daily-wear with two-week replacement schedule

These silicone hydrogel lenses combine an oxygen-rich material, galyfilcon A, and the company's Hydraclear technology, a wetting agent designed to help the lens retain moisture.

I've fit more than 100 patients and have had great success with at least eight out of every 10. These lenses are my first choice for patients with low to moderate levels of astigmatism, except those who are non-compliant with the two-week wearing schedule. I'm confident that my astigmatic patients can now wear contact lenses successfully.

DR. HALL IS IN PRIVATE PRACTICE WITH DIGBY EYE ASSOCIATES IN GREENSBORO AND HIGH POINT, N.C. CONTACT HER AT (336) 454-2020.



Optometric Management, Issue: February 2006