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Soft Disposable Contact Lens:
Uses, pros and cons
Moderators: Presenter:
Niraj Dev Joshi Ashi Lakher
Suraj Chhetri Final year (21st batch)
MMC,IOM
Presentation Layout
ā€¢ Introduction
ā€¢ Types of Disposable lenses
ā€¢ Uses
ā€¢ Pros and Cons
ā€¢ Contact lens available in market
ā€¢ References
Defining Disposables:
ā€¢ According to Oxford dictionary , Disposable is defined as- " Designed to be thrown
away after one use and not to be laundered or refilled".
ā€¢ However, Food and Drug Administration(FDA) mentions - "Disposable lenses as lenses
worn for a period of one day to one week, then discarded when removed".
ā€¢ Disposable contact lens are development of molding based manufacturing method.
ā€¢ There has been a bit of confusion about the word "Disposable" since the lenses are
being discarded either monthly or quarterly. So scientific term preferred is "Planned
replacement programme lenses".
Brief History:
ā€¢ A group of Danish clinicians and engineers, led by ophthalmologist Michael Bay,
developed a moulding process so that low cost, multiple individual lens packs could be
produced (Mertz, 1997). This product ā€“ known as ā€˜Danalensā€™ ā€“ was released into the
Scandinavian market in 1984 and recognized as the first truly disposable lens.
ā€¢ The pharmaceutical giant Johnson & Johnson (vistakon), which had not previously
been involved in the contact lens business, purchased the Danalens technology in 1984
and completely overhauled the lens polymer formulation, packaging system and
moulding technology.
ā€¢ The result was the Acuvue Soft lens, an inexpensive weekly-replacement extended-
wear lens, which was released in the USA in June 1988, and worldwide shortly
thereafter.
ā€¢ In late 1980s and early 1990s ,there were limited lens parameters and design
available.
ā€¢ Today ,all of the larger and some of the small manufacturers offer disposable &
planned replacement lenses with expanded ranges of base curve radii, power, lens
diameter,& thickness.
ā€¢ Spherical, toric & multifocal designs are now available & other option include
visibility and handling tints, cosmetic enhancers, and Ultraviolet filtration.
Classification of lens Replacement Schedules:
ā€¢ The replacement schedule for soft contact lenses are classified as:
a. Conventional/ Traditional lenses:
ā€¢ These lenses are not replaced until their expected longer life span has been
reached.
ā€¢ Lens replacement usually occurs at about 6 months or 12 months providing a
complete care regimen, including enzymatic cleaning.
-Eg: Optima 38 lenses.
b. Planned replacement:
ā€¢ Refers to 1-3 months schedule of lens replacement.
ā€¢ c. Disposable lenses:
- Refers to a schedule of weekly or fortnightly lens replacement ,while using a
care regimen that doesnā€™t usually include enzymatic cleaning.
ā€¢ The key challenge with soft contact lens material is "Deposit".
ā€¢ Material is like sponge which has lot of pores in it. Lens deposit get bound to the
lens surface.
ā€¢ Proper lens care can minimize surface deposits but not totally remove .
ā€¢ Therefore , to face the key challenge use disposable/Planned replacement contact
lens.
Why Disposable lenses / Planned Replacement lenses
Ideal candidates for Disposable lenses:
ā€¢ Allergic individual with sensitivity to chemical lens care system product.
ā€¢ Conventional lens wearer who has difficulty with maintenance, because of type
of work they do.
ā€¢ Business travelers and part time wearer(sports)
For Eg: A golfer who want crisp and clear contact lens vision for his game once or
twice a week or a business traveler. Rather than keeping their contact lens
immersed in solutions between wearing cycles, these part time wearer are
best served with disposable contact lens.
ā€¢ Wearer who are exposed to pollutant.
ā€¢ Patient who frequently lose contact lens or need spare lens.
ā€¢ Individual who form excessive deposit on the contact lens.
ā€¢ Contact lens induced dry eye patients.
ā€¢ Therapeutic uses
ā€¢ Pediatric uses- Aphakia, Anisometropia, Amblyopia(opaque contact lens)
Contraindication for Disposable lenses:
ā€¢ Anterior segment inflammation or infection.
ā€¢ Environment with chemical pollution. (e.g insecticides, chemical fertilizers)
ā€¢ Workers in polluted environments(e.g mechanics, farm workers, bricklayers)
What are the advantages of Disposable lenses?
For Contact lens wearer:
ā€¢ These are very convenient. If using daily disposable lenses, thereā€™s no hassels
with cleaning or disinfecting the lenses. With regards to other disposable lens
options, the care & maintenance is similar to conventional lenses minus the
enzymatic cleaning.
ā€¢ Clean , fresh, sterile lenses are simply more comfortable.
ā€¢ As disposable lenses are replaced more frequently or used for a limited time,
protein and other deposits like lipids, calcium etc have less chance to build-up on
them .
Fewer lens deposits
Fewer eye health
problems
Consistent lens
performance
ā€¢ Simultaneous use with topical medication.
ā€¢ Reasonable cost.
For eye care practioners:
ā€¢ Reduced patient drop-outs
ā€¢ Improved patient management
ā€¢ Promotes annual / more frequent eye examination.
ā€¢ Preventive eye care improves ocular health.
ā€¢ Fewer ā€œunscheduledā€ visits.
What are the disadvantages of Disposable lenses?
Though they are excellent choice for many people, disposable contact lenses are
not for everybody.
ā€¢ Specific prescription may not be available.
ā€¢ Disposable contact lens cost more than conventional lenses.
ā€¢ As wear & care with disposable lenses is easy, one can get false sense of security
with disposable contact lenses. Inspite of their comfort and convenience
,remember that all contact lenses are medical devices that requires periodic
check-ups from Eye care practitioners.
ā€¢ For the patients who have worn conventional contact lenses, it sometimes takes
bit effort to accept the idea that disposable lenses are meant to be thrown out
after just one use.
Types of disposable contact lenses:
Biweekly and Monthly
Disposable
Daily Disposable
Toric lenses
Silicon Hydrogels
Multifocal and bifocals
A. Daily soft lens replacement
ā€¢ Daily disposable contact lenses are intended to be worn during waking hours for a
full day and to be discarded the same day after use.
ā€¢ Wearing of daily disposable lenses eliminates the need for cleaning and/or
disinfecting solutions, resulting in a higher compliance rate for lens replacement
ā€¢ In 2019, it was estimated that soft contact lenses accounted for about 87% of lens
fits. Of the soft contact lenses prescribed in 2019, about 40% were daily disposable
contact lenses.
Morgan P, oods CA, Tranoudis IG, et al. International contact lens prescribing in 2019. Cont Lens Spectrum. 2020;35(1):26ā€“32.
Advantages from the perspective of practioner:
ā€¢ Less patient education time is required(No advice needed for lens care).
ā€¢ The absence of a lens storage case from the regime is beneficial given the
role that a lens case can play in development of occular infection.
ā€¢ Although the risk of microbial keratitis (MK) varies with different daily disposable
lens materials, the risk of severe cases is significantly lower (0.5x) when
compared with other soft lens types worn daily.
