ANNUAL REPORT

Contact Lenses 2008

We take our annual look at the contact lens industry in 2008, including market and practice trends, important research ndings and events and innovations.

By Jason J. Nichols, OD, MPH, PhD, FAAO

Dr. Nichols is an assistant professor of optometry and vision science at The Ohio State University College of Optometry. He has received research funding from Alcon, CIBA Vision and Vistakon.

Another exciting year has passed in the field of contact lenses. We've seen significant activity in the development and launch of new lenses, in addition to much needed parameter changes that help us provide new options to our patients. We've witnessed action taken by the U.S. Food and Drug Administration in response to lens care solution recalls over the past few years. We've also read the results of numerous clinical studies that have answered many questions but also raised new ones.

It's important that we look back to see all that's happened in 2008 as we move forward into this new year. Let's start by looking at some market trends and data that summarize these activities for us.

Overview of General Market Trends

Data obtained from Jeff Johnson, OD, CFA (Vice President, Senior Research Analyst, Robert W. Baird & Co. Inc.) show that as of September 2008, the ophthalmic sector as a whole was up 145 percent over the last five years. This is far ahead of the S&P 500, which is now lagging behind where it was five years ago. The contact lens industry remains healthy with both U.S. (5-to-6 percent) and worldwide (8-to-9 percent) growth predicted over the next year. The worldwide soft contact lens market is estimated at $5.3 billion while the U.S. market is estimated at $1.9 billion. The worldwide GP lens market contributes another $250 million.

Worldwide and U.S. market share estimates by company are similar with Johnson and Johnson leading at nearly 48 percent, CIBA Vision at 18 percent, CooperVision at 18 percent and Bausch & Lomb at 12 percent. Correspondingly, when practitioners were surveyed about their perception of product portfolio innovativeness (1-to-5 scale), Vistakon again led, followed by CIBA, CooperVision and B&L. That being said, when asked what "brands" practitioners were expecting to use in the next year, "increased" brand use was led by CooperVision, followed by Vistakon, CIBA and B&L.

Current Practice Trends

We recently conducted our annual Contact Lens Spectrum Practice Profile Study, whereby we survey our readership regarding practice trends and growth patterns. The survey questions covered a variety of topics including patient base of a practice, business and financial aspects of a practice, fitting and prescribing trends, and care solution trends. We had 459 individuals respond to our survey, and I will present some of that information here.

During the course of 2008, Contact Lens Spectrum and Robert W. Baird & Co. Inc. also surveyed our readership on related topics. As I proceed ahead in discussing trends and observations about the contact lens field, I will draw on information obtained from both surveys.

Practice and Business Trends Most of our respondents were in solo practice, followed by group practice with between one and more-than-30 years of practice experience. In 2008, the typical practice saw an average of 103 patients per week, and approximately 34 percent of patients in a typical practice were contact lens wearers. The average number of contact lens fittings and refitting in a typical week was about 22. Most respondents (37 percent) felt that patient traffic flow was "about the same" or "modestly busier" compared with the previous year.

Correspondingly, most respondents felt that about 30 percent of their gross and about 24 percent of their net profit was derived from the contact lens portion of their practices. Sixty-two percent of respondents felt that their overall contact lens practice growth will increase in the next year, whereas 34 percent felt it will stay the same and only 4 percent of respondents felt that it will decrease.

Our data also show that contact lens patients typically purchase spectacles every two (43 percent) to three (38 percent) years, whereas most non-contact lens patients (requiring vision correction) purchase spectacles every one (26 percent) to two (64 percent) years. However, the typical contact lens patient returns for a comprehensive eye examination every year (82 percent) whereas the typical non-contact lens patient returns for a comprehensive eye examination every two years (65 percent).

Lens Dispensing Trends Without question, silicone hydrogel materials now dominate today's fits and refits; about 54 percent of lens fits and refits were with a silicone hydrogel, whereas 35 percent were with a hydrogel and 10 percent were with a GP (Figure 1). Although other data estimates suggest that silicone hydrogel use should be higher this year, the 2008 values for silicone hydrogel and hydrogel contact lens use are remarkably similar to the data from our 2007 survey.

