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Innovation and controversy’ was the theme for the 5th BCLA Pioneers Conference, as manufacturers revealed their latest products and Australian researcher Professor Nathan Efron challenged four UK speakers to a series of debates on contentious issues in contact lenses.
More than 230 delegates met in London in November for the annual half-day conference, which is free of charge and open only to British Contact Lens Association members.
Co-hosts Professor Efron and Nigel Burnett Hodd, Pioneers’ organiser, opened with ‘What’s new and what’s on show today’, focusing on two slides from each of the sponsoring companies to highlight the latest lenses to be unveiled.
Six rapid-fire presentations followed on topics ranging from painted cosmetic lenses to a third-generation silicone hydrogel (SiH) lens, Clariti from Sauflon, which was launched at the conference. Clariti is a high water, low modulus lens for daily wear, with no surface treatment or wetting agent.
For CIBA Vision, Jayne Schofield described the search for biomimesis and the manufacturing processes and materials that created the surface properties of the Dailies AquaComfort Plus and Air Optix Aqua lenses. Air Optix Aqua MultiFocal, launched this month, is the latest design to incorporate this technology.
David Ruston’s innovation was Johnson & Johnson’s 1-Day Acuvue TruEye, the first daily disposable SiH lens, which had brought an end to compromise in daily disposable prescribing. Ruston also announced that the UK’s Vision Care Institute would open in Berkshire in 2009.
Lynne White described the use of UltraVision’s lathe-cut KeraSoft 3 and Kerasoft IC SiH lenses on highly irregular corneas. High water content SiH lenses masked distortion, retained water content and so delivered comfort and good vision, even for advanced cases of keratoconus.
Steve Lennox of Cantor and Nissel was investigating the possibility of making cosmetic lenses from lathe-cut SiHs. These were early days in the product’s development but he called on delegates with suitable patients needing prosthetic lenses to take part in clinical trials.
Sophie Taylor West reviewed the SynergEyes lens from No 7 Contact Lens Laboratories. This new hybrid design from the US consists of a rigid gas-permeable centre with a Dk of 100 and a strongly bonded soft skirt. Three ranges are currently available: advanced, keratoconus and post-surgery.
Roy Hampson was first introduced to contact lens fitting by Josef Dallos in 1964, working with moulded glass haptic lenses. His latest interest was in large-diameter 14.0mm RGPs for highly irregular corneas, high ametropia and those with low tolerance to standard GPs. The SoClear lens was a large FLOM-type GP, again available from No 7.
In contrast to these latest innovations, the programme also included a historical element as tribute was paid to the pioneering inventor of the soft lens, Otto Wichterle, who died 10 years ago.
Richard Pearson showed footage of the life of the Czech polymer chemist, against a background of the political and social upheaval of the time.
Pearson went on to describe the key role Wichterle played in establishing democracy in Czechoslovakia following the Prague Spring of 1968.
Wichterle’s contribution to the industry and profession will be among those described by contact lens historian Tim Bowden in the first comprehensive book on the history of contact lenses, which is published this month.
Mini-debates
The remainder of the afternoon session featured a series of mini-debates (see summaries in panel) in which Professor Efron challenged four of the UK’s best presenters to debate controversial topics. Each had just seven minutes to defeat his position.
Votes were taken before and after the presentations using interactive technology, a highly effective way of involving a well informed audience of BCLA members.
The contention that ‘We don’t need rigid lenses anymore’, opposed by lens designer Tony Hough, revealed strong support for RGP lens fitting as Efron’s argument failed to persuade the audience.
Views on ‘Orthokeratology is a waste of time’ were more divided and ortho-K advocate Shelly Bansal’s vigorous defence of the technique polarised opinion still further.
Delegates were undecided on whether ‘Flux is better than Dk for describing contact lens performance’ but backed arguments from Efron’s former colleague Dr Philip Morgan in favour of Dk as the more accepted and clinically relevant measure. Morgan later revealed his own preference was for flux rather than Dk.
Efron’s case that ‘There is no such thing as CLPU’ also failed to hold sway, as the audience sided with Brian Tompkins’ view that it was a recognisable condition that could be differentiated from microbial keratitis.
The SiH revolution
In the 5th BCLA Pioneers Lecture that followed, Professor Efron described ‘The silicone hydrogel contact lens revolution’, outlining the latest studies and prescribing trends worldwide.
Since the introduction of these lenses in 1999, a new SiH material had been launched each year, with three new lenses in 2008 alone: CooperVision’s Avaira, J&J’s TruEye and the latest addition, Clariti.
SiH lenses had taken about a third of the market in the UK but the uptake was low compared with many countries. An interactive vote showed that cost was the primary reason for delegates not fitting the lenses, followed by reduced comfort and poor wetting.
Almost all delegates had seen solution-related corneal staining with SiH lenses but most reported this was an occasional or infrequent problem. Asked to vote for the most important criteria for choosing between SiH lenses, they cited modulus, surface wettability and design.
Value-added technologies in prospect for future SiH lenses were: antibacterial and anti-inflammatory lenses; lenses with channels, patterns and grooves to improve blink-induced post-lens tear exchange; and enhanced surfaces that would be more lubricious.
Sponsors for the BCLA Pioneers Conference were Cantor & Nissel, CIBA Vision, CooperVision, David Thomas Contact Lenses, Johnson & Johnson Vision Care, Sauflon Pharmaceuticals and Topcon. The 2009 Pioneers events will take place in November.