Advantages from perspective of lens wearer:
ā€¢ No need to be concern with lens care system.
ā€¢ No anxieties about lost or damaged lens.
ā€¢ Daily disposable lens are more hygienic for intermittent wearer, as storage
problems are eliminated.
ā€¢ Daily disposable lens are convenient and compact for travel ,as there's no need to
carry bulky lens care solution.
ā€¢ Compliance is easier because there are fewer instruction to remember.
Disadvantages:
ā€¢ Patient may reuse the daily disposable lens. Indeed, one study reviewing clinical
record cards found that a higher proportion of daily disposable contact lens wearers
reported non-compliant overnight lens wear compared with other replacement
modalities.
ā€¢ Further case reports have shown that severe keratitis caused by Pseudomonas
Aeruginusa, Acanthamoeba, and fungi are still possible with daily disposable
contact lens.
ā€¢ Patient concerns about the cost of full time wear.
ā€¢ A greater adverse environmental impact compared with other lens replacement
modalities.
Daily disposable contact lenses
Name Manufacturer Material
Water
conte
nt
Base
Curve
(mm)
Diamet
er
(mm)
Central
thicknes
s
(mm)
Power Range Dk/t
Aveo
Hello
Aveo Omafilcon A
(Hy)
58% 8.6 14.2 0.07 +6D to -10D
(0.50 steps above -6.50D
and +4.50D)
36.7
Clarity 1
day
Cooper Vision Somofilcon A
(Si Hy)
56% 8.1 14.1 0.07 -0.5 to -10D/+0.5 to +8D
(0.50 steps after Ā±6D)
86
Soflens
comfort
Bausch and
Lomb
Hilafilcon B
(Hy)
59% 8.6 14.2 0.05-
0.75
+6.5 to -9.00D
(0.50 steps above -6.50D)
22
SEED SEED 2- HEMA
(Hy)
58% 8.8 14.2 0.07 -0.5 to -16D/+0.5 to +8D
(0.50 steps after +5.5D
&-6D)
42.9
1 day
Acuvue
moist
Johnson &
Johnson
Etafilcon A
(Hy)
58% 8.5, 9.0 14.2 0.084 -0.5 to -12D/+0.5 to +6D
(0.50 steps after +5.5D
&-6D)
For both 8.5mm and
9mm BC
25.5
The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
B. The biweekly disposable lenses:
ā€¢ FDA approved lens -These lenses are stored in a lens case for 2 weeks and replaced
with new pair after 2 weeks.
ā€¢ The lenses are worn each day for 8 to 14 hours depending upon the contact lens
material and removed and stored in a lens case after cleaning.
ā€¢ It is generally not necessary to add enzyme cleaning to the lens care regime for
patient replacing their lenses every 1 to 2 week.
ā€¢ These lenses comes in a 6 piece lens pack and each lens can be worn for 2 weeks.
Biweekly contact lenses
Name Manufactur
er
Material Water
conte
nt
Base
curve(m
m)
Diamet
er
(mm)
Central
thickness(m
m)
Power Range Dk/t
Avaira Vitality Cooper
Vision
Fanfilcon
A (Si Hy)
55% 8.4 14.2 0.06 +8 to -12D
(0.50steps above -
6.5D)
110
Acuvue OASYS J & J Senofilcon
A (Si Hy)
58% 8.4, 8.8 14 0.070 -0.5 to -12D/+0.5 to
+8D
(0.50 steps after
Ā±6D)
147
Aveo 2-weeks Aveo Omafilcon
A (Hy)
55% 8.6 14.2 0.070 -0.5 to -10D/+0.50
to +4D (0.50 steps
after Ā±6.5D)
31
2 week pure
moisture
SEED SEED Ionic
Bond (SIB)
(hydrogel)
58% 8.6 14.2 0.09 +5 to -10D
(0.5 steps above -
6.5D)
33.3
The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
Planned soft lens replacement:
ā€¢ Planned replacementā€™ refers to lens replacement at intervals from
monthly to 12 months and, therefore, includes all ā€˜disposable lensesā€™,
which are defined as lenses replaced at least monthly.
ā€¢ Enzymatic treatment should be added to the care regimens.
C. Thirty Day disposable Silicone hydrogel contact lens:
ā€¢ New contact lens material having Dk greater than 100.
ā€¢ Silicon hydrogel contact lens material is surface treated that is more hydrophilic &
more resistant to deposit.
ā€¢ Silicon component provides high permeability to oxygen and hydrogel component
promote comfort and movement.
D. The Monthly Disposable Lenses:
ā€¢ Similar to biweekly these lenses are cleaned every day with the lens care solution
for the period of one month and disposed at the end of the month , replaced with
new one.
ā€¢ These lenses also comes in a 6 piece lens pack and each lens can be worn for 1
month.
Monthly disposable contact lenses
Name Manufactu
rer
Material Water
conte
nt
Base
curve
(mm)
Diame
ter
(mm)
Central
thickness
(mm)
Power range Dk/
t
Aveo 1
month
Aveo Filcon II (Hy) 50% 8.6 14.2 0.075 +6 to -10D
(0.50 steps above +4.5D/-
6.50D)
23.
8
Acuvue
Vita
Johnson &
Johnson
Senofilcon C
(Si Hy)
41% 8.4, 8.8 14 0.08 -0.5 to -12D /+0.5 to +8D
For 8.4BC
-0.5 to -12D/+0.50 to +8D
for 8.8BC
(0.50 steps above Ā±6D)
147
Biofinity Cooper
Vision
Comfilcon A
(Si Hy)
48% 8.6 14 0.08 +15D to -20D (0.50 steps
after Ā±6D)
160
Proclear Cooper
Vision
Omafilcon B
(Hy)
62% 8.6, 8.2 14.2 0.065-0.35 +20 to -20D (0.50 steps
after Ā±6D)
42
Q3 Purecon Etafilcon A
(Hy)
58% 8.5 14.2 0.08 -0.5 to -6D in 0.25 steps
-6 to -12D in 0.50 steps
22
Soflens 59 Bausch & Hilafilcon B 59% 8.6 14.2 0.14 +5 to -6D (on 0.25 steps) 22
The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
Yearly wear Contact Lenses:
ā€¢ They usually come in a pair and the same lens is worn for a long time.
ā€¢ Similar to monthly and biweekly these lenses should be cleaned
every day with a multi-purpose lens care solution.
Yearly Contact lenses
Name Manufacturer Material Water
Content
Base
Curve
(mm)
Diamete
r (mm)
Central
thickness
(mm)
Power
Range
Dk/t
O2X EW Purecon Filcon II (Hy) 70% 8.6 14.00 0.08 -0.25 to -10D
(0.50 steps
above -6.5D)
42
Supersoft Purecon P. HEMA (Hy) 45% 8.6 14.00 0.10 -0.25 to -12D
(0.50 steps
above -6.5D)
9
UV filter Purecon P. HEMA (Hy) 38% 8.6 14.00 0.10 -0.25 to -12D
(0.50 steps
above -6.5D)
9
The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
E.Disposable & planned replacement Toric Contact lenses:
ā€¢ This type of lenses is an alternative for patient with significant refractive astigmatism.
