2012 REVIEW OF
CLINICAL RESEARCH & INNOVATIONS A GUIDE TO OUR AMERICAN ACADEMY OF OPTOMETRY POSTERS AND PRESENTATIONS
1
POSTER
POSTER
Coefficient of Friction and Soft Contact Lens Comfort
Patient Adherence to CL Replacement Schedule
Chantal Coles-Brennan, BSc, OD
Giovanna E. Olivares, OD, FAAO
PURPOSE: In 2009, data were presented to show that contact lens surface coefficient of friction was the only significant contact lens material property that remained in a multiple regression analysis attempting to correlate end-of-day wearing comfort (Brennan and Coles, OVS. 2009:86;e-abstract 90957). Since then, additional data for the coefficient of friction of contact lenses have been published.
PURPOSE: To understand patient behaviors as it pertains to lens wearing time and the replacement of their contact lenses.
Noel Brennan, MScOptom, PhD, FAAO, FCLSA
METHODS: The same large database for contact lens comfort that was previously used was applied again. End-of-day comfort values obtained from over 700 separate 1-month wearing trials were derived using a sensitive and sophisticated method (smoothed median). Coefficient of friction data at 0, 50, and 100 cycles recently published by Roba et al (Tribology Letters, 2011;44:387) were used to correlate with the end-of-day comfort values from the wearing trials. Commercially available lenses made from the following materials were tested in both experiments: balafilcon A, comfilcon A, etafilcon A, galyfilcon A, lotrafilcon B, lotrafilcon A, omafilcon A, polyHEMA, senofilcon A. The lenses made from polyHEMA and omafilcon A were not the same brands in each set so these were included in separate analyses. RESULTS: The r-squared values for correlation between the comfort scores and co-efficient of friction data at 0, 50 and 100 cycles were 0.74, 0.73 and 0.77, respectively, when omafilcon A and polyHEMA were not included. When these other material types were included, the r-squared values were 0.90, 0.87 and 0.90, respectively. All were statistically significant at the p<0.01 level. Separate regression analyses including Dk/t, modulus and water content showed that only coefficient of friction remained in the equation as a predictor of comfort. CONCLUSIONS: While the coefficient of friction data used here were obtained from a different source using a different methodology to those used in a previous presentation, the conclusion from this analysis reinforces the previous finding that the principal lens property associated with end-of-day comfort is coefficient of friction.
Anne Marie Jedraszczak, MA; Jordin Alford, MBA
METHODS: A masked Internet survey was administered to 804 spherical reusable hydrogel and silicone hydrogel contact lens (CL) wearers in the USA for 18 weeks covering 4,160 lens replacements. Over these multiple replacement cycles, patients recorded the exact dates that they replaced their lenses within weekly diary surveys administered online. Brand-use verification was established by ECP identification or UPC code validation. CL wearer satisfaction, wear experience and use were surveyed. Self-report of agreement with statements was analyzed across CL Modality and Brand using All-Pairs statistical tests, with p<0.05 considered significant. RESULTS: On average the data represented 4 to 9 replacement cycles. The results show that patient behavior, as it pertains to replacing lenses on a specific day of the week or date of the month, was not consistent. Of patients with Manufacturer Recommended Replacement Frequency (MRRF) of 1-2 weeks, only 8% of replacements occurred on the 1st of each month. Replacement of lenses was scattered throughout the month showing no consistent pattern with respect to date or day. Patients wearing lenses with a MRRF of 1 month replaced the lenses on the 1st of the month only 28% of the time. Again, patient behavior showed replacement of lenses was scattered throughout the month, showing no consistent pattern with respect to date or day. CONCLUSIONS: The data shows that patient adherence to a prescribed CL replacement routine (ie replacing at the 1st of the month) is variable with patients replacing lenses throughout the month. In the last few years, many have suggested a simplistic solution, such as replacing the lenses at the first of the month, as an easy answer to the problem. The recorded replacement behavior of the patients in this study would indicate that this is not a solution that is highly successful. In order to attain better adherence to a CL prescribed regimen, more extensive patient education or external reinforcement, such as electronic reminders, may need to be instituted.
About 1/4th of monthly wearers replace on the 1st of each month
2
After obtaining her optometry degree from the New England College of Optometry, Dr Coles worked initially in private practice, then as a research optometrist at the Centre for Contact Lens Research, University of Waterloo. In 1994, she moved to Australia where she co-founded Brennan Consultants, and later Coles Brennan Pty Ltd. She worked in both these companies as co-director, senior research consultant, and private practitioner. In 2011 Dr Coles moved to Jacksonville, Florida, to join Johnson & Johnson Vision Care, Inc. where she now works in the DesignResearch and Development platform as a Principal Research Optometrist.
2
October 24 Poster 82
Dr Olivares is the Director of Professional Education at VISTAKON® Division of Johnson & Johnson Vision Care, Inc. In this role, she is responsible for the development of new and innovative educational professional programs. Dr Olivares graduated from the State University of New York with a doctorate degree and subsequently completed a post-doctoral fellowship program in ocular disease management in affiliation with the State University of New York College of Optometry. Upon completion of her fellowship, she became an assistant professor at the College of Optometry, having responsibility in both didactic and clinical programs. Following her academic career, she joined Unilens Corp. USA as the Director of Professional Development and Clinical Affairs, and spent 12 years developing new presbyopic contact lenses. In 2004 she joined VISTAKON®. As the Senior Manager of Clinical Research, she led a multidisciplinary group of optometrists, biostatisticians, and vision scientists that were responsible for the development of new contact lens products such as ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, ACUVUE® ADVANCE® Plus Brand Contact Lenses, and other products that have been launched throughout the world. Dr Olivares is a Fellow of the American Academy of Optometry.