Figure 1. Distribution of materials used in fitting and refitting.

Most of the reported fits are with soft spherical lenses (56 percent) and in full time daily wear (65 percent), followed by soft toric lenses (22 percent), soft multifocal lenses (10 percent), spherical GPs (6 percent) and multifocal and toric GPs (2 percent each) (Figure 2). Most patients are in full-time, daily wear soft lenses and most are using a two-week replacement schedule (Figure 3). Monthly replacement followed closely behind, but daily disposable, quarterly, weekly and annual schedules trailed distantly.

Figure 2. Distribution of lens types used in fitting and refitting.

Figure 3. Distribution of replacement schedules used with soft lens patients.

At least 50 percent of respondents' soft spherical lens wearers are presently in a silicone hydrogel material, and this value is estimated to reach 75 percent over the next two years for spherical lens types. However, silicone hydrogel lens use is lower on a worldwide basis, with silicone hydrogels making up only about 20 percent of spherical fits in this regard (Robert W. Baird & Co. Inc.). Estimates from our survey show that Acuvue Oasys (Vistakon) by far holds the highest ranked "anticipated use" among spherical silicone hydrogel lenses, followed by Biofinity (CooperVision), O₂Optix (CIBA) and Acuvue Advance (Vistakon).

Relative to toric soft lenses, our estimates suggest that about 30 percent of these fits in the United States are with a silicone hydrogel lens, which represents significant growth from two years ago (worldwide estimates suggest that 7 percent of soft toric fits are with a silicone hydrogel, Robert W. Baird & Co. Inc.). Estimates indicate that silicone hydrogel penetration will continue in the toric lens market, possibly up to nearly 40 percent over the next two years. Again, similar to spherical silicone hydrogels, our respondents indicated that Acuvue Oasys for Astigmatism (Vistakon) by far holds the highest ranked "anticipated use" among toric silicone hydrogel lenses, followed by Acuvue Advance for Astigmatism (Vistakon), PureVision Toric (B&L) and Air Optix for Astigmatism (CIBA).

Daily disposables make up about 10-to-13 percent of lens fits in the United States, with projected growth to possibly 20 percent over the next two years. This is similar to data from our 2007 survey, which showed daily disposables comprising 12 percent of fits and refits. Obviously, this is different on a worldwide basis, with estimates suggesting that daily disposables make up about 35 percent of soft lens fits depending on the region (Robert W. Baird & Co. Inc.). Estimates of silicone hydrogel use in the daily disposable category suggest it may be at about 17 percent, again with significant growth projected over the next two years (possibly up to 25 percent). Our surveyed practitioners indicate that Focus Dailies with AquaRelease (CIBA) holds the highest ranked "anticipated use" among daily disposable lenses, followed by Focus Dailies (CIBA) and 1-Day Acuvue Moist (Vistakon).

Most respondents felt that they will prescribe more silicone hydrogel (either two-week or monthly) multifocals and daily disposables over the next year, whereas all classes of traditional hydrogels will decrease. Respondents indicated that extended/continuous wear, cosmetic lens and GP lens prescribing will all stay the same.

Yet, our survey data show that perceived compliance with replacement schedules is worst with one-to two-week lenses (practitioners believe that only 58 percent of patients are compliant with this schedule), and best with daily disposable lenses (80 percent). Practitioners felt that nearly 79 percent of their patients comply with a daily wear schedule, whereas only 60-to-63 percent comply with an overnight wear schedule (in terms of the appropriate number of nights of wear).

For presbyopic patients, most respondents reported prescribing spectacles including progressives (for 37 percent of presbyopes) and bifocal/multifocal spectacles (for 16 percent of presbyopes). For presbyopic patients wearing contact lenses, most respondents indicated a preference for multifocal lenses (59 percent) compared with monovision (27 percent) and over-spectacles (14 percent). However, in practice, respondents reported that they prescribed slightly more presbyopic patients with monovision (16 percent of total presbyopes) than with soft (15 percent of total presbyopes) or GP (3 percent of total presbyopes) multifocal contact lenses. This possibly suggests that although technologies for multifocal contact lenses have greatly improved, we still have a way to go to provide optimal presbyopic correction with a contact lens only.

