LENS UPDATE
2005: The Year in Contact Lenses
We look back and review what was new during 2005 and what might emerge in 2006.

The year 2005 started with what was possibly the biggest corporate business news, the merger of CooperVision and Ocular Sciences — the fourth-largest contact lens company merging with the fifth-largest, and consequently leaping to become the third-largest contact lens business in the world. Our business, however, is about fitting contact lenses to patients. What's often more interesting to practitioners is what new products were introduced and what changes in parameters occurred in existing products We're all busy people, so sometimes new products — or parameter changes that we're waiting for — go unnoticed. Here's a summary of what you might have missed in 2005.

Silicone Hydrogel Materials Silicone hydrogel materials have changed how we fit lenses, and their continued development gives us more choices for our patients. The re-introduction of PureVision (Bausch & Lomb) after the agreement between B&L and CIBA Vision in 2004, came into effect in April. I welcomed the availability of PureVision; having practiced optometry in Australia where both Night & Day (CIBA Vision) and PureVision were available, I saw firsthand the benefits of choice. Continuous wear as a modality will only be better and bigger as a consequence of this increasing choice.

We've known that silicone hydrogel lenses have been prescribed for daily wear worldwide since their original introduction, so the introduction of Acuvue Advance with Hydraclear (Vistakon) in 2004, followed by Acuvue Oasys with Hydraclear Plus last year, was great news. With O₂Optix (CIBA), in 2004, we now have five silicone hydrogel lenses to choose from: great news for clinicians and patients.

Silicone Hydrogel Torics Building on the introduction of Acuvue Advance, Vistakon has expanded this lens design to include the Acuvue Advance for Astigmatism with Hydraclear, which incorporates unique Accelerated Stabilization Design technology.

B&L combined its successful Soflens 66 Toric design with its PureVision material and launched the PureVision Toric, the first of its kind to be approved for up to 30 days of continuous wear.

Daily Disposables Another growth area is daily disposable contact lenses, though this currently includes only conventional hydrogel materials. One of the market leaders, CIBA Vision's Focus Dailies now has a sister product aimed at sustaining/improving end-of-day comfort. Focus Dailies with AquaRelease contains a moisturizing agent that is released gradually over a day's wear, a little bit with every blink.

2005 also saw the introduction of the Biomedics 1-day daily disposable lens (CooperVision) manufactured from a 52 percent water content material.

Sports Vision B&L introduced the Nike Maxsight Sport-Tinted Contact Lens designed to reduce glare and aid visual performance in athletic settings. It also has a larger lens diameter, which provides stability to optimize lens optics and the visual performance.

Planned Replacement Lenses CooperVision released the Biomedics Premier, which incorporates aberration-correcting technology. In December, CooperVision also launched the Biomedics XC, a two-week replacement hydrogel lens with a new material (60 percent water content), aspheric optics and lens design all geared toward improving comfort. CooperVision also introduced Biomedics EP, a Balanced Progressive Technology D lens for OU prescribing, manufactured in the Biomedics XC material for emerging presbyopes up to +1.50D add.

Combination Lens Products

The adaptation and incorporation of aspheric optics is thought to allow a lens to correct both astigmatism and presbyopia. The presbyopic patient is challenging enough to fit, but when he has astigmatism as well, options become very limited. Two new products became available in 2005: Cibasoft Progressive Toric (CIBA) and Ultravue Multifocal Toric (CooperVision). Though these lenses are available at this time on a non-disposable basis only, they do allow practitioners to address a complex situation with contact lenses. The Ultravue Multifocal (non-toric) has been available in a monthly replacement modality as the Frequency 55 Multifocal. It has now been released in the same design utilizing Proclear material as the Proclear Multifocal.

New GP Products

Orthokeratology B&L's Vision Shaping Treatment system offers several orthokeratology lens designs, some of which you can fit empirically using Ks and Rx, and some that you can fit diagnostically or using topographical data and software. Made with Boston Equalens II (oprifocon A) GP material (B&L), these custom-made ortho-k lenses are worn overnight to reduce myopia. The Vision Shaping Treatment system is currently offered in designs that include: BE Retainer (Precision Technology Services, Ltd.), Contex OK E-System, DreamLens (DreimLens, Inc.) and Euclid Corporation's Emerald lens.

Hybrid Lenses The SynergEyes A Lens (SynergEyes, Inc.) is designed with a high-Dk (Paragon HDS 100) rigid center (8.2mm wide) with a hydrophilic, non-ionic soft skirt (30 percent water, 14.5 diameter) to treat ametropia from –20.00D to +20.00D with up to 6.00D of astigmatism.

