Custom Contact Lens News & Views from Art Optical Contact Lens, Inc.
eissue 10/Summer 2012
Mark your calendar and join us at an upcoming meeting:
 
June 28 - 29, 2012
Booth #1927
Chicago, IL 
 
Vision Expo West
September 6 - 8, 2012
Booth #MS9057
Las Vegas, NV
 
East West Eye Conference
October 4 - 6, 2012
Booth #325
Cleveland, OH
 
October 24 - 26, 2012
Booth #410
Phoenix, AZ
KeraSoft IC
QUICK LINKS:
GP Fitting Pearl:
Does a toric lens flex?

If the patient is wearing a toric lens and there is a toric over-refraction it is probably not from flexure. Three likely scenarios can occur with a back or bitoric: 

 

1) The over refraction can include cylinder at the same axis as the patient's spectacle refraction. This is indicating the contact lens needs to include more cylinder than is currently in the lens. 

 

2) If the cylinder in the over-refraction is 90 degrees away from the refractive axis the lens should include less cylinder because the contact lens is over correcting the cylinder. 

 

3) If the cylinder in the over-refraction is oblique, the fit probably needs to be adjusted because the cylinder in the lens is not positioning with the cylinder in the eye.

Consider GP lenses for dry eye patients

Ashley Wallace-Tucker and Kelly Nichols in Contact Lenses Today opened up the discussion as to whether GPs are a viable option for dry eye patients. It is commonly known that approximately 50% of all contact lens wearers suffer from dry eye. The vast majority of recent research has been focused on soft contact lens-related dry eye because this lens type dominates the market. However, some believe that GP lens wearers have fewer symptoms of dry eye, the authors state. Oxygen transmission (Dk/t) and tear exchange are better with GPs than with soft lenses, which may contribute to a successful use of these lenses in dry eye patients. Although specific studies are needed on the topic - the dry eye experts suggest not to exclude GPs for this purpose and to consider them as a viable option.

 

This article reprinted with permission from the June, 2012 I-site Newsletter authored by Eef van der Worp, optometrist, PhD, FAAO, FBCLA, FIACLE, FSLS. To subscribe to the newsletter, contact I-site at: i-site@netherlens.com 

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Art Optical happily hosted a day of laboratory tours in conjunction with the MOA Spring Seminar in May.
Technical Process Manager, Dave Freyling describes the lathing process in the soft production area to some of our visiting practitioners.
Why is KeraSoft® IC so different?
by Michael A. Johnson, FCLSA
Director of Consultation Services

Since becoming the inaugural U.S.   manufacturer of Bausch & Lomb's KeraSoft IC lens last fall, the most common question we hear from practitioners is "What makes KeraSoft IC different than other soft cone/irregular cornea lenses?"

 

In fact, it's the first question asked by nearly every practitioner who is newly introduced to KeraSoft IC. Everyone wants to know how and why KeraSoft works. When I explain this to practitioners, I focus on a very significant and well-known principle to irregular cornea fitters - Mask vs. Drape.  

  

Other soft lens designs intended for use on irregular corneas attempt to mask the irregularity much like a rigid GP lens will do. In the case of a nipple or oval type Keratoconus, other soft lens designs use very steep central base curves to align with the steeper corneal apex along with increased center thickness in an attempt to create a spherical refractive surface. Rigid GP lenses accomplish this very well; however, it takes an exorbitant amount of thickness in a soft lens to get the same effect. Soft lenses of this type use spherical power incorporating spherical equivalents of any cylinder showing through that the design cannot fully correct.

 

KeraSoft IC is the only design of its kind that does not attempt to mask the irregularity. KeraSoft IC actually drapes over the irregularity and allows a normal refractive cylinder to be refracted through it. It will almost always require cylindrical correction to provide the optimum acuity for the patient. This draping method allows much flatter base curves to be used over the irregularity. The lens position is then enhanced by the ability to adjust the periphery either flatter or steeper than the central base curve to accommodate for any excessive peripheral topographical variances from the primary curvature.

 

KeraSoft IC sets itself apart from all other soft lens designs for irregular corneas and has made a major impact on the quality of life for thousands of patients suffering with debilitating corneal issues. While it is a highly advanced design, quite simply, it is the Drape vs. Mask principle that sets it apart from the rest.