In terms of prescription pharmaceuticals, most respondents indicated writing between 10-to-15 prescriptions over the course of a typical week. Within the major anterior segment ophthalmic categories, most prescriptions were written for dry eye (average of 15/week) followed by anti-allergy (average of 11/week), antibiotics (average of 10/week) and antiinflammatories (average of 9/week).

Speaking of dry eye, we know that many of our contact lens patients suffer frequent and severe complaints during lens wear. We asked readers to rank their perceived top three most efficacious "treatments" for contact lens-related dry eye. The highest ranked option was refitting into a new contact lens material (89 percent), followed by prescribing rewetting drops (84 percent), changing the contact lens care solution (58 percent), refitting in a new wear schedule (23 percent), pharmaceutical agent (21 percent) and punctal plugs (11 percent).

On the Horizon For years, there has been a significant interest in drug-eluting contact lenses. These would be contact lenses that correct vision and also deploy the possibly sustained release of an ophthalmic pharmaceutical (e.g., a combination product). Examples of pharmaceuticals that might be incorporated into contact lenses may include anti-allergy, antimicrobial or anti-dry eye medications. However, the use of combination products is estimated to be limited at first due to "high price points and time-intensive follow-up routines" (Jeff Johnson, OD, CFA, Robert W. Baird & Co. Inc.).

Lens Care Trends

According to our survey, most responders are prescribing chemical care systems (79 percent) for contact lens patients, followed by hydrogen peroxide-based systems (~21 percent). AC Neilson data show that Opti-Free Replenish (Alcon), private-label solutions, ReNu MultiPlus (B&L) and Opti-Free Express (Alcon) hold the largest market share of all soft lens disinfectants (Figure 4). For GP lenses, Boston Advance, Boston Simplus and Boston Original (all B&L) hold the largest market share of associated disinfectants/conditioners (Figure 5).

Figure 4. Market share of all soft lens disinfectants. Source AC Nielson 10/4/08 (year-to-date).

Figure 5. Market share of all GP lens disinfectants/conditioners. Source AC Nielson 10/4/08 (year-to-date).

Our data also indicate that practitioners specify care systems with contact lens patients — 88 percent of our respondents are recommending specific brands of contact lens care systems to their contact lens patients. The largest determining factor in their selection was lens material/solution compatibility (74 percent) followed by the potential impact on comfort (~18 percent), while cost played an insignificant role (<1 percent). Interestingly, most respondents believe that the majority of their patients (71 percent) are indeed compliant with their lens care instructions.

Clinical Research

A tremendous amount of clinical research published in 2008 relates to contact lenses and the ocular surface; much of it we have highlighted in our print and electronic media. It's difficult to summarize all of this published clinical research activity of the past year, so we surveyed our editorial team to help narrow down some of the most important topics that have had or will have a major impact on our field.

Interaction of Care Solutions and Lens Materials with the Tear Film and Ocular Surface A major area of interest that still needs much attention to date is the safety and efficacy of contact lens care solutions. As we are all aware, the debate continues about lens care solutions and corneal staining, particularly regarding the actual clinical impact of corneal staining. The Institute for Eye Research published follow-up data in the March 2008 article titled "IER Matrix Update: Adding Another Silicone Hydrogel" to its September 2007 contact lens/care solution article titled, "Corneal Staining: The IER Matrix Study." Researchers in this study followed patients for three months and captured the percentage of patients showing "lens care-related staining in the first three months of lens wear." In the follow-up publication, they showed that Clear Care and Aquify (both CIBA) were generally associated with lower corneal staining responses than were Opti-Free Express and Opti-Free Replenish, with some exceptions.