3
1
POSTER
POSTER
Lens Comfort
Patient Adherence to CL Replacement Schedule
Chantal Coles-Brennan, BSc, OD
Giovanna E. Olivares, OD, FAAO
PURPOSE: only significant contact lens material property that remained in a multiple regression analysis attempting to correlate end-of-day wearing comfort (Brennan and Coles, OVS. 2009:86;e-abstract 90957). Since then,
PURPOSE: To understand patient behaviors as it pertains to lens wearing time and the replacement of their contact lenses.
Noel Brennan, MScOptom, PhD, FAAO, FCLSA
METHODS: The same large database for contact lens comfort that was previously used was applied again. End-of-day comfort values obtained from over 700 separate 1-month wearing trials were derived using a recently published by Roba et al (Tribology Letters, 2011;44:387) were used to correlate with the end-of-day comfort values from the wearing trials. Commercially available lenses made from the following materials were tested in both experiments: balafilcon A, comfilcon A, etafilcon A, galyfilcon A, lotrafilcon B, lotrafilcon A, omafilcon A, polyHEMA, senofilcon A. The lenses made from polyHEMA and omafilcon A were not the same brands in each set so these were included in separate analyses. RESULTS: at 0, 50 and 100 cycles were 0.74, 0.73 and 0.77, respectively, when omafilcon A and polyHEMA were not included. When these other material types were included, the r-squared values were 0.90, 0.87 and 0.90, respectively. All were statistically significant at the p<0.01 level. Separate regression analyses including Dk/t, of comfort. CONCLUSIONS: reinforces the previous finding that the principal lens property associated with end-of-day comfort is
Anne Marie Jedraszczak, MA; Jordin Alford, MBA
METHODS: A masked Internet survey was administered to 804 spherical reusable hydrogel and silicone hydrogel contact lens (CL) wearers in the USA for 18 weeks covering 4,160 lens replacements. Over these multiple replacement cycles, patients recorded the exact dates that they replaced their lenses within weekly diary surveys administered online. Brand-use verification was established by ECP identification or UPC code validation. CL wearer satisfaction, wear experience and use were surveyed. Self-report of agreement with statements was analyzed across CL Modality and Brand using All-Pairs statistical tests, with p<0.05 considered significant. RESULTS: On average the data represented 4 to 9 replacement cycles. The results show that patient behavior, as it pertains to replacing lenses on a specific day of the week or date of the month, was not consistent. Of patients with Manufacturer Recommended Replacement Frequency (MRRF) of 1-2 weeks, only 8% of replacements occurred on the 1st of each month. Replacement of lenses was scattered throughout the month showing no consistent pattern with respect to date or day. Patients wearing lenses with a MRRF of 1 month replaced the lenses on the 1st of the month only 28% of the time. Again, patient behavior showed replacement of lenses was scattered throughout the month, showing no consistent pattern with respect to date or day. CONCLUSIONS: The data shows that patient adherence to a prescribed CL replacement routine (ie replacing at the 1st of the month) is variable with patients replacing lenses throughout the month. In the last few years, many have suggested a simplistic solution, such as replacing the lenses at the first of the month, as an easy answer to the problem. The recorded replacement behavior of the patients in this study would indicate that this is not a solution that is highly successful. In order to attain better adherence to a CL prescribed regimen, more extensive patient education or external reinforcement, such as electronic reminders, may need to be instituted.
About 1/4th of monthly wearers replace on the 1st of each month
2
Dr Olivares is the Director of Professional Education at VISTAKON® Division of Johnson & Johnson Vision Care, Inc. In this role, she is responsible for the development of new and innovative educational professional programs. Dr Olivares graduated from the State University of New York with a doctorate degree and subsequently completed After obtaining her optometry degree from the New England College of Optometry, Dr Coles worked initially in private practice, then as a research optometrist at the Centre for Contact Lens Research, University of Waterloo. In 1994, she moved to Australia where she co-founded Brennan Consultants, and later Coles Brennan Pty Ltd. She worked in both these companies as co-director, senior research consultant, and private practitioner. In 2011 Dr Coles moved to Jacksonville, Florida, to join Johnson & Johnson Vision Care, Inc. where she now works in the DesignResearch and Development platform as a Principal Research Optometrist.
2
York College of Optometry. Upon completion of her fellowship, she became an assistant professor at the College of Optometry, having responsibility in both didactic and clinical programs. Following her academic career, she joined new presbyopic contact lenses. In 2004 she joined VISTAKON®. As the Senior Manager of Clinical Research, she led a multidisciplinary group of optometrists, biostatisticians, and vision scientists that were responsible for the development of new contact lens products such as ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, ACUVUE® ADVANCE® Plus Brand Contact Lenses, and other products that have been launched throughout the world. Dr Olivares is a Fellow of the American Academy of Optometry.
