SLICK OPTIONS FOR THE RGP SURFACE

MELISSA BARNETT, OD, FAAO, FSLS, FBCLA

HISTORY OF LENSES

GP LENS CHARACTERISTICS

MATERIAL CHEMISTRY

POLYMERIZATION

PMMA

EVOLUTION OF GP MATERIALS

SURFACE PROPERTIES

ARTIFICIAL EYE MAKINGORIGINATED IN EGYPT AROUND 2000 BC TO ENSURE THAT EGYPTIANS COULD SEE IN THE AFTERLIFE

GRADUALLY SPREAD THROUGHOUT EUROPE

BIG BUSINESS!

EYE DAMAGE AND EYE LOSS VERY COMMON DUE TO FREQUENT, SEVERE EYE INFECTIONS

DUE TO POOR HYGIENE

NO ANTIBIOTICS

EMERGING INDUSTRIAL PROCESSES USING LIME AND HOT METALS

NO PROTECTIVE EYEWEAR

CLEAR GLASS SHELLS

1859

WILLIAM WHITE COOPER, LONDON OPHTHALMOLOGIST

GLASS MASKS MADE UP BY ARTIFICIAL EYE MAKERS GRAY AND HOLFORD OF LONDON

SEPARATE THE CORNEA FROM THE LIDS IN CASES OF SYMBLEPHARON

SIMILAR TO SCLERAL LENSES

LACKING AN OPTIC ZONE OVER THE CORNEA

FIRST SCLERAL LENSES

1887

FIRST SCLERAL LENSES MADE BY FREDRICH A. MULLER AND ALEBERT C. MULLER

ARTIFICIAL EYE MAKERS FROM WIESBADEN, GERMANY

PROTECTIVE SHELL WITH A CLEAR CORNEA

BLOWN GLASS CONTACT LENS

THE FIRST CONTACT LENS EMERGED

1888-1889

ADOLF EUGEN GASTON FICK

GERMAN OPHTHALMOLOGIST IN ZURICH

HAD GLASS SCLERAL LENSES MADE BY PROFESSOR ERNST ABBE AT CARL ZEISS IN JENA

ABBE DEVELOPED THE FIRST ZEISS CONTACT LENSES FROM GLASS PRODUCED BY OTTO SCHOTT, THE SON OF A FAMILY OF GLASS MAKERS

FIT CONTACT LENSES TO IRREGULARLY SHAPED CORNEAS

EUGENE KALT

1889

OPHTHALMOLOGIST IN PARIS

CONTACT LENSES AS “ORTHOPEDIC APPLIANCES” IN THE TREATMENT OF KERATOCONUS

OBSERVED THAT THE CONTACT LENS CHANGED THE SHAPE OF THE CORNEA

LAYED THE GROUNDWORK THAT LED TO ORTHOKERATOLOGY AND TO CONTACT LENSES BEING CONSIDERED AS A MEANS OF MYOPIA CONTROL

AUGUST M LLER1889

FINAL YEAR MEDICAL STUDENT

KIEL GERMANY

DISSERTATION ENTITLED “SPECTACLE LENSES AND CORNEAL LENSES” INCLUDED THE CORRECTION OF HIS OWN 14 DIOPTERS OF MYOPIA WITH CONTACT LENSES

FIRST TIME A REFERENCE HAD BEEN MADE TO A “CORNEAL LENS”

