contact lens management
Acuvue Advance: Lasting Comfort
The silicone hydrogel lens uses a proprietary wetting agent, Hydraclear.

PETER VAN HOVEN, O.D.

Acuvue Advance with Hydraclear really could be the next big advance in daily wear contact lens prescribing. This lens combines features of hydrogels and silicone hydrogels to bring the best of both worlds to the daily-wear arena. Our office was fortunate to work with this lens in the 510(k) study that Vistakon conducted during the spring of 2003.

The Advance is the first silicone hydrogel that achieves wettability through the use of a proprietary internal wetting agent rather than surface modification or coating. This results in important benefits -- chief among them is comfort that lasts even for the longest day for most wearers. A contact lens that can deliver this, of course, will dramatically reduce the drop-out rate in any optometric practice.

	The Acuvue Advance should be replaced bi-weekly.

Lens lowdown

The Acuvue Advance lens is a silicone hydrogel lens made of galyfilcon A, with a 47% water content and a Dk value of 60. The uniform center thickness of 0.070 for all minus powers provides a Dk/t value of more than 85, which means that this lens will provide ample oxygen across the entire cornea and limbus, even at the thickest part of the lens. A clinical study of 15 neophyte wearers using Acuvue Advance showed that bulbar redness, lid redness and limbal hyperemia were virtually unchanged from the pre-lens wear appearance over a month of wear with bi-weekly replacement. The lens also provides Class I UV blocking -- the highest government standards for ultraviolet protection.

Technology = greater comfort

Hydraclear functions as both a humectant and a lubricant. The ability to bind moisture imparts flexibility to the bulk of the lens and provides a buffer between hydrophobic silicone and the ocular surface. So, Hydraclear not only allows incorporation of silicone to increase oxygen transmissibility without sacrificing the inherent wettability of the lens, but it does so without radically altering the stiffness or modulus of the lens. This results in a soft, flexible feel, initial comfort and the fitting characteristics of the best hydrogel lenses -- without the need to change fitting habits or ask patients to adapt to the initial comfort of the lens.

Our patients' responses to the Acuvue Advance was phenomenal -- all but two fit with the lens preferred it. The comments I heard most frequently were about increased wear time with no discomfort and the easy handling. I had a list of patients who wanted to be fit with the Acuvue Advance as soon as we obtained them from Vistakon after their FDA approval. The contact lens should perform beautifully for patients who have mild to moderate dry eye. Actually, it should
perform beautifully for all patients within these parameters.

What's not to like?

The 1-2-3 punch this lens offers my practice is exciting:

1. Long-lasting comfort and high levels of patient satisfaction -- 82% to 85% of those who wore the lens in our practice's study said after one week of wear that they would purchase the product.

2. Three times the oxygen of traditional hydrogels with clinical performance shown to help keep eyes white and clear.

3. A lens that fits most patients with no change in my current fitting habits.

So who wouldn't you fit with this lens?

DR. VAN HOVEN IS IN PRIVATE PRACTICE IN BRENTWOOD, TENN. CONTACT HIM AT PVANHOVEN@PRIMARYEYECARE.COM.