3
3
POSTER
POSTER
Daily Disposable Hydrogel Lenses: Impact on Frequency of Scheduled and Unscheduled Clinic Visits
Large Scale Survey of Satisfaction Among Current Senofilcon A Contact Lens Wearers
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA
Anna Sulley, BSc, MCOptom, FBCLA, FAAO
PURPOSE: We previously reported the frequency of scheduled and unscheduled clinic visits for contemporary reusable contact lenses (AAO 2010 poster). This study examines the frequency of unscheduled clinic visits and scheduled eye examinations for contemporary daily disposable (DD) spherical hydrogel lens wearers.
PURPOSE: To summarise recent research conducted among senofilcon A (ACUVUE® OASYS®, Johnson & Johnson Vision Care, Inc.) contact lens (CL) wearers to identify the sources of satisfaction with their lenses in key areas including comfort, vision and, as a consequence, their likelihood to recommend their CLs and practitioners to others.
Jordin Alford, MBA
METHODS: 100 US doctors, representative of private and retail practice, participated by selecting and reviewing DD patient charts prospectively as eligible patients attended their clinic. Chart review was then retrospective over the previous time period starting at the current eye exam and back 3 years. Charts were reviewed for scheduled examination frequency and unscheduled visits due to clinical complaints related to contact lens performance. RESULTS: The study sample consisted of 588 daily disposable patient charts. The average time between annual visits was 14.5 months (median 12.7 months). Over the study period (3 years) 18% of daily disposable lens wearers returned for an unscheduled visit due to clinical complaints related to contact lenses, including comfort or vision complaints. DD lens brand had an impact on unscheduled visit rates (ACUVUE® Brands 6%, CIBA DAILIES® Brands, 15% (p<0.05). Annualized rates of unscheduled visits were very low at only 0.11, on average, per year overall (ACUVUE® Brands 0.03 visits per year, CIBA DAILIES® Brands 0.10 visits per year). CONCLUSION: Patients prescribed DD returned regularly for scheduled eye examinations. Most remain trouble-free, with very low rates of potentially disruptive unscheduled clinic visits due to clinical complaints related to their contact lenses.
PERCENTAGE OF PATIENTS RETURNING FOR A DDCL RELATED UNSCHEDULED CLINIC VISIT
4
Anne Madec-Hily; Rachel Packe
METHODS: Senofilcon A wearers (spherical n=1,207, for astigmatism n=316) across 6 European countries (France, Germany, Italy, Poland, Russia, and UK) were surveyed by an independent market research agency online in February and March 2012 about their experience with the CL (in Poland, survey was via computer-aided self-completion interviews). The research was conducted using panel providers to source the representative sample, with no quotas set on gender or age. Screening was conducted to ensure respondents were wearing the correct lens. Additional screening was applied for Poland and Russia to ensure an economically viable sample. In each of the two product groups, equal weightings across countries were applied to total sample data. RESULTS: 89% (±2%) rated the lens as the most comfortable they had worn (n=1,138). 8 out of 10 agreed that even towards the end of day, their lenses feel like they’re not wearing any CLs at all (79% [±2%]). 92% (±1%) of senofilcon A wearers would recommend the product to other CL wearers with 82% (±1%) recommending their practitioner as a result of being prescribed the lens. CONCLUSIONS: The results from a large scale survey of senofilcon A wearers reiterates the findings of previous clinical studies—that the lens offers high levels of overall satisfaction. When CL wearers are fitted with such a product not only are they highly likely to continue wearing their lenses to help minimize lapsing, but it may also result in greater loyalty to their practitioner for return visits and in practitioner recommendation to friends and family, to increase practice growth.
SATISFACTION, LOYALTY, AND RECOMMENDATION OF CURRENT ACUVUE® OASYS® (AOH) and ACUVUE® OASYS® for ASTIGMATISM (AOFA) wearers
4
5
Sheila Hickson-Curran is Director of Medical Affairs for Johnson & Johnson Vision Care, Inc. in North America and is responsible for technical and clinical communications based upon clinical and scientific evidence. Sheila earned her optometry qualifications from the City University London, United Kingdom, and has clinical practice, teaching and research experience spanning five countries. She joined VISTAKON® in 1995 as a Research Optometrist, with positions of increasing responsibility in Research & Development. She is the Co-Inventor of the BLINK STABILIZED™ Design used in ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, and 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM, for which she won a Johnson Medal, the highest award for innovation in Johnson & Johnson. Sheila is the Co-Inventor of other contact lens designs, and has multiple patents and publications in the field of contact lenses. Sheila is a Fellow of the American Academy of Optometry.
Anna graduated from Aston University and worked in private practice before moving to Visioncare Research as a Clinical Investigator. She joined Hydron as International Clinical Manager in 1997 and then Johnson & Johnson Vision Care in 2000 where she was UK Professional Affairs Manager until 2004. After a few years dividing her time between private practice, medical writing, clinical research, and consultancy to the contact lens industry, Anna returned to Johnson & Johnson in 2009 where she is Associate Director Medical Affairs for Europe. Anna is a Fellow of the British Contact Lens Association (BCLA) and AAO, and past president of the BCLA.