DEVELOPMENT OF PMMA1915 - ROHM AND HASS

FIRST DEVELOPED PMMA TO USE IN PAINT AS A PAINT BINDER

1934 - CRAWFORD AND HILL

DEVELOPED AND PATENTED PMMA AS A PLASTIC

PMMA USED AS COCKPIT CANOPIES IN WWII IN UK

1938 – THEODORE OBRIG AND ERNEST MULLEN

MADE FIRST ALL PLASTIC CONTACT LENS “PLEXIGLASS” PMMA IN US

1938 – ISTVAN GY RFFY

FIRST PMMA CONTACT LENSES IN EUROPE

PMMA INTRODUCED AS A PLASTIC FOR CONTACT LENSES

Theodore Obrig

RIGID GAS PERMEABLE (RGP)1979 - FIRST MADE AVAILABLE AS AN ALTERNATIVE TO THE SOFT LENS

IRVING FATT PROVIDED RATIONALE FOR PRODUCING GAS PERMEABLE MATERIALS

STUDIED OXYGEN TENSION AND PERMEABILITY WITH JENNIFER CHASTON, FCOPTOM AND JUDITH MORRIS, FCOPTOM

1977- THE 'HARTFLEX' GAS PERMEABLE CONTACT LENS FITTING SET FROM WÖHLK-CONTACT-LINSEN

FIRST TYPE OF HARD GAS PERMEABLE LENS MANUFACTURED BY COMPRESSION MOULDING FROM CELLULOSE ACETATE BUTYRATE (CAB)

LAUNCHED IN THE UK

Irving Fatt

ARE CORNEAL LENSES DEAD?

“SCLERAL AND CORNEAL RIGID LENSES REPRESENTED 100% OF THE CONTACT LENS MARKET IMMEDIATELY PRIOR TO THE INVENTION OF SOFT LENSES IN THE MID-1960S.”

IN THE UNITED KINGDOM TODAY, RIGID LENSES COMPRISE 2 PER CENT OF ALL NEW LENS FITS.

THE 1998 PREDICTION OF THE AUTHOR THAT RIGID LENSES WOULD BE OBSOLETE BY THE YEAR 2010 HAS ESSENTIALLY TURNED OUT TO BE CORRECT.

RIGID LENSES ARE NOW BEING FITTED BY A MINORITY OF PRACTITIONERS WITH SPECIALIST SKILLS/TRAINING.

“CERTAINLY, RIGID LENSES CAN NO LONGER BE CONSIDERED AS A MAINSTREAM FORM OF CONTACT LENS CORRECTION.”

Efron N. Obituary--rigid contact lenses. Cont Lens Anterior Eye. 2010 Oct;33(5):245-52. doi: 10.1016/j.clae.2010.06.009. Epub 2010 Jul 31.

“NEW FITTINGS ARE INDEED VERY MUCH A SPECIALIST, MINORITY AREA BUT THERE STILL REMAIN AROUND THE WORLD LARGE NUMBERS OF PERFECTLY SUCCESSFUL HARD LENS WEARERS SUPPORTED BY NUMEROUS EQUALLY SUCCESSFUL HARD LENS LABORATORIES”.

- ANDREW GASSON

Gasson A. A response to Nathan Efron. Cont Lens Anterior Eye. 2011 Jun;34(3):149; author reply 150. doi: 10.1016/j.clae.2011.02.015. Epub 2011 Mar 26.

WHICH ARE DO YOU FEEL HAS THE GREATEST POTENTIAL FOR GROWTH IN THE NEXT 12 MONTHS?