Brand Manufacturer Wearing
Modality
Material Water
Content
Base
Curve
(mm)
Diameter
(mm)
Central
thickness
(mm)
Power Range (Sph and Cyl) Dk/t Stabilization
Acuvue
Oasys
Johnson &
Johnson
Bi weekly Senofilcon A
(Si Hy)
38% 8.6 14.5 0.08 plano to -9D/+0.25 to +6D
(0.5 steps above -6.5D)
-0.75 to -2.75D in 0.50 steps
129 Accelerated
Stabilisation
design
Acuvue
vita
Johnson &
Johnson
Monthly
disposable
Senofilcon C
(Si Hy)
41% 8.6 14.5 0.08 +4D to -6.5D in 0.25 steps
-6.5 to -9D in 0.50 steps
-0.75 to -2.25D in 0.50 steps
129 Blink Stabilised
Avaira
Vitality
Toric
Cooper Vision Monthly
disposable
Fanfilcon A
(Si Hy)
55% 8.5 14.5 0.10 +8 to -10D (0.50 steps above
Ā±6D)
-0.75 to -2.25 in 0.50 steps
90 Optimized
Ballast
Aveo Joy Aveo Monthly
disposable
Omafilcon A
(Hy)
58% 8.6 14.5 0.12 -0.5 to -6D in 0.25 steps
-0.75 to -1.75D in 0.50 steps
26 Modified Prism
Ballast
Biofinity
toric
Cooper Vision Monthly
disposable
Comfilcon A
(Si Hy)
48% 8.7 14.5 0.11 +8 to -10D (0.50 steps above
Ā±6D)
-0.75 to -2.25D in 0.50 steps
116 Modified prism
ballast
Clarity 1
day toric
Cooper Vision Daily
disposable
Somofilcon
A (Si Hy)
56% 8.6 14.3 0.07 plano to -9D/+0.25 to +4D
(0.5 steps above -6.5D)
-0.75 to -2.25D in 0.50 steps
57 Prism Ballast
Ultra Bausch & Lomb Monthly
disposable
Samfilcon A
(Si Hy)
46% 8.6 14.5 0.05-0.5 +6D to -9D
(0.5 steps above -6.5D)
-0.75 to -2.75D in 0.50 steps
114 Prism Ballast
Soflens
Toric
Bausch & Lomb Monthly
disposable
Alphafilcon
A (Hy)
66% 8.5 14.5 0.195 +6D to -9D
(0.50D steps above 6.5D)
-0.75 to -2.75D in 0.50 steps
16 Prism Ballast
COLORS
Toric
Celebrations Yearly PolyHEMA
(Hy)
42% 8.6 14.5 plano to -3D in 0.25 steps
-3.5 to -8D in 0.50 steps
-1.00 to -2.50D in 0.50 steps
F. Disposable Bifocal & multifocal lenses:
ā€¢ Aspheric and annular multifocal disposable soft contact lens
design are available.
ā€¢ Advantages of fitting disposable multifocals is the availability
of in-office lenses that patient can try with minimal cost to the
patient.
ā€¢ Before beginning it is important to counsel patient that a bifocal
contact lens may not provide the same clarity as spectacle.
Brand name Manufacturer Water content
%/Dk
Near boost Range
Proclear 1day
Multifocal
CooperVision 60/25 Yes - non-dominant
eye
+6.00 to -10.00
Clariti 1day
Multifocal
Sauflon 56/86 Yes - non-dominant
eye
+5.00 to -6.00
Focus Dailies
Progressive
Alcon 69/26 Yes - both eyes +5.00 to -6.00
ā€¢ Frequently ,monovision provides better results. Monovision system have been another
factor in development of disposable lens because they allow trial fitting with appropriate
power for the patient & afford the oppourtunity to determine which eye is best corrected
for near work.
Ref: CET article
Most frequent complications associated with Disposable
contact lens user non compliant to replacing schedule:
ā€¢ Corneal infiltrates
ā€¢ Contact lens- associated red eye
ā€¢ Giant papillary conjunctivitis
ā€¢ The Dk/t of majority of disposable lenses (excluding Si-Hy) is similar to that of
conventional hydrophilic lenses, therefore hypoxia problem exist with non Si-Hy
lenses.
ā€¢ Keratitis
Research Corner:
Trend of soft contact lens prescribing in an optometry centre in India:
a 6-year analysis.
Sanker N, Noushad B. Trend of soft contact lens prescribing in an optometry centre in India: A 6-year analysis. Contact Lens and Anterior
Eye. 2013 Aug 1;36(4):196-8.
Abstract
This six-year retrospective longitudinal study was conducted to examine the
changes in the pattern of prescribing soft contact lenses in an optometry centre
located in a University in South India. Details regarding the type of lenses, lens
material, wearing pattern and the clinical diagnoses were analyzed from January
2006 to December 2011. A total of 1273 soft contact lens fits (n=1273) were
analyzed. Two-third of the total lenses dispensed was for females and their mean
age (24.0Ā±8.3 yrs) was less than that of male (27.0Ā±11.2 yrs) lens users. Nearly
70% of them had myopia and 48% wore conventional soft contact lenses.
During the six years study, the percentage of conventional lenses declined by
60%. This study demonstrated a gradual and significant increase in popularity of
disposable contact lenses and silicone hydrogel lens material which is comparable
to the global trend.
Daily versus monthly disposable contact lens: Which is better for ocular surface
physiology and comfort?
Sapkota K, Franco S, Lira M. Daily versus monthly disposable contact lens: Which is better for ocular surface physiology and
comfort?. Contact Lens and Anterior Eye. 2018 Jun 1;41(3):252-7
Purpose: To investigate the effect of soft contact lenses (SCL) wearing modality and lens materials on the
changes in conjunctival bulbar and limbal redness and conjunctival and corneal staining after two months of
SCL wear. Comfort level was also analyzed.
Methods: In this longitudinal clinical trial, forty-seven neophyte myopic subjects were fitted with a monthly
disposable lens (lotrafilcon-B or comfilcon-A or balafilcon-A) in one eye and a daily disposable lens
(nelfilcon-A or stenofilcon-A or nesofilcon-A) in the other eye, randomly selected. Conjunctival bulbar and
limbal redness and conjunctival and corneal staining were evaluated before and after lens wear. Effect of
lens wearing modality and lens materials on these changes was also determined. Level of comfort was
evaluated subjectively twice per day. Comfort level and reduction in end-of-day comfort were compared
between different lens wearing modalities and materials.
Results: Bulbar and limbal redness and conjunctival and corneal staining were increased (p<0.001) after
lens wear, and changes were similar with daily and monthly disposable lens wear (p>0.05). Limbal redness
was associated with lens materials, and lotrafilcon-B induced the least among the studied lenses (p<0.05).
There was no significant association between the wearing modality and the average comfort level and
reduction of end-of-day comfort (p>0.05).