3
POSTER
POSTER
Daily Disposable Hydrogel Lenses: Impact on Frequency of Scheduled and Unscheduled Clinic Visits
Large Scale Survey of Satisfaction Among Current Senofilcon A Contact Lens Wearers
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA
Anna Sulley, BSc, MCOptom, FBCLA, FAAO
PURPOSE: We previously reported the frequency of scheduled and unscheduled clinic visits for contemporary reusable contact lenses (AAO 2010 poster). This study examines the frequency of unscheduled clinic visits and scheduled eye examinations for contemporary daily disposable (DD) spherical hydrogel lens wearers.
PURPOSE: To summarise recent research conducted among senofilcon A (ACUVUE® OASYS®, Johnson & Johnson Vision Care, Inc.) contact lens (CL) wearers to identify the sources of satisfaction with their lenses in key areas including comfort, vision and, as a consequence, their likelihood to recommend their CLs and practitioners to others.
Jordin Alford, MBA
METHODS: 100 US doctors, representative of private and retail practice, participated by selecting and reviewing DD patient charts prospectively as eligible patients attended their clinic. Chart review was then retrospective over the previous time period starting at the current eye exam and back 3 years. Charts were reviewed for scheduled examination frequency and unscheduled visits due to clinical complaints related to contact lens performance. RESULTS: The study sample consisted of 588 daily disposable patient charts. The average time between annual visits was 14.5 months (median 12.7 months). Over the study period (3 years) 18% of daily disposable lens wearers returned for an unscheduled visit due to clinical complaints related to contact lenses, including comfort or vision complaints. DD lens brand had an impact on unscheduled visit rates (ACUVUE® Brands 6%, CIBA DAILIES® Brands, 15% (p<0.05). Annualized rates of unscheduled visits were very low at only 0.11, on average, per year overall (ACUVUE® Brands 0.03 visits per year, CIBA DAILIES® Brands 0.10 visits per year). CONCLUSION: Patients prescribed DD returned regularly for scheduled eye examinations. Most remain trouble-free, with very low rates of potentially disruptive unscheduled clinic visits due to clinical complaints related to their contact lenses.
PERCENTAGE OF PATIENTS RETURNING FOR A DDCL RELATED UNSCHEDULED CLINIC VISIT
4
Anne Madec-Hily; Rachel Packe
METHODS: Senofilcon A wearers (spherical n=1,207, for astigmatism n=316) across 6 European countries (France, Germany, Italy, Poland, Russia, and UK) were surveyed by an independent market research agency online in February and March 2012 about their experience with the CL (in Poland, survey was via computer-aided self-completion interviews). The research was conducted using panel providers to source the representative sample, with no quotas set on gender or age. Screening was conducted to ensure respondents were wearing the correct lens. Additional screening was applied for Poland and Russia to ensure an economically viable sample. In each of the two product groups, equal weightings across countries were applied to total sample data. RESULTS: 89% (±2%) rated the lens as the most comfortable they had worn (n=1,138). 8 out of 10 agreed that even towards the end of day, their lenses feel like they’re not wearing any CLs at all (79% [±2%]). 92% (±1%) of senofilcon A wearers would recommend the product to other CL wearers with 82% (±1%) recommending their practitioner as a result of being prescribed the lens. CONCLUSIONS: The results from a large scale survey of senofilcon A wearers reiterates the findings of previous clinical studies—that the lens offers high levels of overall satisfaction. When CL wearers are fitted with such a product not only are they highly likely to continue wearing their lenses to help minimize lapsing, but it may also result in greater loyalty to their practitioner for return visits and in practitioner recommendation to friends and family, to increase practice growth.
SATISFACTION, LOYALTY, AND RECOMMENDATION OF CURRENT ACUVUE® OASYS® (AOH) and ACUVUE® OASYS® for ASTIGMATISM (AOFA) wearers
4
5
Sheila Hickson-Curran is Director of Medical Affairs for Johnson & Johnson Vision Care, Inc. in North America and is responsible for technical and clinical communications based upon clinical and scientific evidence. Sheila earned her optometry qualifications from the City University London, United Kingdom, and has clinical practice, teaching and research experience spanning five countries. She joined VISTAKON® in 1995 as a Research Optometrist, with positions of increasing responsibility in Research & Development. She is the Co-Inventor of the BLINK STABILIZED™ Design used in ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, and 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM, for which she won a Johnson Medal, the highest award for innovation in Johnson & Johnson. Sheila is the Co-Inventor of other contact lens designs, and has multiple patents and publications in the field of contact lenses. Sheila is a Fellow of the American Academy of Optometry.
Anna graduated from Aston University and worked in private practice before moving to Visioncare Research as a Clinical Investigator. She joined Hydron as International Clinical Manager in 1997 and then Johnson & Johnson Vision Care in 2000 where she was UK Professional Affairs Manager until 2004. After a few years dividing her time between private practice, medical writing, clinical research, and consultancy to the contact lens industry, Anna returned to Johnson & Johnson in 2009 where she is Associate Director Medical Affairs for Europe. Anna is a Fellow of the British Contact Lens Association (BCLA) and AAO, and past president of the BCLA.
5
POSTER
POSTER
A Novel Approach for Data Collection Evaluating Doctor and Patient Preferences for Wearing a Daily Disposable Contact Lens for Astigmatism
UV: What Your Patients Don’t Know
W. Lee Ball, OD, FAAO
Anna Sulley, BSc, MCOptom, FBCLA, FAAO
PURPOSE: To report a novel approach using smart phone apps to collect data from participating doctors and patients during an In-Market Assessment (IMA), and to report doctor and patient preferences for using a daily disposable contact lens for astigmatism.