“THE SCLERAL EXPLOSION CONTINUES”ED BENNETT, OD, MSED, FAAO CL SPECTRUM OCTOBER 2016

THE EVOLUTION OF RGP MATERIALS 1978 – CELLULOSE ACETATE BUTYRATE

POOR O2 TRANSMISSION AND PRONE TO WARPAGE

1979 – SILICONE/ACRYLATE MATERIAL SILICONE: O2 PERMEABILITY; METHACRYLATE ACID: WETTABILITY

DK 12-60

SIGNIFICANT PROTEIN DEPOSITION

EASILY BROKEN, SCRATCHED

FLEXURE AND PARAMETER INSTABILITY

1987 – FLUOROSILICONE ACRYLATE MATERIAL FLUORINE IMPROVES WETTABILITY AND MAINTAINS O2 PERMEABILITY

MORE FLEXURE AND SURFACE SCRATCHES THAN PMMA

DK 40-100+

MORE DEPOSIT RESISTANT

MANUFACTURING PROCESS OF A BLANK CAN TAKE UP TO 4 TO 6 WEEKS

FIRST STAGE OF THE MANUFACTURING PROCESS

1. POLYMER MIXING PROCESS

2. BATH POLYMERISATION

3. OVEN ANNEALING

SECOND STAGE

QUALITY CONTROL AND FINISHING

Images courtesy of Contamac

WHEN THE MONOMER MIX IS READY

FED INTO ONE OF TWO MOULD TYPES

HERITAGE TRADITIONAL TRAY PROCESS

ROD MOULDS

Images courtesy of Contamac

TRADITIONAL TRAY PROCESS

AFTER SECOND OVEN ANNEALING, MATERIALS MOVE ONTO THE FINISHING STAGE

THE BLANKS PASS THROUGH THE FIRST QUALITY CHECK POINT

IF THEY PASS, THEY MOVE ONTO TRIMMING LINES

PROCESS OVER 30 YEARS OLD

ROD BLANK POLYMER MOLDING

ALTERNATIVE AND NEWER TYPE OF MOULDING PROCESS

BENEFIT IS EFFICIENCY OF REPRODUCIBILITY AFTER POLYMERISATION

RODS ARE CUT INTO THEIR SPECIFICATIONS BY CUSTOM DESIGNED LATHES

Images courtesy of Contamac

THE COMBINED MONOMER MIXING PROCESS AND BATH POLYMERISATION CAN TAKE UP TO 7 DAYS

NEXT, POLYMERISED MATERIAL GOES INTO OVENS FOR ANNEALING

OVEN ANNEALING TAKES UP TO 5 DAYS

OVEN ANNEALING REMOVES ALL RESIDUAL/UNREACTED MONOMERS

ALL BLANKS HAVE TO GO THROUGH A SECOND HEAT PROCESS TO FORGO STRESS

Images courtesy of Contamac

GP MATERIAL CHARACTERISTICS OXYGEN TRANSMISSIBILITY

WETTABILITY

SURFACE PROPERTIES

SCRATCH RESISTANCE

DEPOSIT RESISTANCE

SURFACE TREATMENTS

REFRACTIVE INDEX

STABILITY / RIGIDITY / DURABILITY

MODULUS

COEFFICIENT OF FRICTION / LUBRICITY

UV & OPTICAL TRANSMISSIBILITY

SPECIFIC GRAVITY

KEY PERFORMANCE AREAS

WETTABILITY

STABILITY

OXYGEN PERMEABILITY

WETTABILITY

STABILITY

OXYGEN PERMEABILITY

SURFACE WETTABILITYDETERMINED BY THE WETTING ANGLE OR CONTACT ANGLE

ANGLE FORMED WHEN A DROP OF LIQUID IS PLACED ON THE SURFACE

DEFINES THE ABILITY OF MOISTURE TO SPREAD

AROUND 90° FOR ALL GP BLANKS

No Wetting Poor Wetting Good Wetting Perfect WettingPhoto Credit: Weistron Co., LTD

CONTACT LENS WETTABILITY

WETTABILITY – REFERS TO HOW EASILY A LIQUID SPREADS OVER THE SURFACE OF A CONTACT LENS

CLINICALLY – OBSERVED BY VIEWING THE INTERACTION BETWEEN THE TEARS AND THE LENS SURFACE.

IN THE LAB – IN VITRO WETTABILITY CAN BE QUANTIFIED BY MEASURING THE “CONTACT ANGLE.”

CONTACT ANGLE

ANGLE FORMED BETWEEN A DROP OF LIQUID AND THE SURFACE OF THE LENS

SMALL CONTACT ANGLES

ASSOCIATED WITH AN INCREASED ABILITY OF THE TEARS TO SPREAD OVER THE SURFACE OF A CONTACT LENS1-3

LEAD TO A MORE STABLE TEAR FILM1-3

A CONTACT ANGLE OF 0˚ = A COMPLETELY WETTABLE SURFACE4, 5

1. Lin MC, Svitova TF. Contact lenses wettability in vitro: Effect of surface-active ingredients. Optom Vis Sci 2010;87: 440-7.2. Maldonado-Codina C, Morgan PB. In vitro water wettability of silicone hydrogel contact lenses determined using the sessile drop and captive bubble techniques. J Biomed Mater Res A 2007;83: 496-502.3. Tonge S, Jones L, Goodall S, Tighe B. The ex vivo wettability of soft contact lenses. Curr Eye Res 2001;23: 51-9.4. French K. Contact lens material properties: Part 1 – Wettability. Optician 2005;230: 20-2, 4-6, 8.5. Campbell D, Carnell SM, Eden RJ. Applicability of contact angle techniques used in the analysis of contact lenses, part 1: comparative methodologies. Eye Cont Lens 2013;39: 254-62.