Conclusion: Two months of SCL wear increased conjunctival redness, conjunctival and corneal staining,
which were not associated with the lens wearing modality. There was a reduction in end-of-day comfort,
similar to daily and monthly lenses. The change in limbal redness and reduction in end-of-day comfort were
associated with the characteristics of the lens material.
SIGNIFICANCES OF DAILY DISPOSABLE CONTACT LENSES DURING
COVID-19
Bhattarai S. Significances of daily disposable contact lenses during COVID-19. Journal of Chitwan Medical College.
2021;11(4):137-8.
ABSTRACT :
Contact lens is one of the preferred modes of refractive correction for children and
adults. With proper care and maintenance, even during pandemic of COVID-19, contact
lenses can be prescribed and worn by the patients without much fear of Coronavirus
infection. Till now there is no strong clinical evidence that proves contact lenses are not
safe to wear during COVID-19. But considering patientā€™s health and hygiene, various
literatures have suggested that with compared to conventional or yearly disposable
contact lenses, daily disposable contact lenses are safer to use during COVID-19.
Since the daily disposable lenses are discarded daily after use at the end of the day,
there is no need of extra care regarding manual cleaning and maintenance. Daily
disposable lenses may have a very less or even no deposits and debris so makes patient
more comfortable all over the time with less risk of Coronavirus infection.
Evaluation of the Ocular Surface in Different Contact Lens
Replacement Schedules
Muhafiz E, Bayhan HA, Sahin S, GƶƧmen AY, Bayhan SA, GĆ¼rdal C. Evaluation of the ocular surface in different contact lens
replacement schedules. Cornea. 2019 May 1;38(5):587-94.
Purpose: To evaluate the effects of different contact lens (CL) replacement schedules and different CL
materials on the ocular surface and tear function.
Methods: Daily disposable hydrogel CLs were given to group 1 (n = 22), daily disposable silicone
hydrogel CLs were given to group 2 (n = 25), and reusable silicone hydrogel CLs were given to group 3 (n
= 24). Tear function tests and inflammatory cytokine [interleukin (IL)-6, IL-8, IL-17A, and matrix
metalloproteinase (MMP)-9] levels were evaluated before and at 1 and 3 months after CL usage.
Impression cytology was evaluated before and at 3 months after CL usage.
Results: At the first and third months of CL usage, a statistically significant difference was determined
between the groups in the levels of IL-6, IL-8, and IL-17A in tears, with the lowest levels in group 1 and
the highest levels in group 3 (all P < 0.05). At the third month of CL usage, the levels of these cytokines
(in picograms/milliliter) were 6.06 Ā± 0.83, 78.18 Ā± 12.42, 61.69 Ā± 13.95, and 37.71 Ā± 5.95 in group 1 and
8.04 Ā± 0.89, 107.34 Ā± 14.40, 68.63 Ā± 13.72, and 46.26 Ā± 6.50 in group 3, respectively. A statistically
significant decrease was determined over time in the Schirmer test in group 1, in only the tear breakup
time in group 2, and in the tear breakup time and Schirmer test in group 3 (all P < 0.05). A statistically
significant increase was determined over time in the levels of IL-6, IL-8, IL-17A, and MMP-9 in all
groups. In the third month, a significant progression was observed in the Nelson grade (P < 0.05) in all
groups.
Conclusions:
The wear of daily disposable CLs can be considered to cause less damage to the ocular surface and less
increase in proinflammatory cytokine levels.
Clinical Comparison of a Silicone Hydrogel and a Conventional Hydrogel Daily
Disposable Contact Lens
Miller J, Giedd B, Subbaraman LN. Clinical comparison of a silicone hydrogel and a conventional hydrogel daily
disposable contact lens. Clinical Ophthalmology. 2021 Oct 29:4339-45.
Purpose: To compare the subjective performances of verofilcon A daily disposable silicone hydrogel
contact lenses (CLs) and etafilcon A hydrogel CLs.
Methods: Successful wearers of spherical soft CLs for distance correction were prospectively
randomized to wear verofilcon A or etafilcon A lenses for 1 week and crossed over to the alternative
lenses. The primary study objective was a comparison of distance visual acuity (VA). Exploratory
endpoints included subjective overall lens preference (5-point scale) and subjective ratings (10-point
scales) of end-of-day (EOD) vision, overall handling, insertion comfort, EOD comfort, overall quality of
vision, overall comfort, vision throughout the day, lens handling at insertion, and lens handling at
removal.
Results: Of 92 subjects (184 eyes), 46 each were randomized to verofilcon A or etafilcon A lenses and
subsequently crossed over to the other lenses. Evaluation of distance VA showed that verofilcon A
lenses were noninferior to etafilcon A lenses. Comparison of lens preference showed that 68 (73.9%)
subjects somewhat or strongly preferred verofilcon A lenses, whereas 21 (22.9%) somewhat or strongly
preferred etafilcon A lenses (p<0.0001). Mean Ā± SD ratings of EOD vision (8.6Ā±1.5 vs 7.7Ā±1.9), overall
handling (8.7Ā±1.5 vs 6.9Ā±2.3), insertion comfort (9.2Ā±1.0 vs 7.7Ā±1.9), and EOD comfort (8.0Ā±1.9 vs
7.0Ā±2.2) were all significantly (pā‰¤0.0001 each) higher for verofilcon A than for etafilcon A lenses. Mean
Ā± SD ratings of overall quality of vision (8.9Ā±1.2 vs 8.2Ā±1.8), overall comfort (8.6Ā±1.5 vs 7.4Ā±1.8), vision
throughout the day (8.9Ā±1.3 vs 8.1Ā±1.8), lens handling at insertion (9.0Ā±1.4 vs 6.9Ā±2.5), and lens
handling at removal (8.3Ā±2.1 vs 7.7Ā±2.2) were also significantly higher for verofilcon A lenses. No
subject experienced any ocular adverse events.
Conclusion: After 1 week of wear, the study population reported that ratings for subjective endpoints
were significantly higher for verofilcon A lenses than for etafilcon A lenses.
References:
CET Articles
Soft disposable contact lens.pptx

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Soft disposable contact lens.pptx

  • 1. Soft Disposable Contact Lens: Uses, pros and cons Moderators: Presenter: Niraj Dev Joshi Ashi Lakher Suraj Chhetri Final year (21st batch) MMC,IOM
  • 2. Presentation Layout ā€¢ Introduction ā€¢ Types of Disposable lenses ā€¢ Uses ā€¢ Pros and Cons ā€¢ Contact lens available in market ā€¢ References
  • 3. Defining Disposables: ā€¢ According to Oxford dictionary , Disposable is defined as- " Designed to be thrown away after one use and not to be laundered or refilled". ā€¢ However, Food and Drug Administration(FDA) mentions - "Disposable lenses as lenses worn for a period of one day to one week, then discarded when removed". ā€¢ Disposable contact lens are development of molding based manufacturing method. ā€¢ There has been a bit of confusion about the word "Disposable" since the lenses are being discarded either monthly or quarterly. So scientific term preferred is "Planned replacement programme lenses".