PURPOSE: A primary role that Eye Care Professionals perform is to make their patients aware of avoidable risks to their ocular health. Research into patients’ understanding of implications of chronic UV exposure was conducted to see how this relates to communication imperatives for their practitioners.
METHODS: Seven hundred doctors were invited to participate in an IMA for a new contact lens product, and asked to give feedback on product performance via a survey. Ninety-four doctors fitting 333 patients with the product participated in the survey and were given the following response method options: smart phone app, online website, or facsimile. The survey was conducted in the USA and questioned both doctor and patient respondents about their reason for choosing a daily disposable (DD) contact lens for astigmatism.
METHODS: Contact lens (CL) wearers (400 in UK, 300 in Poland) and CL considerers (302 in Poland) were surveyed online in 2011 to understand their views on the implications of chronic UV exposure, the risks of UV radiation on their ocular health and on the role of UV-blocking CLs in ocular UV protection.
James LaBuz, BS
6
Sule Sencer; David Ruston
RESULTS: Of surveys collected, 67% (222) were completed using a smart phone app vs 20% (65) online website and 13% (46) facsimile. Doctors and patients were given five possible choices about their reason for choosing a DD contact lens for astigmatism. Of these reasons, doctor responses were 26% health, 23% comfort, 23% convenience, 18% vision and 10% lens you wear/trust. Patient responses were 30% convenience, 24% comfort, 24% health, 19% vision, and 3% lens you wear/trust. CONCLUSIONS: Doctors preferred using a smart phone app to complete surveys compared to more traditional methods. Patients’ reasons for choosing a DD contact lens for astigmatism ranked differently than doctors’ reasons. Doctors chose health more often as the reason for wearing a DD contact lens for astigmatism while patients chose convenience. It is important to understand which benefits of DD contact lenses may resonate best with patients when discussing the attributes of this wear modality and how patient perceptions may differ from doctors.
RESULTS: Whilst over 90% of the sample agreed that it was important to protect both their skin and eyes from UV radiation, only 26% in UK and 66% in Poland were aware that there are CLs that help block UV radiation. 92% felt that they were most at risk in the summer months, but 46% agreed being in the sun did not worry them. Only 26% were aware that cataracts were linked to chronic UV exposure. There was also a greater UV awareness and receptivity in Poland compared to the UK. CONCLUSIONS: Although consumers in Europe claim to be aware of UV and its implications, few understand the impact to eyes and the benefits comprehensive ocular UV protection – including UV-blocking CLs – to help protect their eyes. Consumers associate UV primarily with summer and sunny conditions, with few actively protecting against UV, despite a high level of interest in trying UV-blocking CLs. The ignorance of the all-day and all-year-long risks posed by UV, and the options available to block radiation, indicate a need for practitioners to improve communication methodologies on UV radiation and the eye. CL and spectacle lens manufacturers must also play their part in raising public and practitioner awareness concerning this public ocular health hazard. The greater UV awareness in Poland may be due in part to the consistent investment in consumer and professional education on UV radiation since 2004.
UNderstanding of impact to skin and eyes from uv radiation and options for comprehensive ocular uv protection
6
Patients’ Willingness to Try Daily Disposables Based on ECP Recommentation
7
How open were your patients to your recommendation to try daily disposable?
Dr Ball is Associate Director, Professional Affairs for VISTAKON®. In this role, Dr Ball works to increase the company’s North American leadership through a continuing partnership with eye care professionals and works closely with other members of the Professional Team to provide expert insight into VISTAKON® products and the optometric landscape. He brings over 10 years of hospital-based, academic, and private practice optometry experience to this role and in previous years was part of the Professional Affairs Consultant (PAC) Team. He is a graduate of the University of Houston College of Optometry and a fellow of the American Academy of Optometry. He completed an optometric residency at the University of Miami, Bascom Palmer Eye Institute. After residency, Dr Ball joined the staff at Beth Israel Deaconess Medical Center, which is a teaching hospital of Harvard Medical School. In Boston, he was also adjunct clinical faculty member at the New England College of Optometry and a private practitioner.
Anna graduated from Aston University and worked in private practice before moving to Visioncare Research as a Clinical Investigator. She joined Hydron as International Clinical Manager in 1997 and then Johnson & Johnson Vision Care in 2000 where she was UK Professional Affairs Manager until 2004. After a few years dividing her time between private practice, medical writing, clinical research and consultancy to the contact lens industry, Anna returned to Johnson & Johnson in 2009 where she is Associate Director Medical Affairs for Europe. Anna is a Fellow of the British Contact Lens Association (BCLA) and the American Academy of Optometry (AAO), and past president of the BCLA.
5
POSTER
POSTER
A Novel Approach for Data Collection Evaluating Doctor and Patient Preferences for Wearing a Daily Disposable Contact Lens for Astigmatism
UV: What Your Patients Don’t Know
W. Lee Ball, OD, FAAO
Anna Sulley, BSc, MCOptom, FBCLA, FAAO
PURPOSE: To report a novel approach using smart phone apps to collect data from participating doctors and patients during an In-Market Assessment (IMA), and to report doctor and patient preferences for using a daily disposable contact lens for astigmatism.