CONTACT ANGLE

PARTIALLY WETTABLE – GREATER THAN 0˚ TO 90˚

PARTIALLY NON-WETTING – BETWEEN 90˚ TO 180˚

COMPLETELY NON-WETTING – GREATER THAN 180˚

French K. Contact lens material properties: Part 1 – Wettability. Optician 2005;230: 20-2, 4-6, 8.

CONTACT ANGLE LAB TECHNIQUES

SESSILE DROP

CAPTIVE BUBBLE (CLMA, ISO)

WILHELMY PLATE

SESSILE DROP

SYRINGE USED TO PUT A DROP OF LIQUID ON THE SURFACE OF A CONTACT LENS.4, 5

THE CONTACT ANGLE IS THE ANGLE CREATED BETWEEN THE SURFACE OF THE CONTACT LENS AND THE DROPLET.

IMAGES OR VIDEOS ARE RECORDED AND ANALYSED WITH COMPUTER SOFTWARE.5

METHOD CAN ALSO MEASURE STATIC AND DYNAMIC CONTACT ANGLES

Examples of a contact lens with (A) A low contact angle ( ) and good wettability(B) A higher contact angle (C) A high contact angle with poor wettability

French K. Contact lens material properties: Part 1 – Wettability. Optician 2005;230: 20-2, 4-6, 8.Campbell D, Carnell SM, Eden RJ. Applicability of contact angle techniques used in the analysis of contact lenses, part 1: comparative methodologies. Eye Cont Lens 2013;39: 254-62.

CAPTIVE BUBBLE

CONTACT LENS IS SUBMERGED IN LIQUID (TYPICALLY WATER)

SYRINGE PLACES A SMALL AIR BUBBLE OR ANOTHER LIQUID WITH A LOWER DENSITY ON THE SURFACE OF THE LENS.4, 5

THE CONTACT ANGLE IS THE ANGLE FORMED BETWEEN THE SURFACE OF THE CONTACT LENS AND THE AIR BUBBLE.

French K. Contact lens material properties: Part 1 – Wettability. Optician 2005;230: 20-2, 4-6, 8.Campbell D, Carnell SM, Eden RJ. Applicability of contact angle techniques used in the analysis of contact lenses, part 1: comparative methodologies. Eye Cont Lens 2013;39: 254-62.Special Edition 2011. Exploring the Science and Technology of Contact Lens Comfort. Contact Lens Spectrum. September 2011.

Dynamic captive bubble technique measuresthe contact angle between an air bubble anda CL surface in an aqueous environment.6

WILHELMY PLATE TECHNIQUE

PROVIDES MORE DATA THAN OTHER METHOD

REQUIRES A LARGE VOLUME OF PROBE LIQUID

DIFFICULT

ACQUIRING AND ANALYSING THE DATA – TIME CONSUMING

RESULTS ARE ACCURATE AND REPRODUCIBLE

Campbell D, Carnell SM, Eden RJ. Applicability of contact angle techniques used in the analysis of contact lenses, part 1: comparative methodologies. Eye Cont Lens 2013;39: 254-62. Uyama Y, Inoue H, Ito K, Kishida A, Ikada Y. Comparison of different methods for contact angle measurement. J Colloid Interface Sci 1991;141: 275-9.

Image http://latexconsultants.blogspot.com/2015/07/study-of-effects-of-surface-tension-in.html