  • 4. Brief History: ā€¢ A group of Danish clinicians and engineers, led by ophthalmologist Michael Bay, developed a moulding process so that low cost, multiple individual lens packs could be produced (Mertz, 1997). This product ā€“ known as ā€˜Danalensā€™ ā€“ was released into the Scandinavian market in 1984 and recognized as the first truly disposable lens. ā€¢ The pharmaceutical giant Johnson & Johnson (vistakon), which had not previously been involved in the contact lens business, purchased the Danalens technology in 1984 and completely overhauled the lens polymer formulation, packaging system and moulding technology.
  • 5. ā€¢ The result was the Acuvue Soft lens, an inexpensive weekly-replacement extended- wear lens, which was released in the USA in June 1988, and worldwide shortly thereafter. ā€¢ In late 1980s and early 1990s ,there were limited lens parameters and design available. ā€¢ Today ,all of the larger and some of the small manufacturers offer disposable & planned replacement lenses with expanded ranges of base curve radii, power, lens diameter,& thickness. ā€¢ Spherical, toric & multifocal designs are now available & other option include visibility and handling tints, cosmetic enhancers, and Ultraviolet filtration.
  • 6. Classification of lens Replacement Schedules: ā€¢ The replacement schedule for soft contact lenses are classified as: a. Conventional/ Traditional lenses: ā€¢ These lenses are not replaced until their expected longer life span has been reached. ā€¢ Lens replacement usually occurs at about 6 months or 12 months providing a complete care regimen, including enzymatic cleaning. -Eg: Optima 38 lenses. b. Planned replacement: ā€¢ Refers to 1-3 months schedule of lens replacement.
  • 7. ā€¢ c. Disposable lenses: - Refers to a schedule of weekly or fortnightly lens replacement ,while using a care regimen that doesnā€™t usually include enzymatic cleaning. ā€¢ The key challenge with soft contact lens material is "Deposit". ā€¢ Material is like sponge which has lot of pores in it. Lens deposit get bound to the lens surface. ā€¢ Proper lens care can minimize surface deposits but not totally remove . ā€¢ Therefore , to face the key challenge use disposable/Planned replacement contact lens. Why Disposable lenses / Planned Replacement lenses
  • 8. Ideal candidates for Disposable lenses: ā€¢ Allergic individual with sensitivity to chemical lens care system product. ā€¢ Conventional lens wearer who has difficulty with maintenance, because of type of work they do. ā€¢ Business travelers and part time wearer(sports) For Eg: A golfer who want crisp and clear contact lens vision for his game once or twice a week or a business traveler. Rather than keeping their contact lens immersed in solutions between wearing cycles, these part time wearer are best served with disposable contact lens.
  • 9. ā€¢ Wearer who are exposed to pollutant. ā€¢ Patient who frequently lose contact lens or need spare lens. ā€¢ Individual who form excessive deposit on the contact lens. ā€¢ Contact lens induced dry eye patients. ā€¢ Therapeutic uses ā€¢ Pediatric uses- Aphakia, Anisometropia, Amblyopia(opaque contact lens)
  • 10. Contraindication for Disposable lenses: ā€¢ Anterior segment inflammation or infection. ā€¢ Environment with chemical pollution. (e.g insecticides, chemical fertilizers) ā€¢ Workers in polluted environments(e.g mechanics, farm workers, bricklayers)
  • 11. What are the advantages of Disposable lenses? For Contact lens wearer: ā€¢ These are very convenient. If using daily disposable lenses, thereā€™s no hassels with cleaning or disinfecting the lenses. With regards to other disposable lens options, the care & maintenance is similar to conventional lenses minus the enzymatic cleaning. ā€¢ Clean , fresh, sterile lenses are simply more comfortable. ā€¢ As disposable lenses are replaced more frequently or used for a limited time, protein and other deposits like lipids, calcium etc have less chance to build-up on them . Fewer lens deposits Fewer eye health problems Consistent lens performance
  • 12. ā€¢ Simultaneous use with topical medication. ā€¢ Reasonable cost. For eye care practioners: ā€¢ Reduced patient drop-outs ā€¢ Improved patient management ā€¢ Promotes annual / more frequent eye examination. ā€¢ Preventive eye care improves ocular health. ā€¢ Fewer ā€œunscheduledā€ visits.
  • 13. What are the disadvantages of Disposable lenses? Though they are excellent choice for many people, disposable contact lenses are not for everybody. ā€¢ Specific prescription may not be available. ā€¢ Disposable contact lens cost more than conventional lenses.
  • 14. ā€¢ As wear & care with disposable lenses is easy, one can get false sense of security with disposable contact lenses. Inspite of their comfort and convenience ,remember that all contact lenses are medical devices that requires periodic check-ups from Eye care practitioners. ā€¢ For the patients who have worn conventional contact lenses, it sometimes takes bit effort to accept the idea that disposable lenses are meant to be thrown out after just one use.
  • 15. Types of disposable contact lenses: Biweekly and Monthly Disposable Daily Disposable Toric lenses Silicon Hydrogels Multifocal and bifocals
  • 16. A. Daily soft lens replacement ā€¢ Daily disposable contact lenses are intended to be worn during waking hours for a full day and to be discarded the same day after use. ā€¢ Wearing of daily disposable lenses eliminates the need for cleaning and/or disinfecting solutions, resulting in a higher compliance rate for lens replacement ā€¢ In 2019, it was estimated that soft contact lenses accounted for about 87% of lens fits. Of the soft contact lenses prescribed in 2019, about 40% were daily disposable contact lenses. Morgan P, oods CA, Tranoudis IG, et al. International contact lens prescribing in 2019. Cont Lens Spectrum. 2020;35(1):26ā€“32.
  • 17. Advantages from the perspective of practioner: ā€¢ Less patient education time is required(No advice needed for lens care). ā€¢ The absence of a lens storage case from the regime is beneficial given the role that a lens case can play in development of occular infection. ā€¢ Although the risk of microbial keratitis (MK) varies with different daily disposable lens materials, the risk of severe cases is significantly lower (0.5x) when compared with other soft lens types worn daily.
  • 18. Advantages from perspective of lens wearer: ā€¢ No need to be concern with lens care system. ā€¢ No anxieties about lost or damaged lens. ā€¢ Daily disposable lens are more hygienic for intermittent wearer, as storage problems are eliminated. ā€¢ Daily disposable lens are convenient and compact for travel ,as there's no need to carry bulky lens care solution. ā€¢ Compliance is easier because there are fewer instruction to remember.
  • 19. Disadvantages: ā€¢ Patient may reuse the daily disposable lens. Indeed, one study reviewing clinical record cards found that a higher proportion of daily disposable contact lens wearers reported non-compliant overnight lens wear compared with other replacement modalities. ā€¢ Further case reports have shown that severe keratitis caused by Pseudomonas Aeruginusa, Acanthamoeba, and fungi are still possible with daily disposable contact lens. ā€¢ Patient concerns about the cost of full time wear. ā€¢ A greater adverse environmental impact compared with other lens replacement modalities.