PURPOSE: A primary role that Eye Care Professionals perform is to make their patients aware of avoidable risks to their ocular health. Research into patients’ understanding of implications of chronic UV exposure was conducted to see how this relates to communication imperatives for their practitioners.
METHODS: Seven hundred doctors were invited to participate in an IMA for a new contact lens product, and asked to give feedback on product performance via a survey. Ninety-four doctors fitting 333 patients with the product participated in the survey and were given the following response method options: smart phone app, online website, or facsimile. The survey was conducted in the USA and questioned both doctor and patient respondents about their reason for choosing a daily disposable (DD) contact lens for astigmatism.
METHODS: Contact lens (CL) wearers (400 in UK, 300 in Poland) and CL considerers (302 in Poland) were surveyed online in 2011 to understand their views on the implications of chronic UV exposure, the risks of UV radiation on their ocular health and on the role of UV-blocking CLs in ocular UV protection.
James LaBuz, BS
6
Sule Sencer; David Ruston
RESULTS: Of surveys collected, 67% (222) were completed using a smart phone app vs 20% (65) online website and 13% (46) facsimile. Doctors and patients were given five possible choices about their reason for choosing a DD contact lens for astigmatism. Of these reasons, doctor responses were 26% health, 23% comfort, 23% convenience, 18% vision and 10% lens you wear/trust. Patient responses were 30% convenience, 24% comfort, 24% health, 19% vision, and 3% lens you wear/trust. CONCLUSIONS: Doctors preferred using a smart phone app to complete surveys compared to more traditional methods. Patients’ reasons for choosing a DD contact lens for astigmatism ranked differently than doctors’ reasons. Doctors chose health more often as the reason for wearing a DD contact lens for astigmatism while patients chose convenience. It is important to understand which benefits of DD contact lenses may resonate best with patients when discussing the attributes of this wear modality and how patient perceptions may differ from doctors.
RESULTS: Whilst over 90% of the sample agreed that it was important to protect both their skin and eyes from UV radiation, only 26% in UK and 66% in Poland were aware that there are CLs that help block UV radiation. 92% felt that they were most at risk in the summer months, but 46% agreed being in the sun did not worry them. Only 26% were aware that cataracts were linked to chronic UV exposure. There was also a greater UV awareness and receptivity in Poland compared to the UK. CONCLUSIONS: Although consumers in Europe claim to be aware of UV and its implications, few understand the impact to eyes and the benefits comprehensive ocular UV protection – including UV-blocking CLs – to help protect their eyes. Consumers associate UV primarily with summer and sunny conditions, with few actively protecting against UV, despite a high level of interest in trying UV-blocking CLs. The ignorance of the all-day and all-year-long risks posed by UV, and the options available to block radiation, indicate a need for practitioners to improve communication methodologies on UV radiation and the eye. CL and spectacle lens manufacturers must also play their part in raising public and practitioner awareness concerning this public ocular health hazard. The greater UV awareness in Poland may be due in part to the consistent investment in consumer and professional education on UV radiation since 2004.
UNderstanding of impact to skin and eyes from uv radiation and options for comprehensive ocular uv protection
6
Patients’ Willingness to Try Daily Disposables Based on ECP Recommentation
7
How open were your patients to your recommendation to try daily disposable?
Dr Ball is Associate Director, Professional Affairs for VISTAKON®. In this role, Dr Ball works to increase the company’s North American leadership through a continuing partnership with eye care professionals and works closely with other members of the Professional Team to provide expert insight into VISTAKON® products and the optometric landscape. He brings over 10 years of hospital-based, academic, and private practice optometry experience to this role and in previous years was part of the Professional Affairs Consultant (PAC) Team. He is a graduate of the University of Houston College of Optometry and a fellow of the American Academy of Optometry. He completed an optometric residency at the University of Miami, Bascom Palmer Eye Institute. After residency, Dr Ball joined the staff at Beth Israel Deaconess Medical Center, which is a teaching hospital of Harvard Medical School. In Boston, he was also adjunct clinical faculty member at the New England College of Optometry and a private practitioner.
Anna graduated from Aston University and worked in private practice before moving to Visioncare Research as a Clinical Investigator. She joined Hydron as International Clinical Manager in 1997 and then Johnson & Johnson Vision Care in 2000 where she was UK Professional Affairs Manager until 2004. After a few years dividing her time between private practice, medical writing, clinical research and consultancy to the contact lens industry, Anna returned to Johnson & Johnson in 2009 where she is Associate Director Medical Affairs for Europe. Anna is a Fellow of the British Contact Lens Association (BCLA) and the American Academy of Optometry (AAO), and past president of the BCLA.
7
POSTER
pOSTER
Net Promoter Score – How Happy Patients Can Drive Referrals in Your Practice
AFM and SEM Analysis of Limbal Ring Contact Lenses
Cristina Schnider, OD, MSc, MBA, FAAO, FBCLA
Kathrine Osborn Lorenz, OD, MS, FAAO, FBCLA
PURPOSE: To understand correlates of patient satisfaction and practice recommendation using the concept of NPS, or Net Promoter Score.
PURPOSE: Limbal ring (also known as “circle-tinted”) contact lenses have received negative press in the past few years, and even led to an AAO/AOA joint statement regarding prescribing practices. All limbal ring lenses, however, are not the same. The pigment particles can be found on the front or back surface of the contact lens or “enclosed” within the lens matrix, which may lead to differences in on-eye performance. The purpose of this study was to evaluate the pigment location and surface roughness of “circle” contact lenses from six manufacturers.
