VISIONARY OPTICS has launched Europa Tangent, a scleral lens that combines an optimized, customizable design with a streamlined fitting process. According to the company, this enhanced lens design is based on clinical experience and the analysis of more than 10,000 fittings driven by profilometry data and Visionary Optics’ scleral shape classification expertise.

The Europa Tangent design offers a three-zone step system that ensures advanced customization options remain available. The design has one landing zone curve, engineered to follow the natural slope of the scleral surface. The company says that this enhanced form offers a smoother, softer transition to the landing zone, patterned after its free-form lens design. A softer landing can eliminate the compression and blanching commonly observed during the fitting process, according to Visionary Optics.

Here, CLS shares the clinical experiences of three practitioners who are using Visionary Optics’ Europa Tangent scleral lenses in their practices.

Please tell us about your experience with Europa Tangent.

Randy Charrier, OD, who practices in Spring, TX, began working with the Europa Tangent before its release. “Even in the early stage, I saw a consistent improvement in the landing profile compared to the standard Europa lens, as well as other designs,” he says.

Dave Shin, OD, who practices in Gig Harbor, WA, initially started using the Europa Tangent lens design to troubleshoot cases in which scleral lens patients complained of discomfort but had lenses that appeared to fit well. “After we saw a trend of patients reporting improved comfort with the new slimmer and smoother edge design,” Dr. Shin explains, “we decided to make it our go-to lens for scleral lens fits and haven’t looked back since.”

Who are the best candidates for this product and why?

According to Dr. Shin, any patient looking for increased comfort compared to older lens designs would benefit from the Europa Tangent. “The smoother, tapered edge provides a softer landing compared to the thicker lens edges that I’ve seen in the past,” he says. “Granted, there are some complicated cases in which the patient is better served by a free-form lens design, but overall, the vast majority of patients who need scleral lenses are good candidates for this new lens design.”

Dr. Charrier concurs and notes that he uses the Europa Tangent as the first trial lens placed on nearly every patient. “In the cases in which I need a more complex lens…I still use the Europa Tangent to obtain an over-refraction and potential acuity measurement,” he says. “ This lens is a true ‘workhorse’ in my office.”

Tell us about the fitting process.

Steven Sorkin, OD, who practices in Fairfield, NJ, has been working with Visionary Optics for about 15 years and still has dozens of patients in the company’s original Jupiter design. “The new Europa Tangent has been a nice addition to my practice. It is very customizable and intuitive to fit and troubleshoot, if needed, which is rare,” he says. “Consultation is excellent and I rarely need to make any adjustments to the initial lenses ordered. Additionally, the lab fabricates and ships the lenses in one to two business days almost 100% of the time.”

Both Dr. Shin and Dr. Charrier use the Europa Tangent Fitting Set to choose the right lenses for their patients. The fitting set includes 12 lenses (six spherical lenses, three 200µ toric haptic lenses, and three 400µ toric haptic lenses), each with a 16.5mm diameter.

“An in-house Europa Tangent fitting kit is an investment that pays for itself the first time you use it. Putting lenses on a patient’s eyes dramatically increases the likelihood of a patient moving forward with a scleral lens fitting,” Dr. Shin says. “Once the patient experiences how the lens feels and realizes how much better they can see, the question changes from ‘Do I want to get this lens?’ to ‘How soon can I get this lens?’”

“I’ve also noticed a reduction in chair time with Europa Tangent lenses,” he continues. “I’ve received fewer complaints and seen fewer complications caused by poor edge design, allowing me to finalize lenses with fewer remakes.”

Dr. Shin also notes that ordering lens changes is easier. “The simplified design allows me to implement the changes I need without dealing with multiple curves that overcomplicate things,” he says. “And I love how changing one part of a lens won’t cause a cascade of changes that complicates and extends the fitting process.”

Dr. Charrier also prefers fitting with trial lenses. “With the standard Europa, I would often have to flatten the landing after adjusting for central and limbal clearance. It is rare for me to have to do this with the Europa Tangent lens,” he says. “I have long considered the Europa lens to be superior to other designs I have worked with, in that I am able to come to a final lens prescription faster, with fewer remakes and adjustments.

“The Europa Tangent lens has made me more efficient, and this is critical in a fast-paced specialty lens practice,” continues Dr. Charrier.

Tell us about any success stories.

Dr. Charrier notes that he has had several hundreds of cases in which the Europa Tangent has been successful in his office. He gives one example involving a 36-year-old Hispanic male who was suffering from severe keratoconus.

“He he had tried scleral lenses at two different offices and was unsuccessful due to redness, irritation, and reduced wear time,” he says. “Our evaluation with trial lenses revealed that his sclera exhibited significant sloping just outside the limbus. This, combined with the severe steepening of his corneas, set up an impossible situation for a lens with traditional peripheral curve radii. If the lens was fit with enough clearance to vault the apex of the cornea, the periphery would misalign with the sclera significantly.

“Though the landing of the Europa Tangent lens had to be adjusted, it was able to dramatically improve the fit,” he continues. “The patient now has good vision, and is able to wear the lens comfortably all waking hours of the day.”

Dr. Shin tells of an elderly patient he saw recently. “The patient experienced a complication during an intraocular lens replacement surgery that resulted in an irregular cornea with 6D of astigmatism and 20/200^-2 vision in his right eye. He couldn’t tolerate spectacle correction and had seen multiple corneal specialists, the last of whom referred him to me for a specialty lens fitting.

“Despite his irregular cornea, the first scleral lens I ordered fit well and provided great comfort,” notes Dr. Shin. “A small power change was incorporated into his second lens, which ultimately improved the vision in his right eye to 20/20^-2. CLS