contact lens management
New Choices for Comfort
Give patients the end-of-day comfort they are looking for.

In my practice, as in many others, dry eyes are a common problem associated with contact lenses. According to Fonn in 1996, an estimated 34% of contact lens wearers drop out each year, and a survey from 2002 (Young, et al.) indicates that contact lens wearers identify dryness as one of the primary reasons they discontinue use (40% of participants). In addition, contact lens patients encounter issues such as ocular allergies, side effects to systemic medications and lid disease such as meibomian gland dysfunction and posterior blepharitis.

Taking this into account, we clearly must evaluate our lens selection carefully to increase wearer satisfaction. I was looking for a lens that was easy to fit and would stand up to the product's claim of superior end-of-day comfort. I've found that contact lenses specially designed for dry eye fit the bill.

Extreme H2O 54% Xtra

LENS POWERS: 13.6mm: +6.00D to -12.00; 14.2mm: +6.00D to -10.00D; both in 0.50D steps above -6.00D MATERIAL: Hioxifilcon D (46%); water (54%) DK/T: 29 BASE CURVES: 13.6mm, 14.2mm COST: Tier pricing: $11.00 to $17.00 per six pack.

Specialty lenses hit the spot

While lecturing across the country, I always receive questions about whether silicone hydrogels are the lens of choice for dry eye patients. I've always felt this was incorrect, so I conducted an investigative masked study comparing the performance of a popular silicone hydrogel contact lens with a specialty dry eye contact lens, Extreme H2O 59% Xtra (Hydrogel Vision Corp.) and an omafilcon lens, also designed for dry eye patients. Data from 105 patients shows that the above lenses outperformed their previous lens materials. Further, the "dry eye" contact lenses, Extreme H20 and omafilcon, provided significantly more comfort, longer wear time, better Schirmer scores and TBUT (see page 97). Also, the performance of each lens significantly improved with the concomitant use of Restasis (cyclosporine, Allergan). I will present this study at the American Academy of Optometry meeting in Denver next month.

More options, better comfort

I was pleased that my results confirmed that I have been fitting a truly beneficial lens for the past five years — the Extreme H2O. Manufactured with a GMA/HEMA material called hioxifilcon A, Extreme H2O is a non-ionic lens with a water content of 59%. Both components hold very tightly to their hydrogen bonds, enabling hydration levels to remain almost unchanged during the wearing period.

Extreme H2O 54% is made with a new material called hioxifilcon D and has a water content of 54% (indicated in the name). It's available in two diameter designs. In addition to the advanced moisture retention properties, the new material offers improved durability. Not only has the lens worked very well on many of my patients who experience dryness and discomfort, but the greater durability is an upgrade from older, Group 4 lenses.

Precise fits

The two sizes (13.6mm and 14.2mm) enable me to get a more precise fit on my patients, which definitely contributes to the comfort they experience when wearing the lens. Over the past couple of months, I've fit an increased number of children in the 13.6mm lens. The smaller size lens enables me to get full corneal coverage with the least amount of material on the eye. It's great for my patients with tight lids and small fissures. I'd say that approximately 75% of my dry eye patients wear the Extreme line of lenses, and 25% of my new fits wear the new 54% lens.

It's a classic win-win

The new 54% is my first choice for first time-contact lens wearers, and for patients who are simply looking for a lens that gives them end-of-day comfort. Providing my patients with the comfort they want has brought great success to my practice. In addition to patient retention, I have received many referrals — between three and five a week — from patients wearing the lens. I am confident your success rate with Extreme H2O 54% will be as positive as mine.

DR. KISLAN IS OWNER AND MEDICAL DIRECTOR OF STROUDSBURG EYE SPECIALISTS, HAZLETON EYE SPECIALISTS AND THE DRY EYE CLINIC OF NORTHEAST PA. HE LECTURES ON DRY EYE DISEASE AND GLAUCOMA AND HAS NO FINANCIAL INTEREST IN THE PRODUCTS MENTIONED.