JOHNSON & JOHNSON Vision’s Acuvue Abiliti Overnight Therapeutic Lenses for Myopia Management are U.S. Food and Drug Administration (FDA)-approved orthokeratology (ortho-k) lenses that are worn overnight to temporarily reduce refractive error when subject to an eyecare professional’s myopia management plan and may eliminate the need to wear contact lenses or glasses during waking hours after the lenses are removed.

According to the company, the lenses are designed to match a patient’s eye based on its unique corneal shape and prescription. Additionally, the FitAbiliti software guides the ECP through the fitting process empirically and recommends a lens.

The Abiliti Overnight lenses are now available nationwide in two different lens designs: Acuvue Abiliti Overnight Therapeutic Lenses for Myopia Management and Acuvue Abiliti Overnight Therapeutic Lenses for Myopia Management for Astigmatism. Available diameters are 10.2mm, 10.6mm, and 11.0mm, with base curves of 7.20mm to 9.50mm (in 0.05mm steps). Additionally, designs are available with sagittal depths of 1.0mm to 1.8mm (in 0.01mm steps).

Here, CLS shares the clinical experiences of three practitioners who are using Acuvue Abiliti Overnight lenses in their practices.

Please tell us about your experience with Acuvue Abiliti Overnight lenses.

According to Grant Miller, OD, who practices in River Grove, IL, the lenses have proven to be an excellent addition to his expanding myopia management center. “They have aided in the simplification of lens design and troubleshooting processes, and I can now design a lens inside the office, or even at home, on my own time without having to email or call a consultation team,” he says. “In addition, we can now offer our patients and their parents the added comfort of an FDA-approved orthokeratology lens for myopia management.”

Selena Chan, OD, who practices in San Francisco, has also experienced good results prescribing Abiliti lenses. “My clinical consultant has been super helpful; there is no other ortho-k or soft/GP representative who would answer my text on Saturday at 8 p.m.!” she says. “Johnson & Johnson has the policy of no exchange or return fees within 90 days of lens order.”

Who are the best candidates for this product and why?

Dr. Chan has had good patient outcomes with both children and adults who are willing to wear ortho-k lenses. “Some of the characteristics of ideal candidates are less than 5D of myopia, less than –1.50D of astigmatism, Ks from 42D to 45D, refractive cylinder equal to half or less than half of myopia, and eccentricity (e) values 0.3-0.7 (flat e > steep e),” she says.

According to Glenda Aleman Moheeputh, OD, who practices in Pembroke Pines, FL, the Acuvue Abiliti ortho-k lens is excellent for kids who are active or who practice sports. “It provides clear vision without glasses or contact lenses during the day. It does so much more than just correct their myopia,” she says.

Her ortho-k patients have shown an improvement in school performance, and parents report that their kids are more confident after starting ortho-k treatment. “[Kids should be] having fun playing whatever sports they’re playing, rather than having to worry about their glasses falling off their faces,” she continues. “The other thing that we cannot disregard is that kids [can be] mean and little kids are very self-aware of how they look. So, ortho-k is for those kids who have visual problems, but they really do not want to wear glasses because they don’t want to be picked on.”

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

Dr. Miller points to the FitAbiliti software as a big help when fitting Abiliti Overnight lenses. “The topography-based software makes fitting simple, regardless of your level of ortho-k experience,” he explains. “Simply upload the patient’s topography, enter refractive error, and within seconds, you’ll have a lens customized to the patient’s topography maps and refraction. Because of the topography-based design, corneal e value is automatically incorporated into the lens to ensure an improved ortho-k outcome.

He also notes that to achieve the best results with topography-guided design systems, it is critical to have well-trained technicians capture several high-quality images on a calibrated topographer. “Eyelid and ocular surface conditions should be properly managed before fitting to ensure a stable tear film,” he says. “Quality input will give quality output.”

Dr. Chan agrees that getting the best baseline topography scans is the key. “If our staff or practitioners need additional training or a review of how to best capture images, we don’t hesitate to reach out to our clinical consultant, and she is always there to help guide us in the office or virtually!” she says. “The consultants are also available to help assist me and my staff with application and removal for patients in Abiliti Overnight as well.”

How has the Acuvue Abiliti Overnight helped troubleshoot particular patients?

Again, Dr. Miller points to the FitAbiliti software as a help when troubleshooting. “The FitAbilti app takes out the guesswork and guides the prescribing physician through steps to properly adjust decentered lenses or insufficient treatment zones,” he says. He adds that individual parameters such as fitting heights and curves, compression factor, and lens diameter can be adjusted as the prescribing physician gains confidence in fitting.

Tell us about any success stories.

Dr. Moheeputh tells of a 6-year-old girl who had bright curly red hair. When she initially came in, her mother asked if her daughter needed glasses. “I replied ‘Yes, she needs glasses.’ The little girl started to cry, ‘I don’t wanna wear glasses. I won’t wear them.’

“She’s now in ortho-k. She’s doing wonderfully,” she says. “Every time they come into the office, her mom cries. First, it was because her daughter was getting worse. Now, she’s crying happy tears because her daughter did not get worse in the first year that she’s been with me.”

Dr. Chan also recounts the story of a young girl whom she treated. “Both of 8-year-old Ellie’s parents have high myopia, and her father had a retinal detachment several years ago. When her parents learned that Ellie was myopic, they asked me about options to manage her myopia so that it will not progress as far as her parents. Ellie loves swimming and prefers to be glasses-free during the day. I discussed current treatment options and determined that ortho-k would be best suited for Ellie,” she says.

“Ellie has been wearing the Abiliti lenses for one year. There was no change in her myopia and her axial length has been stable. Another success!” CLS