Surface treatment Another development in the GP field from Paragon Vision Sciences was a plasma treatment aimed at enhancing wettability and comfort of the surfaces of their GP lenses. You can now order this treatment for all Paragon GP materials.

Lens Care Solutions

The surface is everything when it comes to lens comfort and performance, and solutions designed to sustain a hydrogel surface may not enhance comfort as effectively for a silicone hydrogel lens surface. As we've gradually been shifting from hydrogel materials to silicone hydrogel materials, new lens care products have been introduced.

Three companies released new multipurpose disinfecting solutions: Alcon with Opti-Free Replenish MPDS, B&L with ReNu with MoistureLoc Multi-Purpose Solution and Menicon with MeniCare Soft with Comfortec. All three products have new formulations to optimize disinfection and enhance lens comfort.

Comfort Products

Refreshing a lens in the eye can provide many patients with prolonged wearing times. In 2005, Menicon released MeniTears, which contains carboxymethylcellulose, a wetting agent, and Advanced Vision Research launched TheraTears Contact Lens Comfort Drops. MeniTears drops are designed for use while wearing the lens, to sustain lens wettability and comfort. The TheraTears Contact Lens Comfort Drops are designed to be placed on soft and GP lenses immediately before application on the eye, displacing soaking solutions and thus aiding initial comfort. TheraTears Contact Lens Comfort Drops can also be used in the eye with lenses in place.

Advanced Vision Research also introduced TheraTears Nutrition, a capsule containing an optimized blend of flaxseed oil and fish oil that provides both short-chain and long-chain omega-3s designed as a nutrient to improve comfort and tear quality.

A Look Ahead

What's about to be released can be a closely guarded secret, but you can expect the following in 2006:

CooperVision will expand the disposable Proclear Toric range with a steeper base curve.

B&L will launch PureVision Multifocal, the first silicone hydrogel to correct presbyopia, incorporating the Soflens Multifocal design.

CIBA Vision will launch FreshLook One-Day, daily disposable tinted lenses (blue, green and hazel) as well as the O₂Optix Toric, a silicone hydrogel lens for correcting astigmatism.

After many presentations at conferences about the CooperVision silicone hydrogel lens (comfilcon A, Biofinity) in 2005, the company will launch the lens in 2006.

Polyvue Distribution will launch its HDX Toric Progressive, which combines the comfort of the HDX Progressive with a toric back surface, stabilized with a prism ballast to provide consistent vision at all distances.

Paragon and Menicon have combined forces and will launch Paragon CRT Z, a lens for orthokeratology incorporating the CRT concept and the Menicon Z material.

And finally, we can anticipate Vistakon launching One-Day Acuvue with Hydraclear, a lens that is already available in Europe.

Predictions for 2006

Trying to look beyond what we know is always difficult. Making predictions, especially in print, can provide the hangman with more than enough rope. But here are some possible developments for 2006:

Daily Disposables It's only a matter of time before the first daily disposable silicone hydrogel appears, and I anticipate it will be fabricated in a non-surface-treated material; economics must dictate that.

Saturn III Remember the Saturn lenses, which became Softperm? They were the lenses with the GP center and a HEMA flange. What about combining a super high-Dk GP material with a super high-Dk silicone hydrogel?

Cosmetic Tints Surely soon to be available in silicone hydrogel materials?

More Silicone Hydrogels How about a material available for custom designs, available through your local laboratory? A bit of a niche market — but we all have patients waiting for it.

Conventional Hydrogels Here is my big one: Will 2006 be the end of conventional hydrogel lenses (I mean non-planned-replacement soft lenses)? Maybe 2006 is a little early to predict this, but if we get a silicone hydrogel material available for custom designs, who knows! In last month's issue, Morgan et al reported for the fifth time on the survey for international contact lens prescribing and suggest that during 2005 non-disposable soft lenses were down to 10 percent of soft lenses prescribed to new patients for all countries surveyed and as low as 1 percent in Norway and 2 percent in the United Kingdom.

Continuous Wear Developments There's much activity on the patent front with regard to incorporating antibacterial agents into contact lens materials, the ideal presumably being a surface that cannot sustain bacteria, reducing the risk of infection. Does this offer the next step towards making continuous wear a safer modality?

Presbyopia Will Bausch & Lomb still be the only company to have launched a multifocal in a silicone hydrogel material by the end of 2006?

2005 was a busy year for launching new products and for redesigning existing lenses. So far it looks like 2006 will be just as busy.

Craig Woods is the Research Manager of the Centre for Contact Lens Research at the School of Optometry, University of Waterloo, Ontario, Canada. He is a therapeutically accredited optometrist, a Fellow of the Victorian College of Optometry, the American Academy of Optometry and a member of the College of Optometry (UK).