Andrasko and Ryen published a summary of the "Staining Grid" results in Optometry this past year showing that certain PHMB solution/contact lens combinations can be associated with increased punctate corneal staining after two hours of wear. Non-PHMB-based care solutions, including hydrogen peroxide, were associated with the lowest areas of corneal staining. Andrasko published a similar study in our September issue titled "Solution-Induced Staining and Comfort During Lens Wear" that demonstrated a link between solution-induced staining and reduced comfort. In this regard, many of you are using hydrogen peroxides more frequently (Efron and Morgan, Contact Lens and Anterior Eye), especially for your problematic patients, but there is little scientific data on the ability of these systems to clean contact lenses in the traditional sense.

There is still debate about the uptake of lipids on contact lenses, although Carney and coworkers (Investigative Ophthalmology and Vision Science) showed in an in-vitro "doping" study that senofilcon A (Acuvue Oasys), galyfilcon A (Acuvue Advance) and balafilcon A (PureVision, B&L) tend to be most associated with cholesterol and phospholipid uptake. This trend was similarly reported by Iwata and coworkers (Eye and Contact Lens) in another in-vitro study using a different methodology. What is not clear is what happens in-vivo and the impact of different contact lens care solutions on cleaning lipids from contact lenses.

There is still major interest in proteins associated with contact lenses, and two reports (Green-Church and Nichols, Molecular Vision, and Zhao and coworkers, Molecular Vision) showed that many more proteins exist on contact lenses than originally thought.

Contact Lens Comfort Although we have come a long way, comfort during contact lens wear continues to be a major challenge to long-term success for contact lens wearers. It has long been known that comfort decreases significantly during a day's wear, but a report by Dumbleton and coworkers (Eye and Contact Lens) showed that subjects were able to wear silicone hydrogel lenses for longer than they could wear traditional HEMA-based materials. Another report by Chalmers and coworkers (Eye and Contact Lens) showed that refitting traditional hydrogel lens wearers into lotrafilcon A or B resulted in significant reductions in dryness. A report by Geldis (Eye and Contact Lens) showed in a double-masked clinical trial that punctal occlusion had little effect on overall comfort during lens wear compared to a sham procedure. Ozkan and Papas (Optometry and Vision Science) showed that lubricant use during contact lens wear was associated with only a short-term improvement in comfort. Likewise, Ramamoorthy and coworkers (Optometry and Vision Science) showed that although contact lens wearers with dry eye were more prone to use rewetting drops, the drops did not appear to have a substantial impact on comfort. Ramamoorthy and coworkers also showed that Group II and IV lens materials were more likely to be prescribed to contact lens wearers who have dry eye and that care solutions had little impact on patient comfort.

Contact Lens Safety Although silicone hydrogel lenses were developed to improve safety during contact lens wear, recent reports suggest that these lenses have not reduced the risk of microbial keratitis (MK). However, this doesn't mean that patients haven't benefited from these new materials, as most believe they have. In a case-control study, Dart and coworkers (Ophthalmology) showed that silicone hydrogel lenses did not reduce the odds of MK development compared to planned replacement traditional hydrogel lenses. A very interesting finding from this report was that daily disposable lenses were associated with significantly increased odds of MK development. As expected, the overnight wear of any contact lens type significantly increased the odds of developing MK. In a related report (published as a companion paper in Ophthalmology), Stapleton and colleagues showed that the annual incidence estimates of MK are similar to historically reported rates.

Shoff and coworkers (Cornea) showed clinical and tap water strains of Acanthamoeba trophozoites were highly virulent against most contact lens care systems, especially multipurpose care solutions. Hydrogen peroxides were more effective, but still not entirely effective.

As noted previously, there is continued interest in drug-eluting contact lenses (with pharmaceuticals incorporated), and there are a few published reports on this topic. Hui and coworkers (Eye and Contact Lens) examined the ability of nine different traditional hydrogel or silicone hydrogel lenses to release ciprofloxacin. Although there were differences between lens types, the majority of lenses released the drug very quickly (within about 10 minutes). The authors concluded that the materials generally release drugs too quickly to make them effective drug delivery devices. Kim and colleagues (Biomaterials) examined the ability of silicone hydrogels (of varying chemistries) to release timolol, dexamethasone and dexamethasone 21-acetate. Their results showed that these particular drugs were released for much longer periods, in some cases up to three months. Kapoor and Chauhan (International Journal of Pharmaceutics) evaluated the ability of polyHEMA-based hydrogel lenses to deliver cyclosporine A. They showed that these hydrogels can deliver therapeutic doses for periods of up to 20 days.

