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CO-MANAGEMENT CRISIS
Controversial Florida Bill Tabled

Florida has become a battle-ground state again, but this time the issue is who should be permitted to provide follow-up care to patients who undergo ocular surgery.

The Florida Society of Ophthalmology (FSO), the Florida Medical Association, and the Florida College of Emergency Physicians contend that only physicians should be al-
lowed to care for post-op patients.

On the flip side, the Florida optometry community and ophthalmologist members of the International Society of Refractive Surgery (ISRS) believe that well-trained optometrists have a proven record of providing high-quality routine post-op care, particularly for cataract and refractive surgery patients.

In the Florida legislature, bills seek to ban non-M.D.s from providing follow-up care to ocular surgery patients. At press time, the Senate had passed a version of the bill saying that patients must see a licensed M.D. for 28 days following eye surgery. A House amendment more favorable to O.D.s, mandating M.D. care for only 7 days post-op, passed the House, and the bill was set to go before the full House. Then, on May 1, The Miami Herald reported that the bill was tabled. According to the Herald, ". . . contentious debate on the measure prompted its sponsor, Rep. Mike Haridopolos, R-Melbourne, to declare the bill dead for the session."

Steve Hull, FSO lobbyist and public relations director, says the legislation was introduced after Florida emergency room physicians complained of being overburdened by co-managed postoperative ocular surgery patients who suffer complications and seek help in hospitals.

Ken Franklin, executive director of the Florida Optometric Association, contends that assertion is false.

"We've surveyed emergency rooms across the state and see no evidence of patients being dumped after eye surgery," he says. "If there's an issue, it's with those few ophthalmologists who practice bad medicine and then abandon their patients."

Jeffrey B. Robin, M.D., executive vice president of ISRS and a refractive surgeon in Orlando, Fla., says: "I don't know a refractive or cataract surgeon who supports this legislation. We've found no evidence of substandard patient care or harm related to co-management."

If the law passes next session, Florida ophthalmologists who send surgical cases to non-physicians for follow-up are subject to disciplinary action.

In another attempt to regulate co-management, the Missouri Society of Eye Physicians & Surgeons (MOSEPS) lost momentum in the Missouri legislature after the Missouri Optometric Association (MOA) announced its opposition to the proposed legislation.

"The MOA believes that standards for co-management don't belong in statute," says LeeAnn Barrett, O.D., president of the MOA. "Regulations for co-management can be set by the governing boards of the professional organizations."

Rich Paul, executive director of MOSEPS says the legislation was introduced after MOSEPS members asked for legal standards.

"Our bill derives from the standards recommended by major ophthalmological organizations and the federal government," says Paul. "These guidelines form an ethical base for co-management. Nothing needs to change for doctors who already follow these standards."

"These guidelines form an ethical foundation for co-management. For doctors who are already following these standards, nothing needs to be changed."

LEGAL WOES
J&J 1-Day Acuvue Class-Action Settlement Postponed

At press time, Johnson & Johnson's proposed 1-Day Acuvue class-action suit settlement hearing is postponed by court order until May 18. According to company spokes- person Jeffrey Leebaw, the judge asked both parties not to comment. Industry insiders speculate that the postponement follows premature comments from the plaintiffs' attorney. The proposed settlement of up to $860 million would have ended a 1996 class-action suit accusing the company of misleading consumers about its contact lenses. The suit claims that J&J increased sales of its 1-Day Acuvue lenses by instructing patients to discard the lenses after one wearing, although the lens material is the same as the company's 2-week Acuvue lenses.

J&J's parent company, Vistakon, had agreed to remove "disposable" and "for single use" from packaging of 1-Day Acuvue lenses. The company says, " Acuvue and 1-Day Acuvue are different in several respects, and we've always accurately stated the similarities and differences between the two lenses."

Under the settlement, J&J would pay $20 million in lawyers' fees and costs, and up to $840 million in cash and coupons to consumers. Says Leebaw: "The ultimate cost will depend upon the number of people seeking compensation. Based on our best assessment, the ultimate cost will be modest, far less than $860 million. We don't see it having a financial impact on J&J or Vistakon."

O.D. NOTEBOOK
PEOPLE AND PROMOTIONS

BVI member speaks at Harvard Conference on children's vision. Thirteen distinguished speakers gathered for "An Educational Barrier We Can Actually Eliminate: Visual Problems of Children in Poverty and Their Interference with Learning" at the Harvard University Graduate School of Education. One of the featured speakers was Joel Zaba, O.D., a Better Vision Institute Advisory Council member.

ICON executives switch around. Ernest B. Remo has resigned as a director of Lasik Vision, a newly acquired subsidiary of ICON Laser Eye Centers, and Ghassan Barazi resigned as Lasik Vision's CEO. Barazi remains ICON's president/CEO, while Remo, also an ICON director, has been appointed chairman, replacing Simone Mencaglia, who resigned as chairman but remains ICON's CEO and a director.

