While in soft lens research much attention goes toward material innovation and research, it is much quieter on the (R)GP lens front. For instance, we don't really have the answers to basic questions like: is there actually a lipid layer on (R)GP lenses? A discussion paper in Global Contact looks at this topic and compares low, medium and high Dk materials, with and without plasma treatment, and tries to answer the question of whether there is lipid coverage on (R)GP lenses as well as its clinical relevance. In the meantime, it is not only the lack of new research in (R)GPs that is slow: new high index (R)GP materials have been available for a while, but practitioners have been slow on their uptake. Why is this? Is it the reported lower wettability? The oxygen permeability with these (R)GP lenses can hardly be the problem, since it is still at a very high level. High index materials do provide the option to produce significantly thinner lenses. Ronald Watanabe reports in his Contact Lens Spectrum column 'When to Go High-Index' a 0.04mm or 400micron reduction in thickness compared to that of a conventional -10D lens, and 0.05 or 500 micron improvement for a +10D lens. For patients requiring higher adds (+2D or more) it is sometimes challenging to deliver enough add with aspheric multifocals. Making the lens in a high index material can add up to +0.5D more add power depending on the design, according to the author. Photo: In-Vivo Precorneal Tear Film Lipid Layer Microscopy, The Ohio State University Contact Lens and Tear Film Laboratory.