ALCON'S TOTAL30 MULTIFOCAL is a monthly water gradient multifocal designed to address contact lens (CL) dropout due to lens dryness, discomfort, and visual acuity issues for wearers over the age of 40. It utilizes the company’s proprietary Water Gradient Technology, which works to combat issues related to digital device usage, according to Alcon. The CLs employ the Precision Profile multifocal optical design. They are available with a full power range of +6.00D to –10.00D (in 0.25D steps) and three add powers.

Here, practitioners share their clinical experiences.

TELL US ABOUT YOUR EXPERIENCE WITH TOTAL30 MULTIFOCAL CLs.

Jessica Crooker, OD, practices in an office in Scituate, MA, that primarily uses daily disposable lenses. “My initial reaction was that I probably would not have much use for the lens. Once I started fitting the lens and found how much patients loved it, I found myself reaching for [it] more and more,” she explains. “The lens centers quickly and patients are impressed with how nice the lens feels on their eye immediately.” 

Pamela Lowe, OD, who practices in Niles, IL, also works in an office that strives to fit and/or refit most patients into daily disposables. However, she notes that “It has been amazing to finally have innovation in the monthly, reusable category. It’s been a game-changer to have a reusable lens that is deposit- and bacteria-resistant from day one to day 30.”

WHO ARE THE BEST CANDIDATES?

Dr. Crooker started off switching patients who were unhappy with their vision in their current multifocals, but has been prescribing this lens for emerging presbyopes and patients who had low add powers but may not have complained about their near vision. “Some patients who were previously daily contact lens wearers were interested to try monthly lenses because they are a better fit for their lifestyle,” she notes.

TELL US ABOUT THE FITTING PROCESS. 

For Dr. Lowe, the fitting process allows for reduced chair time and improved patient experiences. She also notes that in the rare instances that aren’t successful, the fitter can efficiently move to another design that may be a better option. “If a practitioner meticulously follows the two-step fit guide, success is reached [nearly every] time.”

Dr. Crooker agrees that the fitting is very easy if you follow the fitting guide carefully. “By following the fit guide, I feel like I can fit almost all my patients on the very first lens that I select,” she says. “I like to have my patients try the lens on immediately with good lighting, and they often rave about how clear their vision is right away.” 

HOW HAS THE LENS HELPED WITH TROUBLESHOOTING?

According to Dr. Lowe, understanding the importance of following the fit guidelines simplifies any troubleshooting that may be necessary. “No matter what the patient’s visual complaint is—be it blur at distance, near, or both—simply revisiting the binocular over-refraction that only involves adding more plus to each eye individually (no occluding is ever necessary), then confirming if any over-refraction found over each eye improves vision when the change is made, leads the practitioner to an efficient endpoint,” she says. “There really is no troubleshooting rabbit holes with this lens design if we humble ourselves to follow the clinically proven, efficient fit guide!”

PLEASE SHARE ANY SUCCESS STORIES.

All of Dr. Lowe’s success stories center on improving comfort for a reusable lens wearer. “Seasoned contact lens patients, especially those wearing older technologies, come to expect that there is a ‘compromise’ built into wearing contact lenses. They are convinced that all contact lenses get uncomfortable and/or blurry at some point in the day,” she says. “When I can offer these folks a comfortable lens-wearing experience all day, from day one to day 30, that’s a huge win for the patient and, in turn, a huge win for our practice.”