It was long thought that soft contact lenses, particularly low-Dk lenses, were clinically associated with "myopic creep." However, Walline and coworkers (Investigative Ophthalmology and Vision Science) showed otherwise. After three years, they found no difference in measured refractive error, axial length or corneal curvature.

The question of improved vision associated with aspheric lenses has also long been of interest. Efron and coworkers (Eye and Contact Lens) examined that question, showing that the aspheric design used (controlled for material) showed no improvement in vision measurements (visual acuity and aberration control as well as subjective improvement) compared to the spherical design.

Psycho-Social Impact of Contact Lenses Although many of us have experienced this during patient care, a report by Court and coworkers (Optometry and Vision Science) showed that patients' anxiety levels do indeed increase during a contact lens eye examination/fitting (particularly during the history and during application/removal of contact lenses). The authors suggest keeping this in mind when conducting patient education, as peak arousal can be associated with poor attention.

Events and Innovations

The information printed in this section is derived from manufacturers' press releases that we printed in Contact Lenses Today and in the Product Spectrum throughout 2008. Thus, it may not be fully inclusive of all contact lens or care solution parameter changes, lens introductions or new product introductions in this regard. Please see our annually published Contact Lenses & Solutions Summary for full details on lens materials, parameters, care solutions and rewetting drops. Table 1 lists a summary of new options and parameter expansions for soft and GP lenses only.

Care Solutions The FDA approved several more care systems for use with SynergEyes (SynergEyes, Inc.) hybrid contact lenses including Aquify, Complete Multipurpose Easy Rub Formula (Advanced Medical Optics [AMO]), Oxysept Ultracare Formula Peroxide Disinfection System (AMO) and ReNu MultiPlus. SynergEyes lenses are already approved for use with Clear Care and Opti-Free Express.

Alcon Laboratories announced continued limited production of its Unique pH for GP lens care.

Advanced Vision Technologies (AVT) introduced Naturalens RDS (rinsing, disinfecting, storage) Multipurpose Contact Lens Solution, a "no tap water rinse" multipurpose contact lens solution, approved by the FDA for the care of GP and hydrogel lenses.

GP Lenses ABBA Optical introduced the MVP (Multi-Visual Performance) multifocal lens in the one-day fitting and dispensing GP delivery system called SureFit (Paragon Vision Sciences). Surefit is a patent-pending system that enables trial fitting and dispensing of GP lenses, similar to what is done with soft lenses. It is available in the Paragon HDS material. AccuLens is also offering its Clarity Plus Extended Add in the SureFit GP Delivery System.

Blanchard Contact Lens introduced two new specialty contact lenses called the RSS (Refractive Surgery Specific) and MSD (Mini-Scleral Design), which are targeted for post-surgical and irregular corneas, respectively.

Lens Dynamics has introduced Quad Sym technology for its Dyna Cone Plus and Dyna Intra-Limbal lenses. A unique edge treatment, Quad Sym PC allows practitioners to flatten or steepen the edge differently in four quadrants. Quadrant-specific lathing is also available in these designs for base curve treatment. The company says that the posterior side of the lens can be made in four separate radii to match flat and steep areas of the cornea using the Quad Sym BC option.

Paragon Vision Sciences launched the Paragon RG-4 corneal reshaping lens (as an alternative to the Paragon CRT lens). It offers a more traditional four-curve design and is manufactured in Paragon HDS 100 (approved for overnight corneal reshaping).

SynergEyes, Inc. was awarded a patent for improving the hydrophilicity (wettability) of its hybrid contact lens. The company was also awarded patents related to its lens bonding technology as well as manufacturing and fitting techniques associated with its hybrid design in post-surgical patients. It also released SynergEyes PS, a hybrid lens for irregular corneas, and SynergEyes Multifocal, a multifocal hybrid lens.