Image credit Contamac

PLASMA TREATMENTFINISHED LENS BOMBARDED WITH HIGH-ENERGY RADIO WAVES IN AN OXYGEN-RICH ENVIRONMENT

GP LENS SURFACE UNDERGOS RADIOFREQUENCY IONIZED OXYGEN THAT MAKE HYDROPHOBIC SURFACES MORE HYDROPHILIC

EXOTIC OXYGEN RADICALS STRIKE THE SURFACE OF THE LENS

DISLODGES HYDROCARBONS SUCH AS OILS

MOLECULES ON THE SURFACE OF THE LENS ARE REARRANGED

CARBON MIGRATES AWAY FROM THE SURFACE

OXYGEN AND NITROGEN MIGRATE TOWARD THE SURFACE

THE LENS SURFACE BECOMES IONIZED, INCREASING ITS ABILITY TO ATTRACT LIQUIDS

PLASMA TREATMENTRESULTS IN

IMPROVED WETTING ANGLE

IMPROVED SURFACE TENSION

FEWER LIPID, PROTEIN AND BACTERIA DEPOSITS

IMPROVES SURFACE WETTABILITY

LESS LENS AWARENESS

IMPROVED COMFORT

REDUCED FOGGING

PLASMA TREATMENT

ALMOST STANDARD OF CARE

EFFECTIVELY REMOVES RESIDUE FROM MANUFACTURING PROCESS

IMPROVES ON-EYE WETTABILITY AND COMFORT

FDA APPROVED FOR ALL MATERIALS

PJ Plasma System

Photo Credit: Bausch & Lomb

PLASMA TREATMENT

HAS BEEN SHOWN TO REDUCE THE WETTING ANGLE TO <20°

CREATES A MORE HYDROPHILIC LENS SURFACE

NOT A LENS COATING

THINK OF IT AS A “SUPER SURFACE CLEANING”

Photo Credit: Dr. Chrysostomou

Wetting angle before and after plasma treatment

TFOS DEWS II REPORT

“MULTIFACTORIAL DISEASE OF THEOCULAR SURFACE CHARACTERIZEDBY A LOSS OF HOMEOSTASIS OFTHE TEAR FILM AND ACCOMPANIEDBY OCULAR SYMPTOMS, IN WHICHTEAR FILM INSTABILITY AND HYPER-OSMOLARITY, OCULAR SURFACEINFLAMMATION AND DAMAGE, ANDNEUROSENSORY ABNORMALITIESPLAY ETIOLOGICAL ROLES.”

DEWS II PREVALENCE

DED PREVALENCE FOR STUDIES INVOLVING SYMPTOMS WITH OR WITHOUT SIGNS 5% TO 50%

UP TO 75% FOR STUDIES BASED PRIMARILY ON SIGNS (HIGHER AND MORE VARIABLE RATES)

REVIEW OF 437 PREVALENCE STUDIES

PREVALENCE OF DED FROM 24 LARGE STUDIES

DRY EYE SYNDROME

PREVALENCE IS MUCH HIGHER AMONG WOMEN

AGING IS A RISK FACTOR

SEX HORMONES ARE KEY FACTORS

CHANGING HORMONE LEVELS / DECREASED ANDROGENS ARE CONTRIBUTORY

MAJOR INDICATIONS FOR SCLERAL LENSES

CORNEAL IRREGULARITY

OCULAR SURFACE DISEASE

IMPROVED COMFORT

PROTECTION OF THE OCULAR SURFACE

REFRACTIVE CORRECTION

SCLERAL LENS INDICATIONS

SEVERE DRY EYES GRAFT VERSUS HOST DISEASESJÖGREN’S SYNDROMESTEVENS JOHNSON SYNDROMENEUROTROPHIC KERATOPATHY

“INCREASING APPRECIATION THAT DAILY WEAR OF A RIGID GAS PERMEABLE SCLERAL LENS MAY PLAY AN IMPORTANT ROLE IN THE MANAGEMENT OF MODERATE TO SEVERE DED.”

THE USE OF SCLERAL LENSES FOR OSD IS MORE WIDELY REPORTED IN A VARIETY OF REVIEWS.

CLINICAL STUDIES REPORT SUCCESS IN THE MANAGEMENT OF DED WITH SCLERAL LENSES, MINI-SCLERAL LENSES AND PROSE DEVICES.

www.sclerallens.org

POOR SURFACE WETTABILITY

DECREASES VISION

DIMINISHES LENS COMFORT

INCREASES CHAIR TIME

INCREASES PATIENT COSTS

Photo Credit: Karen Lee, OD

PATIENTS AT RISK

OCULAR SURFACE DISEASE

OCULAR ROSACEA

MGD

FILAMENTARY KERATITIS

EXCESSIVE LIPIDS IN THE TEAR FILM CREATE A FOGGY, HYDROPHOBIC LENS SURFACE

Photo Credit: James Thimons, OD

PATIENTS AT RISK

EXPOSURE

PTOSIS

STROKE / NERVE PALSY

EYELID REPAIR

EXTERNAL CAUSES

POOR PLUNGER HYGIENE

MAKEUP/SKINCARE REGIME (OIL-BASED PRODUCTS)

