Bausch + Lomb (B+L) recently launched its Bausch + Lomb Infuse silicone hydrogel (SiHy) daily disposable contact lens, made of the next-generation material kalifilcon A. The lens’ ProBalance Technology formula includes the osmoprotectants erythritol and glycerin and the electrolyte potassium; it also includes two moisturizers, Poloxamine 1107 and Poloxamer 181, to help retain hydration, provide a smooth, wettable surface, and maintain tear proteins in a healthy state, according to the company. B+L says that ProBalance Technology is infused into the lens material during the manufacturing process, and these ingredients are released during lens wear.

B+L Infuse has the highest moisture content (55%) and lowest modulus (0.5 MPA) among SiHy daily disposables, and it maintains 96% of its moisture for a full 16 hours, according to the company. It has a reported Dk/t of 134 at –3.00D and features a class II UV blocker and a visibility tint. Parameters include 8.6mm base curve, 14.2mm diameter, center thickness of 0.08mm at –3.00D, and sphere powers of +6.00D to –6.00D in 0.25D steps and from –6.50D to –12.00D in 0.50D steps.

I recently talked with practitioners who are actively fitting the Infuse lens in their practices. Here we share their clinical experiences.

Please tell us about your general experience with B+L’s Infuse contact lens.

Roy Kline, OD, who practices in Glens Falls, NY, says that he always has a potential list of patients ready for a new lens design. “Infuse was certainly no different. The science behind Infuse is so intriguing that I was anxious to get it on eyes,” he says. “The general impression was spectacular from the start. Patients felt a ‘cooling effect,’ like they weren’t wearing a lens at all.”

Additionally, Dr. Kline notes that with improved high-definition optics, most patients immediately felt that there was an improvement in their clarity of vision as well. “Putting it on eyes and receiving this kind of feedback gave me the confidence to introduce it to more of my patients,” he explains.

In addition to prescribing the lens for his patients, Thomas P. Finley, OD, who practices in Herndon, VA, has first-hand experience with wearing it. He had laser correction 20 years ago, has 39.00D corneas, and has chronic dry eyes. He notes that “wearing a face mask all day due to COVID forced me from my eyeglasses that always fogged up back into contact lenses.

“I tried all types [of lenses] but have been happiest with Infuse in both eyes. My vision is good enough to see up close and to read my electronic health records on the computer and to see far away in a familiar environment,” he says. “I can wear them comfortably all day and have forgotten to remove them after work a few times because they felt so good.”

Who are the best candidates for this lens and why?

Jessica O. Yu, OD, who practices in Westport, CT, says that there hasn’t really been anyone who isn’t a candidate for the lens. “The standout candidates for me, however, have been those on the opposite ends of the spectrum: patients who are new to contact lenses and patients who have tried many other products with limited success, whether because of comfort issues or vision complaints,” she notes. “For the former, the lower modulus of the lens allows new wearers to be able to handle the lens more easily. Plus, the UV protection is great for kids and teenagers as they start out with lenses for the first time. For the latter, the next-generation material, in combination with the ProBalance Technology, has culminated in a more comfortable wearing experience, allowing many of my patients who had previous complaints of dryness or discomfort to increase their daily wearing time and to be able to do more with their lenses.”

For Dr. Finley, the best candidates are dry eye patients or those who are spending several hours per day on the computer. “Because of the aspheric optics, I think patients may also experience slightly better vision with these lenses,” he explains. “I don’t arbitrarily upgrade patients into Infuse from whatever they’ve been wearing, providing they’re happy, but I have been making them aware of this new lens and dispensing 10-pair [boxes] to them to try.”

Dr. Kline believes that those patients who already are in a daily wear SiHy lens and still experiencing issues are the obvious patients for this lens design. He also targets daily wear patients who are in a HEMA material. “The increased oxygen transmissibility and all of the lens’ improved qualities make this an ideal upgrade for these patients,” he explains.

Dr. Kline’s third target group are monthly SiHy spherical patients. “With the increased awareness of healthy habits, a more frequent replacement regimen is indicated, and patients are very receptive to this concept,” he says.

Tell us about the fitting process for the Infuse lens and what has worked best for you.

Most of Dr. Finley’s patients are already wearing contact lenses, so his approach to fitting is essentially discussing the benefits and technology of the Infuse lens and letting patients try them. “I let them know that there’s no obligation,” he explains. “We can return to what they’ve been successfully wearing or move to the better and more comfortable lens.”

Dr. Kline approaches fitting by asking how he can help patients improve their contact lens-wearing experience. Then, he has patients trial the lens in office first or, if their issues involve long-term wear, he sends patients home with a supply. “What’s nice is that Bausch + Lomb made 10-packs of diagnostic lenses to dispense to patients. This gives patients the ability to wear lenses for five days and to let us know how they are doing,” he says. “If everything is good, we either have patients come in and pick up a supply from our inventory or we order a supply and have them delivered direct to patients.”

Dr. Yu strongly believes in fitting patients based on specific reasons, whether it’s their ocular parameters and ocular health, lifestyle, or features of newer technology. “During my fitting process, I like to educate my patients about why I choose to fit them with a particular lens,” she notes. “With Infuse, depending on the patients’ current modality or lens, I may educate them on the importance of ocular surface homeostasis, benefits of improved oxygen transmissibility, or other features that could improve their overall lens-wearing experience.”

How has the Infuse lens helped with troubleshooting for particular patients? Tell us about any success stories in that regard.

Dr. Kline has had lots of success across his practice with this lens. For example, he tells of one of his first Infuse patients, a 21-year-old college student who was wearing a daily disposable contact lens. The patient noted that he experienced discomfort and dryness during the last three-to-four hours of wear. He also noted that because he didn’t want to wear glasses, he just left the lenses on. “From the first application of Infuse lenses, he noticed a difference. He told me that they were easy to apply and had an immediate comfort feeling,” he says. “With [the patient] being a basketball player, I told him that Infuse has improved optics. And, because the lenses will stay moist, vision should be clearer and should stay clear. I told him that I expected his shooting to improve.”

At the one-week follow-up exam, the patient told Dr. Kline that he didn’t feel like he had to “put up” with his lenses as he did with his old ones and that comfort lasted well into the night. When asked about his vision, he said that he noticed two big areas of improvement: much less glare while driving at night and consistency with his vision. “Clarity was improved and stable. He felt that he could focus on the rim better, allowing him to improve his shooting,” Dr. Kline notes. “In short, he was very excited about the changes with Infuse contact lenses.”

Dr. Yu says that the Infuse lenses have been especially helpful with patients who experience greater end-of-day discomfort while wearing their lenses or those who still experience discomfort or dryness despite the fact that they are wearing a good-quality or premium lens. “I have also enjoyed taking advantage of the aspheric optics of Infuse to fit patients in the newest technology while providing exceptional vision with spherical aberration control,” she says. This has worked well with several post-laser-assisted in situ keratomileusis (LASIK) patients who either want to wear lenses socially or who are not ready to commit to a more advanced specialty lens such as GPs or sclerals. CLS