  • 20. Daily disposable contact lenses Name Manufacturer Material Water conte nt Base Curve (mm) Diamet er (mm) Central thicknes s (mm) Power Range Dk/t Aveo Hello Aveo Omafilcon A (Hy) 58% 8.6 14.2 0.07 +6D to -10D (0.50 steps above -6.50D and +4.50D) 36.7 Clarity 1 day Cooper Vision Somofilcon A (Si Hy) 56% 8.1 14.1 0.07 -0.5 to -10D/+0.5 to +8D (0.50 steps after Ā±6D) 86 Soflens comfort Bausch and Lomb Hilafilcon B (Hy) 59% 8.6 14.2 0.05- 0.75 +6.5 to -9.00D (0.50 steps above -6.50D) 22 SEED SEED 2- HEMA (Hy) 58% 8.8 14.2 0.07 -0.5 to -16D/+0.5 to +8D (0.50 steps after +5.5D &-6D) 42.9 1 day Acuvue moist Johnson & Johnson Etafilcon A (Hy) 58% 8.5, 9.0 14.2 0.084 -0.5 to -12D/+0.5 to +6D (0.50 steps after +5.5D &-6D) For both 8.5mm and 9mm BC 25.5 The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
  • 21.
  • 22. B. The biweekly disposable lenses: ā€¢ FDA approved lens -These lenses are stored in a lens case for 2 weeks and replaced with new pair after 2 weeks. ā€¢ The lenses are worn each day for 8 to 14 hours depending upon the contact lens material and removed and stored in a lens case after cleaning. ā€¢ It is generally not necessary to add enzyme cleaning to the lens care regime for patient replacing their lenses every 1 to 2 week. ā€¢ These lenses comes in a 6 piece lens pack and each lens can be worn for 2 weeks.
  • 23. Biweekly contact lenses Name Manufactur er Material Water conte nt Base curve(m m) Diamet er (mm) Central thickness(m m) Power Range Dk/t Avaira Vitality Cooper Vision Fanfilcon A (Si Hy) 55% 8.4 14.2 0.06 +8 to -12D (0.50steps above - 6.5D) 110 Acuvue OASYS J & J Senofilcon A (Si Hy) 58% 8.4, 8.8 14 0.070 -0.5 to -12D/+0.5 to +8D (0.50 steps after Ā±6D) 147 Aveo 2-weeks Aveo Omafilcon A (Hy) 55% 8.6 14.2 0.070 -0.5 to -10D/+0.50 to +4D (0.50 steps after Ā±6.5D) 31 2 week pure moisture SEED SEED Ionic Bond (SIB) (hydrogel) 58% 8.6 14.2 0.09 +5 to -10D (0.5 steps above - 6.5D) 33.3 The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
  • 24.
  • 25. Planned soft lens replacement: ā€¢ Planned replacementā€™ refers to lens replacement at intervals from monthly to 12 months and, therefore, includes all ā€˜disposable lensesā€™, which are defined as lenses replaced at least monthly. ā€¢ Enzymatic treatment should be added to the care regimens.
  • 26. C. Thirty Day disposable Silicone hydrogel contact lens: ā€¢ New contact lens material having Dk greater than 100. ā€¢ Silicon hydrogel contact lens material is surface treated that is more hydrophilic & more resistant to deposit. ā€¢ Silicon component provides high permeability to oxygen and hydrogel component promote comfort and movement. D. The Monthly Disposable Lenses: ā€¢ Similar to biweekly these lenses are cleaned every day with the lens care solution for the period of one month and disposed at the end of the month , replaced with new one. ā€¢ These lenses also comes in a 6 piece lens pack and each lens can be worn for 1 month.
  • 27. Monthly disposable contact lenses Name Manufactu rer Material Water conte nt Base curve (mm) Diame ter (mm) Central thickness (mm) Power range Dk/ t Aveo 1 month Aveo Filcon II (Hy) 50% 8.6 14.2 0.075 +6 to -10D (0.50 steps above +4.5D/- 6.50D) 23. 8 Acuvue Vita Johnson & Johnson Senofilcon C (Si Hy) 41% 8.4, 8.8 14 0.08 -0.5 to -12D /+0.5 to +8D For 8.4BC -0.5 to -12D/+0.50 to +8D for 8.8BC (0.50 steps above Ā±6D) 147 Biofinity Cooper Vision Comfilcon A (Si Hy) 48% 8.6 14 0.08 +15D to -20D (0.50 steps after Ā±6D) 160 Proclear Cooper Vision Omafilcon B (Hy) 62% 8.6, 8.2 14.2 0.065-0.35 +20 to -20D (0.50 steps after Ā±6D) 42 Q3 Purecon Etafilcon A (Hy) 58% 8.5 14.2 0.08 -0.5 to -6D in 0.25 steps -6 to -12D in 0.50 steps 22 Soflens 59 Bausch & Hilafilcon B 59% 8.6 14.2 0.14 +5 to -6D (on 0.25 steps) 22 The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
  • 28.
  • 29. Yearly wear Contact Lenses: ā€¢ They usually come in a pair and the same lens is worn for a long time. ā€¢ Similar to monthly and biweekly these lenses should be cleaned every day with a multi-purpose lens care solution.
  • 30. Yearly Contact lenses Name Manufacturer Material Water Content Base Curve (mm) Diamete r (mm) Central thickness (mm) Power Range Dk/t O2X EW Purecon Filcon II (Hy) 70% 8.6 14.00 0.08 -0.25 to -10D (0.50 steps above -6.5D) 42 Supersoft Purecon P. HEMA (Hy) 45% 8.6 14.00 0.10 -0.25 to -12D (0.50 steps above -6.5D) 9 UV filter Purecon P. HEMA (Hy) 38% 8.6 14.00 0.10 -0.25 to -12D (0.50 steps above -6.5D) 9 The Sight-Vol.16,Iss.1-Contact lens available in Nepal -Garima paudyal
  • 31. E.Disposable & planned replacement Toric Contact lenses: ā€¢ This type of lenses is an alternative for patient with significant refractive astigmatism.