HAND SOAPS WITH MOISTURIZING AGENTS

OLDER BLOCKING COMPOUNDS SUCH AS PITCH

TFOS CL DISCOMFORT CLASSIFICATION

ACCORDING TO THE TFOS EXECUTIVE SUMMARY ON CONTACT LENS DISCOMFORT

“CONTACT LENS DISCOMFORT IS A FREQUENTLY EXPERIENCED PROBLEM, WITH MOST ESTIMATES SUGGESTING THAT UP TO HALF OF CONTACT LENS WEARERS EXPERIENCE THIS PROBLEM WITH SOME FREQUENCY OR MAGNITUDE.”1

1. Nichols JJ, Willcox MD, Bron AJ, et al; members of The TFOS International Workshop on Contact Lens Discomfort. The TFOS International Workshop on Contact Lens Discomfort: executive summary. Invest Ophthalmol Vis Sci. 2013 Oct 18;54(11):TFOS7 TFOS13. Figure courtesy of TFOS

PREVENTING AND MANAGING POOR SURFACE WETTABILITY

TREATMENT STRATEGIES

INCREASED LUBRICATION WITH PRESERVATIVE-FREE ARTIFICIAL TEARS OVER THE LENS THROUGHOUT THE DAY

PHYSICAL REMOVAL

REMOVE, MANUALLY CLEAN, RINSE AND REAPPLY

SQUEEGEE TECHNIQUE

POLISH FRONT SURFACE OF LENSES BUT REMOVE PLASMA SURFACE

FIRST AND FOREMOST

TREAT AND MANAGE OCULAR SURFACE DISEASE!

LIPIDS AND MUCINS ARE ATTRACTED TO HYDROPHOBIC GP MATERIAL

PREVENTION THROUGH EDUCATION

WASH HANDS BEFORE HANDLING CONTACT LENSES

ASK PATIENTS ABOUT HAND SOAP

HAND SOAPS

MILD, BASIC HAND SOAPS

CONTACT LENS HANDSOAP

ACNE TREATMENT HAND SOAPS

ASK PATIENTS ABOUT FACE AND EYE CREAMS

PREVENTION THROUGH EDUCATION

DO NOT APPLY OIL-BASED MOISTURIZERS TO THE EYELIDS

DO NOT APPLY ANY MAKEUP TO THE INSIDE AREA OF THE EYELID MARGIN (WATERLINE) OR MEIBOMIAN GLAND ORIFICES

INCREASES RISK FOR MGD AND GLAND OBSTRUCTION OVER TIME

APPLY CREAMS AND MAKEUP AFTER LENS INSERTION

REMOVE CONTACT LENSES, THEN REMOVE MAKEUP

Image O’Dell, Sullivan, PerrimanAOC January 2017

PREVENTION THROUGH PATIENT EDUCATION

USE EYELINER PENCILS – SHARPEN THEM BEFORE EVERY APPLICATION

REPLACE MOIST COSMETICS (MASCARA) MONTHLY

REMOVE MAKEUP DAILY

NEVER USE FACIAL CLEANSERS OR HAND SOAP TO REMOVE EYE MAKEUP

CLEAN EYE MAKEUP BRUSHES REGULARLY

O’Dell, Sullivan, Perriman AOC January 2017

USE PARABEN-FREE POWDER EYE SHADOW THAT HAS A HIGH CLING AND IS NOT EASILY TAPPED OFF THE APPLICATOR OR BRUSH (KNOWN AS FALLOUT)

ALTERNATIVELY, USE A PARABEN-FREE AND RETINOL-FREE SHADOW BASE (PRIMER) OR A PARABEN-FREE CREAM-BASED EYE SHADOW TO PREVENT FALLOUT INTO THE TEAR FILM