TruForm Optics received a patent for Quad Technology associated with its QuadraKone keratoconus GP lens design made from Paragon HDS, Paragon Thin, and FluoroPerm materials.

Valley Contax launched two new GP lens designs — Comfort XL and KMax. The company designed the Comfort XL lens for superior comfort in intolerant wearers of soft torics or alternative GP designs. The KMax is a large-diameter lens designed for advanced stages of keratoconus, pellucid marginal degeneration and post-surgical patients.

Lensco announced the launch of Zenith LD, which is a large-diameter GP lens that the company reports is especially useful for patients who have irregular corneas.

Carter Contact Lens, Inc. introduced its CarterKone and RevKone GP designs for fitting decentered cones in keratoconus. The CarterKone is also available in toric designs, and the RevKone is a reverse geometry design with decentered optics that's designed for advanced inferior cones with large flat superior corneas.

Menicon Co., Ltd. and Rose K International Limited entered into an agreement for Menicon to acquire 100 percent of the ownership of Rose K. Dr. Paul Rose and Mr. Ian Jennings, founders and owners of Rose K International Limited, joined the global Menicon group and continue to act as the main figures of the global Rose K operations. The existing arrangements related to manufacturing and distribution of Rose K in North America remain unchanged.

Hydrogel Lenses Art Optical Contact Lens introduced the Intelliwave soft contact lens system. These advanced, lathe-cut hydrogels have patented wave-front technology and aberration control.

B&L introduced the SofLens Daily Disposable, which is made from hilafilcon B. It offers aspheric optics designed to reduce spherical aberrations.

CIBA announced the release of Dailies Aqua-Comfort Plus, which is a daily disposable with Triple Action Moisture targeted at improved comfort throughout the day.

CooperVision introduced the ClearSight 1 Day Toric lens made of ocufilcon D. It's the second toric daily disposable lens on the market and is available in axes of 180, 160, 90 and 20 degrees and cylinder powers of –0.75D and –1.25D. The multifocal lenses Biomedics EP and Proclear Multifocal were also expanded in spherical power parameters. Lastly, the Proclear Sphere monthly lens sphere powers expanded to include +20.00D to –20.00D and the Proclear 1 Day lens was extended in the plus sphere power range to +6.00D.

Hydrogel Vision Corporation expanded its Extreme H₂O 54% toric line with a mid cylinder (MC) lens (–1.25DC), which is available in 10-degree axis increments. Later in the year, the company expanded the LC (low cylinder) line with axes around-the-clock in 15-degree steps.

Marietta Vision announced a low cost hydrogel contact lens, the VisionCare 2, made from etafilcon A. It's designed to be an alternative to other higher cost etafilcon A lens designs. Marietta Vision also received FDA approval for custom tinting of all types of lenses (except silicone hydrogels).

Metro Optics received FDA clearance for a new soft contact lens, RevitalEyes, for post-refractive surgery vision correction. It's made from hioxifilcon B and is fit diagnostically, offering exact sphere, cylinder and axis parameters.

Ocu-Ease Optical Products introduced its Elite series of disposable lenses including the Elite Sphere, Elite Aberration Control, Elite AC Daily and Elite AC Toric. They are manufactured from methafilcon A and offer a UV blocker.

Unilens Vision Inc. announced the launch of C-Vue 1 Day ASV (Aspheric Single Vision), which is another daily disposable that offers aspheric optics and is manufactured in methafilcon A. The company also announced the launch of the C-Vue Advanced Custom Toric lens, made from hioxifilcon D.

Silicone Hydrogels CIBA released Air Optix for Astigmatism, a toric silicone hydrogel lens, in early 2008 and announced further toric parameter expansions in late 2008. The lens is made from lotrafilcon B and has a monthly recommended replacement schedule. CIBA later launched Air Optix Aqua, which contains the Aqua Moisture System and is manufactured in lotrafilcon B.

CooperVision expanded the parameters of its Biofinity monthly replacement silicone hydrogel contact lens (comfilcon A), with sphere powers now ranging from +8.00D to –10.00D. CooperVision also introduced a new spherical silicone hydrogel lens, Avaira, which has a two-week replacement schedule. It is made from enfilcon A and offers UV blocking.