  • 32. Brand Manufacturer Wearing Modality Material Water Content Base Curve (mm) Diameter (mm) Central thickness (mm) Power Range (Sph and Cyl) Dk/t Stabilization Acuvue Oasys Johnson & Johnson Bi weekly Senofilcon A (Si Hy) 38% 8.6 14.5 0.08 plano to -9D/+0.25 to +6D (0.5 steps above -6.5D) -0.75 to -2.75D in 0.50 steps 129 Accelerated Stabilisation design Acuvue vita Johnson & Johnson Monthly disposable Senofilcon C (Si Hy) 41% 8.6 14.5 0.08 +4D to -6.5D in 0.25 steps -6.5 to -9D in 0.50 steps -0.75 to -2.25D in 0.50 steps 129 Blink Stabilised Avaira Vitality Toric Cooper Vision Monthly disposable Fanfilcon A (Si Hy) 55% 8.5 14.5 0.10 +8 to -10D (0.50 steps above Ā±6D) -0.75 to -2.25 in 0.50 steps 90 Optimized Ballast Aveo Joy Aveo Monthly disposable Omafilcon A (Hy) 58% 8.6 14.5 0.12 -0.5 to -6D in 0.25 steps -0.75 to -1.75D in 0.50 steps 26 Modified Prism Ballast Biofinity toric Cooper Vision Monthly disposable Comfilcon A (Si Hy) 48% 8.7 14.5 0.11 +8 to -10D (0.50 steps above Ā±6D) -0.75 to -2.25D in 0.50 steps 116 Modified prism ballast Clarity 1 day toric Cooper Vision Daily disposable Somofilcon A (Si Hy) 56% 8.6 14.3 0.07 plano to -9D/+0.25 to +4D (0.5 steps above -6.5D) -0.75 to -2.25D in 0.50 steps 57 Prism Ballast Ultra Bausch & Lomb Monthly disposable Samfilcon A (Si Hy) 46% 8.6 14.5 0.05-0.5 +6D to -9D (0.5 steps above -6.5D) -0.75 to -2.75D in 0.50 steps 114 Prism Ballast Soflens Toric Bausch & Lomb Monthly disposable Alphafilcon A (Hy) 66% 8.5 14.5 0.195 +6D to -9D (0.50D steps above 6.5D) -0.75 to -2.75D in 0.50 steps 16 Prism Ballast COLORS Toric Celebrations Yearly PolyHEMA (Hy) 42% 8.6 14.5 plano to -3D in 0.25 steps -3.5 to -8D in 0.50 steps -1.00 to -2.50D in 0.50 steps
  • 33. F. Disposable Bifocal & multifocal lenses: ā€¢ Aspheric and annular multifocal disposable soft contact lens design are available. ā€¢ Advantages of fitting disposable multifocals is the availability of in-office lenses that patient can try with minimal cost to the patient. ā€¢ Before beginning it is important to counsel patient that a bifocal contact lens may not provide the same clarity as spectacle.
  • 34. Brand name Manufacturer Water content %/Dk Near boost Range Proclear 1day Multifocal CooperVision 60/25 Yes - non-dominant eye +6.00 to -10.00 Clariti 1day Multifocal Sauflon 56/86 Yes - non-dominant eye +5.00 to -6.00 Focus Dailies Progressive Alcon 69/26 Yes - both eyes +5.00 to -6.00 ā€¢ Frequently ,monovision provides better results. Monovision system have been another factor in development of disposable lens because they allow trial fitting with appropriate power for the patient & afford the oppourtunity to determine which eye is best corrected for near work. Ref: CET article
  • 35. Most frequent complications associated with Disposable contact lens user non compliant to replacing schedule: ā€¢ Corneal infiltrates ā€¢ Contact lens- associated red eye ā€¢ Giant papillary conjunctivitis ā€¢ The Dk/t of majority of disposable lenses (excluding Si-Hy) is similar to that of conventional hydrophilic lenses, therefore hypoxia problem exist with non Si-Hy lenses. ā€¢ Keratitis
  • 37. Trend of soft contact lens prescribing in an optometry centre in India: a 6-year analysis. Sanker N, Noushad B. Trend of soft contact lens prescribing in an optometry centre in India: A 6-year analysis. Contact Lens and Anterior Eye. 2013 Aug 1;36(4):196-8. Abstract This six-year retrospective longitudinal study was conducted to examine the changes in the pattern of prescribing soft contact lenses in an optometry centre located in a University in South India. Details regarding the type of lenses, lens material, wearing pattern and the clinical diagnoses were analyzed from January 2006 to December 2011. A total of 1273 soft contact lens fits (n=1273) were analyzed. Two-third of the total lenses dispensed was for females and their mean age (24.0Ā±8.3 yrs) was less than that of male (27.0Ā±11.2 yrs) lens users. Nearly 70% of them had myopia and 48% wore conventional soft contact lenses. During the six years study, the percentage of conventional lenses declined by 60%. This study demonstrated a gradual and significant increase in popularity of disposable contact lenses and silicone hydrogel lens material which is comparable to the global trend.
  • 38. Daily versus monthly disposable contact lens: Which is better for ocular surface physiology and comfort? Sapkota K, Franco S, Lira M. Daily versus monthly disposable contact lens: Which is better for ocular surface physiology and comfort?. Contact Lens and Anterior Eye. 2018 Jun 1;41(3):252-7 Purpose: To investigate the effect of soft contact lenses (SCL) wearing modality and lens materials on the changes in conjunctival bulbar and limbal redness and conjunctival and corneal staining after two months of SCL wear. Comfort level was also analyzed. Methods: In this longitudinal clinical trial, forty-seven neophyte myopic subjects were fitted with a monthly disposable lens (lotrafilcon-B or comfilcon-A or balafilcon-A) in one eye and a daily disposable lens (nelfilcon-A or stenofilcon-A or nesofilcon-A) in the other eye, randomly selected. Conjunctival bulbar and limbal redness and conjunctival and corneal staining were evaluated before and after lens wear. Effect of lens wearing modality and lens materials on these changes was also determined. Level of comfort was evaluated subjectively twice per day. Comfort level and reduction in end-of-day comfort were compared between different lens wearing modalities and materials. Results: Bulbar and limbal redness and conjunctival and corneal staining were increased (p<0.001) after lens wear, and changes were similar with daily and monthly disposable lens wear (p>0.05). Limbal redness was associated with lens materials, and lotrafilcon-B induced the least among the studied lenses (p<0.05). There was no significant association between the wearing modality and the average comfort level and reduction of end-of-day comfort (p>0.05). Conclusion: Two months of SCL wear increased conjunctival redness, conjunctival and corneal staining, which were not associated with the lens wearing modality. There was a reduction in end-of-day comfort, similar to daily and monthly lenses. The change in limbal redness and reduction in end-of-day comfort were associated with the characteristics of the lens material.
  • 39. SIGNIFICANCES OF DAILY DISPOSABLE CONTACT LENSES DURING COVID-19 Bhattarai S. Significances of daily disposable contact lenses during COVID-19. Journal of Chitwan Medical College. 2021;11(4):137-8. ABSTRACT : Contact lens is one of the preferred modes of refractive correction for children and adults. With proper care and maintenance, even during pandemic of COVID-19, contact lenses can be prescribed and worn by the patients without much fear of Coronavirus infection. Till now there is no strong clinical evidence that proves contact lenses are not safe to wear during COVID-19. But considering patientā€™s health and hygiene, various literatures have suggested that with compared to conventional or yearly disposable contact lenses, daily disposable contact lenses are safer to use during COVID-19. Since the daily disposable lenses are discarded daily after use at the end of the day, there is no need of extra care regarding manual cleaning and maintenance. Daily disposable lenses may have a very less or even no deposits and debris so makes patient more comfortable all over the time with less risk of Coronavirus infection.
