Mary Jo Stiegemeier in Contact Lens Spectrum looks at managing irregular corneas with soft lenses. Today, there are a number of ways to utilize soft lenses in the care of irregular cornea patients, she writes. In the past, we have used higher-modulus soft lenses to mask irregular astigmatism in the early stages of keratoconus, and we have used soft lenses as a base lens in piggyback lens systems, which still continues to work very well for managing keratoconus.

A number of posters presented at the EAOO meeting in Budapest in May referred to soft lens fitting. McKernan O'Dwyer and Manion investigated the influence of previous soft contact lens wear on outcomes of corneal refractive surgery.  There was a trend toward equal or even superior refractive surgery outcomes for efficacy, predictability and safety in the two weeks lens cessation group compared to the non-lens wearing group. These findings were reiterated in the 24 hours lens cessation group, with a trend toward superior refractive surgery outcomes for efficacy, predictability and safety compared to the non-lens wearing group following LASEK/PRK.

A range of soft (specialty) lens topics were presented at the Association for Research in Vision & Ophthalmology (ARVO) meeting this spring. Greenspan (poster # 3081) described the use of prosthetic tinted lenses in photophobia. After a concussion, lights seem brighter and more painful in some patients. This can affect work, daily activities and quality of life in general. Sunglasses may not be very convenient indoors - but tinted soft lenses can block bright lights and provide comfort for the patient the study found.  

Drug delivery with contact lenses has the potential to revolutionize how we treat ocular diseases, but our understanding of drug delivery on the eye has been hindered by the lack of an appropriate eye model. Previous studies reported a rapid drug release and plateau phenomenon that results from using a large volume vial as the release system. But Phan et al (poster # 3085) developed a new eye model that simulates the tear volume and tear flow similar to an on-eye situation. They found with this new model, with low volume physiological tear flow, that commercial lenses can maintain a sustained drug release profile for up to 24 hrs. The results suggest that contact lenses are promising devices for ocular drug delivery.

Conventional methods in contact lens practice using a slit lamp to evaluate toric contact lens' orientation and rotational stability are subjective, time-consuming, and not always precise. A novel video processing-based algorithm was developed by Aghazadeh et al (poster # 3091) to automatically track the standard orientation mark on contact lenses and provide an objective method to evaluate their rotational stability. The method provided means to better evaluate toric contact lens rotational stability compared to subjectively, can help better understand lens dynamics on eye with various toric lens ballast designs, and can help better understand lens rotation between blinks / during blinks and with lens superior-inferior movement.

Another novel technique is the use of toric soft lenses in vitreous surgery. Ohzeki et al studied the visibility of the fundus in a model eye inserted with a toric intraocular lens (IOL). Based on the results of the experiment, they concluded that toric contact lenses for vitreous surgery appear to be useful for improving the visibility during vitreous surgery in eyes implanted with toric IOLs.