contact lens management

Keep Presbyopes in CL Wear

Meet the comfort, vision and fitting needs of these hard-to-please patients.

JANET M. MINT, O.D., & SUSAN NEADLE

The vast majority of monofocal contact lens wearers are low myopes. Market data gathered by Vistakon, as well as other contact lens manufacturers, indicate that these wearers are committed to remaining in contact lenses, yet by age 50, approximately 80% have dropped out.¹ We know that many of these myopic contact lens wearers have dropped out even before becoming presbyopic due to lens dryness, irritation and dissatisfaction with the provided vision.

A total of 24% of multifocal fits are successfully accomplished in just two visits, compared with nearly 90% of spherical lens fits.² In fact, the average number of visits required for a successful multifocal fit is 3.4, and even then, nearly half the fits are unsuccessful.²

The good news: I've discovered that Acuvue Oasys for Presbyopia, from Vistakon, can prevent the contact lens drop out of these patients, as it meets their comfort and vision needs, while reducing the frustration associated with fitting.

Comfort

The Acuvue Oasys for Presbyopia lens is made with the same senofilcon A material and Hydraclear Plus moisture-rich wetting agent as the Acuvue Oasys lens. In clinical trials, the average comfortable wear time was 13.2 hours — a testament to the all-day comfort this lens provides.²

Because the comfort properties of this lens are the same as the Acuvue Oasys lens, the transition for those early presbyopes already wearing the Acuvue Oasys lens into the Acuvue Oasys for Presbyopia lens is easy. Essentially, you're really just changing their prescription.

In my own practice, it's not unusual for a patient to comment on the comfort of the lens immediately upon its insertion. In fact, even at the one-week visit, patients tell me how comfortable the lens is.

Acuvue Oasys For Presbyopia MATERIAL: Senofilcon A DK/T: 147 SCHEDULE: Daily wear; may be worn for up to six nights/seven days of extended wear. RECOMMENDED REPLACEMENT SCHEDULE: Two weeks BASE CURVE: 8.4mm DIAMETER: 14.3mm PATIENT COST: Average of $45/box

Vision

This lens features Stereo Precision Technology optics, which represents the positive design aspects of ring and aspheric lens designs, while minimizing the negative aspects, such as ghost images and pupil dependence. The result: a zonal aspheric front surface and an aspheric back surface, which work in combination and leverage the eyes' natural depth of clear focus. This optical approach offers emerging and early presbyopes balanced vision near, far and in between with less dependence on illumination.

Also, the company has adjusted the lens' zone spacing, height and asphericity to account for age-related changes in pupil size and depth of focus.

In addition, Vistakon research reveals that 83% of successfully fit patients reported that the Acuvue Oasys for Presbyopia lens provides balanced near and distance vision throughout a wide range of daytime and evening activities involving varied lighting conditions.²

My own patients have told me how the lens has enabled them to effectively read under all conditions, do work on the computer and/or drive at night.

Fitting

To facilitate the fitting process of both your emerging and full presbyopic patients, Vistakon has developed a fitting tool for the Acuvue Oasys for Presbyopia lens. Specifically, the tool consists of tables that shows you how to fit the dominant/non-dominant eye by add power needed. It provides you with a first choice and then a second visit adjustment depending on whether the patient needs better near or distance vision. Essentially, the tool limits the typical fit tweaking and experimenting by identifying the lens pair that will result in the highest probability of success based on the patient's current spherical refraction, add power and eye dominance. The result: You'll successfully fit nearly six in 10 patients with the very first lens pair.²

The company created the tool from research gleaned from nine substantive crossover clinical trials involving 890 patients. Vistakon tested the complete range of all the possible combinations of lens pairs for each add on patients representative of the entire range of presbyopes.

Acuvue Oasys for Presbyopia lenses currently meet the needs of patients with cylinder < 1.0 D and an add power < 2.0 D, as they are available in distance parameters of -0.50 D to -9.00 D in 0.25-D steps and near additions of "low" and "mid." Vistakon will roll out additional parameters in the future, though no specific timetable is currently available.

Because the Acuvue Oasys for Presbyopia lens can meet the comfort and vision requirements of your patients, while minimizing the frustration often associated with the fitting process, you have an excellent chance of preventing your emerging presbyopic contact lens wearers from dropping out of contact lens wear. OM

1. 2008 Contact Lens Usage Generation and Engagement & HPR data

2. Vistakon Global ECP Fit Study 2006.