USE PARABEN-FREE AND FORMALDEHYDE-FREE EYELINER PENCILS

AVOID THE EYELASH ROOTS AND LID MARGINS – MAY CAUSE SUPERFICIAL OBSTRUCTION OF THE GLANDS

O’Dell, Sullivan, Perriman AOC January 2017

SOLUTIONS

CHANGE TO PEROXIDE BASED SOLUTIONS

CONSIDER ENZYMATIC CLEANER / MENICON PROGENT

IF DEPOSIT-PRONE, ALTERNATE A DAILY GP LENS CLEANER WITH AN EXTRA STRENGTH OR AN ALCOHOL-BASED DAILY CLEANER

APPLICATION SOLUTIONS

Polymer encapsulates lens

Improves wettability

Increases surface water retention

Increases lubricity

Reduces deposits

PROTEIN AND LIPID DEPOSITION

SCLERAL LENS FOGGING AND COMFORT STUDYDR. MARIA WALKER-PRINCIPAL INVESTIGATOR

18 SUBJECTS

26 – 72 YEARS OLD

ALL HABITUAL SCLERAL LENS WEARERS

FOGGING IS DRAMATICALLY IMPROVED

HYDRA-PEG IMPROVES END OF DAY COMFORT

PATIENTS PREFER HYDRA-PEG LENSES

PARTNER LAB - END OF DAY COMFORT STUDY

Falco Linsen, Switzerland

n = 34 eyes n = 11 eyes

PARTNER LAB – WEAR TIME AND PREFERENCE

Hetych Kontaktlinsen, Austria

WHICH WOULD YOU CHOOSE FOR YOUR PATIENT?

TANGIBLE HYDRA-PEG: PATIENT EDUCATION

EDUCATE PATIENTS THAT THE TANGIBLE HYDRA-PEG SURFACE WILL RESULT IN A MORE “SLIPPERY” LENS

MAY REQUIRE A BRIEF ADJUSTMENT PERIOD FOR HANDLING, INSERTING AND REMOVING THE LENS

TANGIBLE HYDRA-PEG: PATIENT SELECTIONMAY BE USED BY ANY PATIENT

NO CONTRAINDICATIONS

NO NEED FOR FIT CHANGES

PATIENTS WHO MAY BENEFIT THE MOST:THOSE EXPERIENCING DRYNESS OR DISCOMFORT ASSOCIATED WITH LENS WEAR

MODERATE TO HEAVY DEPOSITORS

SCLERAL LENS WEARERS EXPERIENCING FOGGING

COMPATIBLE SOLUTIONS WITH TANGIBLE HYDRA-PEGMULTIPURPOSE SOLUTIONS

MENICON UNIQUE PH

BOSTON SIMPLUS®

HYDROGEN PEROXIDE SOLUTIONSCLEAR CARE®

CLEAR CARE® PLUS WITH HYDRAGLYDE®

INCOMPATIBLE SOLUTIONSTAP WATER, ABRASIVE OR ALCOHOL-BASED CLEANERS

ABRASIVE CLEANERS

BOSTON® ADVANCE

ALCOHOL BASED CLEANERS

MIRAFLOW

OTHERS

MENICON PROGENT

BOSTON ONE STEP LIQUID ENZYMATIC CLEANER

OPTIMUM BY LOBOB ESC EXTRA STRENGTH CLEANER

TANGIBLE HYDRA-PEG BY THE NUMBERSWITH PROPER CARE, COATING LASTS 12-18 MONTHS

HYDRA-PEG WAS LAUNCHED IN JANUARY 201740,000 PATIENTS TREATED IN 2017HYDRA-PEG COATED LENSES AVAILABLE FROM 18 GLOBAL MANUFACTURERSPRICE IS MINIMAL COMPARED TO PRICE OF LENS

A d v a n c e d V i s i o nA d v a n c e d V i s i o nT e c h n o l o g i e sT e c h n o l o g i e sT e c h n o l o g i e s

®

BEFORE HYDRA-PEG

Images Tom Arnold, OD

WITH HYDRA-PEG

Image Tom Arnold, OD

HOW TO CREATE A SLICK SURFACE

TREAT AND MANAGE OCULAR SURFACE DISEASE

REVIEW SOLUTIONS

PATIENT EDUCATION

HAND SOAP

LOTIONS

MAKEUP

UTILIZE PLASMA AND TANGIBLE HYDRA-PEG