Clay Gillam
METHODS: An online survey of 1000 non-CL wearers and 3000 soft contact lens wearers representing the census of the general US population for adults 18 years or older was conducted by an independent market research firm to assess attitudes and behaviors regarding vision care. Subanalyses were done according to the “0-10 Likely to recommend” score using Net Promoter Score (NPS) concept to determine correlates of referral. NPS is the difference between % Promoters (9-10 rating) and % Detractors (0-6 rating). RESULTS: Referral/recommendation were related to satisfaction with doctor, exam, and vision correction products; provides comprehensive exam, treats me as valued customer, is an expert in their profession, follows up on next exam, and friendly helpful staff. With regard to the impact of CL satisfaction on recommendation, of 2539 CL wearers with a regular eye care practitioner, CL wearers who were Very or Extremely Satisfied had an NPS of 70 (73% promoters, 3% detractors), whereas Satisfied to Dissatisfied wearers had an NPS of -61 (3% promoters, 64% detractors). For patients with astigmatism, NPS scores were lower, with NPS scores of 37 for CL wearers and 32 for non-wearers. CONCLUSIONS: Providing a thorough vision exam and clearly communicating with the patient, as well as a friendly and helpful staff, are related to the desire to recommend. For CL wearers, ensuring that they are well satisfied is critical to their propensity to recommend a doctor. It also appears there is a particular opportunity for improving the vision care experience with patients with astigmatism.
8
David Pinto; Joseph Kakkassery, PhD
METHODS: Scanning Electron Microscopy (SEM) was completed by an ISO-certified laboratory to discern the placement of pigment, whether on top of or enclosed within the contact lens material, to a sub-micron level. Atomic Force Microscopy (AFM) was used to measure the surface roughness of both pigmented and non-pigmented regions of the front surface and back surface of the contact lenses. RESULTS: SEM cross-section images at 500x and 2,000x magnification showed pigment on the surface of 5 of the 6 lens types tested. The mean depth of pigment for 1-DAY ACUVUE® DEFINE™ Brand Contact Lenses (1DAD) (JJVCI) lenses was 8.1 μm below the front surface of the lens, while the remaining lens types tested had pigment particles on the front surface or back surface of the lens. Results of AFM analysis indicated that 1DAD lenses had lower RMS roughness and Peak-to-Peak (PtP) values than the other lens types tested (1DAD RMS roughness pigmented area mean=8 μm vs 30-67 μm) (1DAD PtP pigmented area mean=79 μm vs 285-669 μm). Also, no significant difference was found between the pigmented and non-pigmented areas for RMS roughness or PtP roughness for 1DAD lenses (pigmented area mean RMS=8[2] μm/PtP=79[30], non-pigmented mean RMS=6[2] μm/PtP=62[24]), further supporting the pigment being enclosed within the lens matrix. CONCLUSIONS: SEM and AFM testing revealed pigment on the surface of the lens for all types tested with the exception of 1DAD. Further research is required to determine if the difference in pigment location influences on-eye performance. SEM image at 2,000x of 1-DAY ACUVUE® DEFINETM
AFM image of 1-DAY ACUVUE® DEFINETM front surfact (RMS=8nm)
8
9
Cristina is Senior Director, Professional Communications for Johnson & Johnson Vision Care, Inc. She received her doctor of optometry from Pacific University College of Optometry, a Master of Science in Clinical Research from the University of New South Wales in Australia, and a Master of Business Administration from the University of Florida. She is a Fellow, a Contact Lens Diplomate, and a member of the leadership team in the Section on Cornea, Contact Lenses, and Refractive Technologies of the American Academy of Optometry. Cristina is also a council member for the International Society for Contact Lens Research, and has spoken and published in several languages on topics related to cornea and contact lenses.
Kathrine has worked for Johnson & Johnson Vision Care, Inc. in Florida in the R&D division for 15 years. She has conducted over 150 clinical trials in the development of multiple products, including ACUVUE® OASYS® Brand Contact Lenses. As a Senior Principal Research Optometrist, she currently leads the New Product Clinical Performance Research group. Dr Lorenz received her optometry training and Advance Practice Fellow/ Corneal and Contact Lens Residency at The Ohio State University. She is a member of the ARVO and the American Optometric Association, and is a Fellow of BCLA and the American Academy of Optometry.
7
POSTER
pOSTER
Net Promoter Score – How Happy Patients Can Drive Referrals in Your Practice
AFM and SEM Analysis of Limbal Ring Contact Lenses
Cristina Schnider, OD, MSc, MBA, FAAO, FBCLA
Kathrine Osborn Lorenz, OD, MS, FAAO, FBCLA
PURPOSE: To understand correlates of patient satisfaction and practice recommendation using the concept of NPS, or Net Promoter Score.
PURPOSE: Limbal ring (also known as “circle-tinted”) contact lenses have received negative press in the past few years, and even led to an AAO/AOA joint statement regarding prescribing practices. All limbal ring lenses, however, are not the same. The pigment particles can be found on the front or back surface of the contact lens or “enclosed” within the lens matrix, which may lead to differences in on-eye performance. The purpose of this study was to evaluate the pigment location and surface roughness of “circle” contact lenses from six manufacturers.
