In this second summary of key moments at this year’s BCLA conference, Optician reports on developments in presbyopia correction and maintenance of the optimal wearing environment
There is no doubt that contact lens correction of presbyopia has made major strides forward in recent years and this was reflected at this year’s BCLA, both in the lectures and research programme and the exhibition.
Presbyopia correction is no longer a matter of preparing the patient for monovision. Indeed, in one research finding presented, researchers found greater areas of focus in the intermediate and near zones for multifocal contact lens vision correction in comparison to monovision correction. Lead researcher Dr Robert Montes-Mico (Valencia) confirmed: ‘Our results suggest that multifocal contact lenses provide better visual performance than monovision for established presbyopes.’
Fortunately, the options for multifocal correction were significantly expanded by the launch at the conference of the much anticipated Johnson & Johnson 1-Day Acuvue Moist Multifocal for which pre-launch trials had been rumoured to reflect excellent vision and comfort results. Delegates flocked to the stand to try out the lens for themselves.
Any remaining concern from some practitioners that prescribing multifocals is complicated may be assuaged by the new addition to the CooperVision app which allows you to input refractive error and immediately offers initial trial lens options.
Safilens may be a new player to the UK market but there is considerable interest in the new Fusion 1-Day Presbyo. The incorporation of hyaluronic acid into the material bodes well for the more compromised presbyopic tear film of potential wearers, and the ‘reverse pinhole’ design allows a single dioptric specification to offer excellent distance, intermediate and near vision by relocation of the circle of least confusion at the retina. A detailed look at the optics of this lens will appear in a future issue of Optician.
[CaptionComponent="1594"]The Alcon Air Optix Colors lens has improved cosmetic results by additional pigment in the (lotrafilcon B) silicone hydrogel material. Archana Rao reported the results of a study using scanning electron microscopy and x-ray photoelectron spectroscopy to confirm that the added pigment does not affect the total amount of oxygen reaching the eye.
Opportunities
Scope invited delegates to a discussion session where well-known panellists Brian Tompkins, Scott Mackie and Sarah Farrant were encouraged by moderator Ian Cameron to share their experience of setting up dedicated clinics for dry eye and lid management. The main message that came across was that any concerns about differential pricing, popularity with patients and management of patient expectations were best addressed by ‘just do it and you will be impressed by the results’. Further guidance on setting up specialised clinics will be published in the coming weeks.
Exhibition
The LipiView II instrument attracted many delegates who were able to have their tear film analysed along with an assessment of their meibomian gland patency. The quick and non-invasive process offers excellent visualisation of the tear constituency along with representation of any meibomian gland dropout. Look out for a full review in the coming weeks.
Research
Following on from a discussion at last year’s event, Professor James Wolfssohn and Ian Cameron reviewed some of the feedback from practitioners with low dropout rates to see if any overall message could be gleaned. Asked to reveal their strategies for retaining new lens wearers, the practitioners engaged in the study who had very low dropout rates reported that they:
- Make sure they understand the new wearers’ contact lens needs and expectations
- Establish a good rapport with the wearers, engaging them in a partnership and encouraging their input into their own decision-making when it comes to lens wear
- Set wearers up with a ‘contact lens buddy’ from within the clinical support team, who can advocate for them and be more accessible to respond to questions and concerns
- Follow up quickly after fitting and schedule regular six-month check-in visits.
All of these strategies focus on maintaining good communication with patients, inviting input and checking in often.
In a useful review of meibomian gland disease management, Dr Jennifer Craig (Auckland) compared an eye mask containing disposable warming units (EyeGiene) and a microwavable flaxseed eye bag (MGDRx EyeBag) and found both methods were effective in raising eyelid temperature and would be suitable for treating mild MGD. However, the flaxseed eye bag might be more effective in treating severe MGD, which was associated with a higher lipid melting temperature.