E-dr. appoints top executive. E-dr. recently named Lou Fouts as president and CEO of the company. Fouts was formerly vice president of business development for e-dr.

Corning welcomes new manager. Corning Incorporated Ophthalmic division recently announced that Yvonne Gleek has joined the division as its Lens Manufacturer Development Manager, reporting to Lorell Stewart.

CooperVision names manager. CooperVision has named Krist Jani manager, Authorized Distributors. Mr. Jani will lead the company's efforts with its Authorized Distributor network.

VISX announces promotions. Elizabeth H. Davila, president and COO of VISX, has been promoted to CEO. According to VISX, Mark Logan, CEO and chairman since 1994, will continue as chairman until the board of directors' next annual meeting.
The company also promoted Douglas H. Post from vice president of operations to executive VP, operations.

"Person of Vision" for 2001 honored. Prevent Blindness/New York honored Claudio Gottardi, president and CEO of Safilo USA, as the 2001 "Person of Vision" at its annual reception on March 22 at The Sky Club in New York's Met Life Building.

COMPANY NEWS

CIBA-B&L lawsuit resumes. CIBA Vision Corporation's lawsuit against Bausch & Lomb for infringement of its extended wear contact lens patent and trademarks has been restarted by a ruling in the Gainesville, Georgia Federal District Court.
CIBA Vision originally filed the lawsuit in March 1999, claiming that B&L's PureVision contact lenses infringe on it's own patents that protect its Focus Night & Day product. CIBA Vision is looking to have the Court prohibit B&L from continuing to sell its infringing product.

Vista Eyecare metamorphosis. Vista Eyecare has been operating under Chapter 11 bankruptcy protection since April 5. The reason for the company's current status is that it suffered a net loss of $139.9 million for 2000, compared to a $17.6-million loss in 1999.
Vista Eyecare, which originally began operations as National Vision Associates Ltd., plans to change its name again after emerging from Chapter 11 bankruptcy protection sometime in the second quarter. The new name will be National Vision Inc.

VSP makes donation. Vision Service Plan (VSP) donated $75,000 to Operation Bright Start, a program of the American Foundation for Vision Awareness. The money will be used in part to support education of parents about the importance of comprehensive eye exams for children as young as 6 months old. The funding will also be used to develop an educational video for doctors who require more training on proper techniques for examining infants and young children.

WJ files suit against CooperVision for contact lens patent infringement. CIBA Vision Corporation recently announced that its subsidiary, Wesley Jessen Corporation, filed a lawsuit against CooperVision, Inc.
Specifically, the lawsuit makes the claim that CooperVision's Frequency Colors contact lenses infringe on the existing patents that protect Wesley Jessen's FreshLook brand of contact lenses.
CIBA Vision is seeking to have the California Federal District Court prohibit CooperVision from selling its infringing product.

NEW APPROVALS

First One-Bottle, No Rub Lens Solution

CIBA Vision received approval from the FDA for its new contact lens cleaning and disinfecting solution, AOSEPT Clear Care. The product's advantages include being the first one-bottle, no rub, preservative-free lens care solution. It will be available later this year.

New Diagnostic Instrument

The OPD-Scan diagnostic system, an instrument that measures optical aberrations, was granted 510(k) clearance by the FDA. Manufactured by Nidek, Inc., the OPD-Scan (optical path difference) combines dynamic skiascopy technology and placido disk corneal topography to map the eye's aberrations. As a result, the machine plots more than 1,400 power points on the cornea out to about 6 mm, giving you a true power map of the cornea in addition to the patient's prescription. It also measures corneal topography in less than 1 second during the same examination. For more information, see the department "Instrumental Strategies" in our April issue.

First Multifocal Daily Disposable Approved

Focus Dailies Progressives just gained FDA approval. CIBA Vision's lens is the first single-use lens for presbyopic correction. The company expects to offer the lens later this year. The lenses will be available in +5.00D to -6.00D in 0.25D steps, and they'll have an 8.6-mm base curve and 13.8-mm diameter.

New Soft Toric Lens

Ocular Sciences introduced its new disposable soft toric lens, the Biomedics Toric. The lens design hinges on four key elements: a horizontal iso-thickness ballast; a wide ballast band; a constant ramp angle and edge design and a smooth and continuous surface.

Lens Benefits Seasonal Allergy Sufferers

Focus Dailies, CIBA Vision's single-use lenses, can claim to be the only contact lens that helps seasonal allergic conjunctivitis (SAC) sufferers to experience fewer days of burning and redness if they wear the lens versus their usual lenses.

The FDA designated Focus Dailies as the only contact lens that can make this claim after reviewing research results from 112 SAC patients. The research showed Focus Dailies wearers:

• had a reduction in burning and redness compared to those who wore a new pair of their usual contact lenses
• had more symptom-free days
• had a history of always experiencing SAC symptoms, had less watering and were able to wear the lenses longer than the other contact lenses in the study.

The study was conducted in 10 U.S. cities at the height of the allergy season last spring.