Vistakon announced that its Acuvue Oasys is now available in plano powers for therapeutic use. The FDA granted this indication in October 2007. The company also added another base curve option and received the Seal of Acceptance for Ultraviolet Absorbing Contact Lenses from the American Optometric Association's Commission on Ophthalmic Standards for this lens. Vistakon also announced the release of the 1-Day TruEye lens. This is the first daily disposable lens made from a silicone hydrogel material (narafilcon A). It has been launched in the United Kingdom, with a planned launch in 2009 elsewhere. Lastly, Vistakon launched Acuvue Oasys for Astigmatism, which uses the Accelerated Stabilization Design. It's manufactured in senofilcon A.

Dry Eye Treatments Acucela and Otsuka Pharmaceuticals announced an agreement to co-develop rebamipide ophthalmic suspension for treating dry eye. It's thought to increase mucins in the tear film, and was in Phase III clinical trials in the United States in 2008.

Advanced Medical Optics introduced Blink Tears, Blink GelTears and Blink Tears Preservative-Free, which are over-the-counter eye drops for dry eye.

Advanced Vision Research released a prescription-only Nutri-Dox Convenience Kit used to treat meibomian gland disease. This three-part kit includes doxycycline monohydrate 75mg capsules, TheraTears Nutrition (omega-3) and iHeat Warm Compress System.

Alcon launched Systane Ultra lubricant eye drops, which are Polyquad preserved, over-the-counter artificial tears used to treat dry eye.

Allergan launched Optive Sensitive Preservative Free Lubricant Eye Drops. The over-the-counter drops are targeted for sufferers of dry eye, including post-LASIK patients, who have signs and symptoms.

Aton Pharma, Inc. expanded upon it distribution and doctor and patient resources for Lacrisert (hydroxypropyl cellulose ophthalmic insert). Lacrisert is a preservative-free, sustained-release prescription insert placed in the inferior cul-de-sac, where it dissolves.

Nordic Naturals released ProDHA Eye, which is a blend of purified fish oils, lutein and zeaxanthin that can be used to help protect ocular cells from oxidative stress.

Oasis Medical, Inc introduced Oasis Tears and Oasis Tears Plus, which are glycerin-based lubricant eye drops for mild and moderate-to-severe dry eye patients, respectively. Both are preservative-free.

Global Meeting

The second Global Keratoconus Congress convened in late January in Las Vegas. The meeting drew nearly 500 participants from 28 countries with more than 100 sponsors/exhibitors present. Contact Lens Spectrum and the Lippincott, Williams & Wilkins Health Care Conference Group hosted the event, which focused on the latest diagnostic methods and treatments for keratoconus. The Congress included information for all vision care providers with 17.5 credit hours of continuing education, and the international faculty provided cutting edge information on this disease that affects so many of our patients.

Mourning Their Loss

Several of our colleagues passed away in 2008, and our sincerest condolences go out to their friends and families. Charles A. "Ted" Bayshore, OD, contributed significantly to clinical and developmental aspects of contact lenses; he held at least three "eye-correction" patents and was awarded numerous honors throughout the years.

Edward Lohmann was a 31-year veteran sales professional in the contact lens industry who represented Hydrocurve, CooperVision, CIBA Vision and finally Hydrogel Vision Corporation.

Lastly, Kenneth V. "Kenny" Swanson was a past president of the CLSA, who endowed the "Kenneth V. Swanson Merit Award" to serve as a recognition to those who made an outstanding contribution to the contact lens industry.

Looking Ahead

We are indeed optimistic for the year 2009 in contact lenses. We expect to see several completely new contact lens or care solution introductions. There should also be significant activity in the regulatory aspects of lens care solutions, and possibly progress in the pharmaceutical treatment of dry eye disease.

We'd again like to thank all our readers and supporters for a fabulous 2008, and we are indeed excited about and looking forward to 2009. CLS

To obtain references, for this article, please visit http://www.clspectrum.com/references.asp and click on document #158.