contact lens focus

A Vignette on Duette

Hybrid lens provides consistent vision and enhanced comfort

Tara Rosenzweig, Contributing Editor

A professional baseball player recently presented to the Institute for Sports Vision in Ridgefield, Conn. complaining of “inconsistent vision” with his soft toric contact lenses. Specifically, he said his vision fluctuated much too often when he was trying to read the catcher's signs and focus on the catcher's glove when releasing a pitch.

“I ended up switching him [the baseball player] into a hybrid astigmatism lens, and when he returned for follow-up, he said he was thrilled with the lens,” explains Donald Teig, O.D., the Institute for Sports Vision's director. “The patient said the hybrid lens provided him with consistent vision, that he was playing much better, and his confidence had improved since wearing it.”

Optometrist Brian Chou, of Carmel Mountain Vision Care, in San Diego, Calif., says he's successfully fit this same lens in patients with up to 4.00D of corneal toricity. “In the past, patients with that much corneal toricity would need bitoric GP lenses to achieve the best vision,” he explains. “But this hybrid lens offers flexure resistance, which enables crisp, stable vision.”

The lens to which Drs. Teig and Chou are referring is the Duette Hybrid Contact Lens for Astigmatism, from SynergEyes, Inc. The lens, comprised of a patent-pending, silicone hydrogel skirt and proprietary hyper-DK, flexure-resistant RGP center, is rotationally symmetric and provides corneal astigmatism correction sans inconsistent axis shift, the company says. Specifically, it uses the patient's lacrimal layer to decrease aberrations and enhance optical performance, SynergEyes Inc. says. In addition to providing consistent vision, the lens also affords comfort, ease of fitting and practice benefits, according to those interviewed.

Comfort

The new reverse geometry design of the Duette lens incorporates a junction lift area, which corresponds to the peripheral curve area of an RGP, with slightly more modest lift. It has a flatter radius than the skirt curve and lifts the hybrid junction and the RGP portion of the lens completely off the cornea. These design features improve wearing comfort, simplify removal and allow for all-day tear flow and movement, the company says. Further, SynergEyes' patent-pending surface treatment, HealthyEyes, increases wettability, maximizing comfort—something Michael DePaolis, O.D., of Visionary Eye Associates, in Rochester, N.Y., has seen first-hand:

“I recently saw a patient who tried GP lenses—which gave her great vision, but chronic dryness and attending redness. From there, I fit her in four different soft toric lenses—some of which caused a dry eye problem and others inconsistency in vision,” he explains. “She transitioned into the Duette lens very nicely,” he explains.

Ease of fitting

SynergEyes provides a fitting nomogram that determines the initial lens selection. The lens' base curve and skirt curve are independent of each other, allowing for customization to the cornea. Also, Duette's diagnostic fitting set reduces chair time, as it eliminates the need to determine proper axis and cylinder power, says Dr. DePaolis.

“Don't let any prior negative experiences with specialty lenses sway you from trying to fit this lens,” says Dr. DePaolis. “The Duette's nomogram and the fitting guide are very straightforward.”

(See “Duette Hybrid Contact Lenses for Astigmatism: Fitting Guide and Tips for Achieving Success,” www.fitsynergeyes.com/documents/DuetteFittingGuideSinglesDec2010.pdf.)

Practice benefits

Offering the Duette lens can help set your practice apart from other practices, says Dr. Teig. “In a highly competitive eyecare industry, as a private practitioner, the ability to offer something unique that's very cutting edge and meets patients' needs is a big benefit,” he says.

Dr. DePaolis adds that his high success rate with the Duette lens has prompted several referrals.

“Those patients who have special needs that you're able to solve typically become not just patients for life but a very viable referral source,” he says.

Dr. Chou adds, “Commodity contact lenses seem to engender a product-patient relationship in which any prescribing doctor will do. This isn't the case with this lens.” OM

Duette Hybrid Lens for Astigmatism

MATERIALS: Petrafocon A (center) and hem-larafilcon A (skirt) WATER CONTENT: 32% (skirt) RECOMMENDED REPLACEMENT SCHEDULE: Six months BASE CURVES: 7.1mm to 7.9mm in 0.2mm steps SKIRT CURVATURES: Flat, medium, steep DIAMETER: 14.5mm (8.4mm rigid center) PARAMETERS: +20.00 to −20.00 in eyes with astigmatism up to 6.00D SPHERE POWERS: −8.50 to −10.00 in 0.50D steps; +2.00 to −8.00 in 0.25D steps; +2.25 to +4.00 in 0.50D steps; −10.50 to −12.00 in 0.50D steps.

TARA ROSENZWEIG IS A FREELANCE WRITER AND FORMER EDITOR OF EYECARE BUSINESS MAGAZINE (A SISTER PUBLICATION OF OPTOMETRIC MANAGEMENT) WHO LIVES IN THE PHILADELPHIA AREA. E-MAIL HER AT TARA.ROSENZWEIG@VERIZON.NET, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.