More Keratoconic options help insure more successful patient outcomes

by Bethany Peebles, ABOC, NCLE-AC, 

Fitting Consultant 

Keratoconus can take on a number of different appearances. There are small central cones, low decentered cones, large globus cones and even Pellucid Marginal Degeneration (PMD). Each presents its own unique fitting challenges. The topography above depicts a low decentered cone which is one of the more common forms of keratoconus that we assist with on a daily basis. The typical fitting challenges that this type of cornea presents are the possibilities for inferior edge lift, poor centration, mid peripheral seal off, and wearing comfort. We offer three different contact lens fitting approaches for this situation; a corneal GP lens, GP corneal-scleral GP lens, and a Keratoconic custom soft lens.

 

A GP corneal design fitting approach has been the most common method of fitting keratoconus and has been quite successful. The fitting philosophy of our AKS design (Art Keratoconic System) is to fit the apex of the cone by using a small diameter with a controlled optic zone. The standard diameter is 8.50 and often addresses the issue of inferior edge lift. If the diameter is too large for the size of the cone it tends to lift away from the steep inferior portion of the cornea causing concern that the lens may spontaneously dislodge. As the cone advances we may utilize a smaller diameter than the 8.50. The controlled optic zone is a key feature of the AKS design and helps maintain appropriate tear exchange by eliminating mid-peripheral seal off. The AKS lenses will center over the cone and in the case of the topography above, will mean a slight inferiorly decentered lens. This should not be cause for concern as it rarely has any negative effect on the patient's acuity. The patient's best acuity is achieved through the visual axis which is at the apex of the cone. The AKS has had years of success and with the availability of loaner fitting sets, a per lens cost equivalent to our standard lens designs, and a liberal warranty, it remains a viable lens option.

 

The use of corneal-scleral/semi-scleral lens designs for irregular corneas, and specifically keratoconus, has greatly increased over the last few years. We have seen this reflected in the ever growing success of our SoClear family of lens designs. Due to the lens design being both scleral and corneal seated, it addresses many of the common issues related to keratoconus. The 14.0 mm lens diameter sits just over a millimeter past the limbus which addresses lens awareness by providing a comfort level that is often equivalent to a soft lens. The size of the SoClear lens also aids in centration along with minimizing inferior edge lift and therefore, any concerns about spontaneous removal. This makes it a great choice for keratoconic patients with an active lifestyle. SoClear lenses require the use of a fitting set to establish an appropriate scleral fit since k-readings and topography only provide information regarding a small portion of the cornea. The ideal fit would provide scleral alignment without scleral compression or blanching, along with a mild ring of pooling just inside the limbus and central alignment over the cone, keeping touch on the cone to a minimum. An informative webinar is available on our website and offers a step-by-step fitting process with fluorescein pattern references and video of an on-eye fit. The use of a trial set, along with a warranty allowing exchanges and cancellation priviliges affords ample opportunity for a successful outcome.

 

A recent and exciting addition to our arsenal of keratoconic lens designs is KeraSoft IC. This unique soft lens design has the capability to offer high levels of comfort for patients that have struggled with constant lens awareness or limited wearing schedules while still providing optimal acuity levels. KeraSoft is a great option for those patients who, regardless of parameter or design changes, continue to struggle with GP's, or first time wearers that are apprehensive about a GP lens. Designed with a large back optic zone that allows the lens to drape over a significant portion of the corneal irregularity, it utilizes much flatter base curves than what might be anticipated. The acuity is achieved by the prescription generated on the front surface using aberration control optics. Due to KeraSoft's unique fitting aspects, the use of a fitting set is required, along with a requirement of certification which is achieved through online training modules. The use of the 8 lens trial set, in conjunction with the comprehensive fitting guidelines and a risk-free warranty, almost guarantee a positive result.

 

Although the latter two designs rely on trial fitting to determine the end results, topographical information is helpful in learning the shape of the cornea and determining your fitting process. As always, our consultation department is happy to assist by further discussing these varying options for your particular office or patient needs.

The Perfect Fit for your most demanding astigmatic patients!

Intelliwave® Precise Prescription Toric & Multifocal Toric lenses are opening the eyes of practitioners and patients everywhere.  Made to order in virtually unlimited parameter combinations, Intelliwave makes it easy to manage tough prescriptions and satisfy more patients. Perfect for new fits or as an upgrade to discontinued brands, Intelliwave's proprietary wavefront technology provides patented aberration control for exceptional optical performance, plus, the latest in silicone hydrogel material technology insures optimum wearing comfort.  From a standard Rx to astigmatic presbyopes, or extreme cylinder and high power needs,Intelliwave fits.