  • 40. Evaluation of the Ocular Surface in Different Contact Lens Replacement Schedules Muhafiz E, Bayhan HA, Sahin S, GƶƧmen AY, Bayhan SA, GĆ¼rdal C. Evaluation of the ocular surface in different contact lens replacement schedules. Cornea. 2019 May 1;38(5):587-94. Purpose: To evaluate the effects of different contact lens (CL) replacement schedules and different CL materials on the ocular surface and tear function. Methods: Daily disposable hydrogel CLs were given to group 1 (n = 22), daily disposable silicone hydrogel CLs were given to group 2 (n = 25), and reusable silicone hydrogel CLs were given to group 3 (n = 24). Tear function tests and inflammatory cytokine [interleukin (IL)-6, IL-8, IL-17A, and matrix metalloproteinase (MMP)-9] levels were evaluated before and at 1 and 3 months after CL usage. Impression cytology was evaluated before and at 3 months after CL usage. Results: At the first and third months of CL usage, a statistically significant difference was determined between the groups in the levels of IL-6, IL-8, and IL-17A in tears, with the lowest levels in group 1 and the highest levels in group 3 (all P < 0.05). At the third month of CL usage, the levels of these cytokines (in picograms/milliliter) were 6.06 Ā± 0.83, 78.18 Ā± 12.42, 61.69 Ā± 13.95, and 37.71 Ā± 5.95 in group 1 and 8.04 Ā± 0.89, 107.34 Ā± 14.40, 68.63 Ā± 13.72, and 46.26 Ā± 6.50 in group 3, respectively. A statistically significant decrease was determined over time in the Schirmer test in group 1, in only the tear breakup time in group 2, and in the tear breakup time and Schirmer test in group 3 (all P < 0.05). A statistically significant increase was determined over time in the levels of IL-6, IL-8, IL-17A, and MMP-9 in all groups. In the third month, a significant progression was observed in the Nelson grade (P < 0.05) in all groups. Conclusions: The wear of daily disposable CLs can be considered to cause less damage to the ocular surface and less increase in proinflammatory cytokine levels.
  • 41. Clinical Comparison of a Silicone Hydrogel and a Conventional Hydrogel Daily Disposable Contact Lens Miller J, Giedd B, Subbaraman LN. Clinical comparison of a silicone hydrogel and a conventional hydrogel daily disposable contact lens. Clinical Ophthalmology. 2021 Oct 29:4339-45. Purpose: To compare the subjective performances of verofilcon A daily disposable silicone hydrogel contact lenses (CLs) and etafilcon A hydrogel CLs. Methods: Successful wearers of spherical soft CLs for distance correction were prospectively randomized to wear verofilcon A or etafilcon A lenses for 1 week and crossed over to the alternative lenses. The primary study objective was a comparison of distance visual acuity (VA). Exploratory endpoints included subjective overall lens preference (5-point scale) and subjective ratings (10-point scales) of end-of-day (EOD) vision, overall handling, insertion comfort, EOD comfort, overall quality of vision, overall comfort, vision throughout the day, lens handling at insertion, and lens handling at removal. Results: Of 92 subjects (184 eyes), 46 each were randomized to verofilcon A or etafilcon A lenses and subsequently crossed over to the other lenses. Evaluation of distance VA showed that verofilcon A lenses were noninferior to etafilcon A lenses. Comparison of lens preference showed that 68 (73.9%) subjects somewhat or strongly preferred verofilcon A lenses, whereas 21 (22.9%) somewhat or strongly preferred etafilcon A lenses (p<0.0001). Mean Ā± SD ratings of EOD vision (8.6Ā±1.5 vs 7.7Ā±1.9), overall handling (8.7Ā±1.5 vs 6.9Ā±2.3), insertion comfort (9.2Ā±1.0 vs 7.7Ā±1.9), and EOD comfort (8.0Ā±1.9 vs 7.0Ā±2.2) were all significantly (pā‰¤0.0001 each) higher for verofilcon A than for etafilcon A lenses. Mean Ā± SD ratings of overall quality of vision (8.9Ā±1.2 vs 8.2Ā±1.8), overall comfort (8.6Ā±1.5 vs 7.4Ā±1.8), vision throughout the day (8.9Ā±1.3 vs 8.1Ā±1.8), lens handling at insertion (9.0Ā±1.4 vs 6.9Ā±2.5), and lens handling at removal (8.3Ā±2.1 vs 7.7Ā±2.2) were also significantly higher for verofilcon A lenses. No subject experienced any ocular adverse events. Conclusion: After 1 week of wear, the study population reported that ratings for subjective endpoints were significantly higher for verofilcon A lenses than for etafilcon A lenses.

Editor's Notes

  1. laundered =Ā to make ready for use by washing molding based manufacturing method= a pair of matching molds one male and another female.moulds are mated and clamped together and space is filled with liquid monomer and cured with uv .after seperating mould the finished lens then pass to secondary manufacture.Ā 
  2. molding based manufacturing method= a pair of matching molds one male and another female.moulds are mated and clamped together and space is filled with liquid monomer and cured with uv .after seperating mould the finished lens then pass to secondary manufacture.Ā  Convienient method for production of disposable contact lens in high volume. Female mould front surface/ male mould back surface.
  3. Optima 38 yearly disposable ā€“ polymacon material.
  4. Fortnightly=a period of 14 days
  5. Therapeutic uses Anterior segment disorder=corneal perforation, Abrasion, bullous keratophy, chemical burn ,post surgical indication pain management Promting epithelization or wound healing Soft contact lens as a bandage after LASEK(Laser assissted epithelial keratomileus) Pediatric uses:
  6. deep stromal striae or folds, epithelial microcysts and vacuoles, or epithelial and stromal clouding indicates oxygen deprivation and it contraindicate contact lens wear. any active corneal infection or inflammation e.g. corneal infiltration, corneal ulcer, microbial keratitis.
  7. This is likely to be due to decreased levels or less pathogenic type of microbial contamination since bioflim do not form as they do in contact lens cases for reusable lenses.
  8. Furthermore it has been found that 95% of wearer who replaced their dd CL into a lens with original bliser pack solution for overnight storage on five occasions had at least one pair of contaminated lenses, the most common organism being the gram positive Staphylococcus bacteria. This serves to highlight the importance of patient education, especially in this modality where wearers may feel they have less chance of complications and therefore take more risks.
  9. Omaficon A, hilafilcon B= high water,non ionic group 2 Etafilcon= high water ,ionic group 4
  10. Polymacon group 1 ā€“low water ,non ionic
  11. Alignment markers When toric = sphere to cylinder ratio= less than 4;1 RGP not tolerated by patient Best sphere doent give satisfactory visual acuity.
  12. Alphafilcon A = group 2 high water content ,non ionic ASD: type of dynamic stabilization .four active zones of added thickness located in mid periphery of lens which on blinking actively rotates the lens to correct axis and maintain it in that position.
  13. Monovision= Single vision contact lens one eye corrected for distance and other for reading.(Dominant eye for distance , non dominant for near) Lack of BSV Lack of stereopsis
  14. A retrospective longitudinal study isĀ when you take pre-existing data from previous online surveys and other research.