Clay Gillam
METHODS: An online survey of 1000 non-CL wearers and 3000 soft contact lens wearers representing the census of the general US population for adults 18 years or older was conducted by an independent market research firm to assess attitudes and behaviors regarding vision care. Subanalyses were done according to the “0-10 Likely to recommend” score using Net Promoter Score (NPS) concept to determine correlates of referral. NPS is the difference between % Promoters (9-10 rating) and % Detractors (0-6 rating). RESULTS: Referral/recommendation were related to satisfaction with doctor, exam, and vision correction products; provides comprehensive exam, treats me as valued customer, is an expert in their profession, follows up on next exam, and friendly helpful staff. With regard to the impact of CL satisfaction on recommendation, of 2539 CL wearers with a regular eye care practitioner, CL wearers who were Very or Extremely Satisfied had an NPS of 70 (73% promoters, 3% detractors), whereas Satisfied to Dissatisfied wearers had an NPS of -61 (3% promoters, 64% detractors). For patients with astigmatism, NPS scores were lower, with NPS scores of 37 for CL wearers and 32 for non-wearers. CONCLUSIONS: Providing a thorough vision exam and clearly communicating with the patient, as well as a friendly and helpful staff, are related to the desire to recommend. For CL wearers, ensuring that they are well satisfied is critical to their propensity to recommend a doctor. It also appears there is a particular opportunity for improving the vision care experience with patients with astigmatism.
8
David Pinto; Joseph Kakkassery, PhD
METHODS: Scanning Electron Microscopy (SEM) was completed by an ISO-certified laboratory to discern the placement of pigment, whether on top of or enclosed within the contact lens material, to a sub-micron level. Atomic Force Microscopy (AFM) was used to measure the surface roughness of both pigmented and non-pigmented regions of the front surface and back surface of the contact lenses. RESULTS: SEM cross-section images at 500x and 2,000x magnification showed pigment on the surface of 5 of the 6 lens types tested. The mean depth of pigment for 1-DAY ACUVUE® DEFINE™ Brand Contact Lenses (1DAD) (JJVCI) lenses was 8.1 μm below the front surface of the lens, while the remaining lens types tested had pigment particles on the front surface or back surface of the lens. Results of AFM analysis indicated that 1DAD lenses had lower RMS roughness and Peak-to-Peak (PtP) values than the other lens types tested (1DAD RMS roughness pigmented area mean=8 μm vs 30-67 μm) (1DAD PtP pigmented area mean=79 μm vs 285-669 μm). Also, no significant difference was found between the pigmented and non-pigmented areas for RMS roughness or PtP roughness for 1DAD lenses (pigmented area mean RMS=8[2] μm/PtP=79[30], non-pigmented mean RMS=6[2] μm/PtP=62[24]), further supporting the pigment being enclosed within the lens matrix. CONCLUSIONS: SEM and AFM testing revealed pigment on the surface of the lens for all types tested with the exception of 1DAD. Further research is required to determine if the difference in pigment location influences on-eye performance. SEM image at 2,000x of 1-DAY ACUVUE® DEFINETM
AFM image of 1-DAY ACUVUE® DEFINETM front surfact (RMS=8nm)
8
9
Cristina is Senior Director, Professional Communications for Johnson & Johnson Vision Care, Inc. She received her doctor of optometry from Pacific University College of Optometry, a Master of Science in Clinical Research from the University of New South Wales in Australia, and a Master of Business Administration from the University of Florida. She is a Fellow, a Contact Lens Diplomate, and a member of the leadership team in the Section on Cornea, Contact Lenses, and Refractive Technologies of the American Academy of Optometry. Cristina is also a council member for the International Society for Contact Lens Research, and has spoken and published in several languages on topics related to cornea and contact lenses.
Kathrine has worked for Johnson & Johnson Vision Care, Inc. in Florida in the R&D division for 15 years. She has conducted over 150 clinical trials in the development of multiple products, including ACUVUE® OASYS® Brand Contact Lenses. As a Senior Principal Research Optometrist, she currently leads the New Product Clinical Performance Research group. Dr Lorenz received her optometry training and Advance Practice Fellow/ Corneal and Contact Lens Residency at The Ohio State University. She is a member of the ARVO and the American Optometric Association, and is a Fellow of BCLA and the American Academy of Optometry.
9
pOSTER
PRESENTATION
Orientational Performance of Two Daily Disposable Toric Soft Lens Designs
Change in the 8-Item Contact Lens Dry Eye Questionnaire (CLDEQ-8) Before and After Refitting With Silicone Hydrogel Daily Disposable Contact Lenses
Lee A. Hall, BSc (Hons), MCOptom, FBDO CL
Robin L. Chalmers, OD, FAAO, FBCLA
PURPOSE: To compare the clinical performance of two daily disposable toric soft contact lens designs with respect to orientation after random insertion.
PURPOSE: To describe soft contact lens (SCL) wearers’ responses to the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) in a large registry of patients recently fit with daily disposable (DD) SCLs.
METHOD: This was a 40-subject, one-visit, single-masked (subject), randomized, bilateral crossover study comparing two lenses utilizing different methods of stabilization; an “accelerated stabilized design” (ASD), 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM (Johnson & Johnson Vision Care, Inc.) and a “dual thin” design (DTD), DAILIES® Toric All Day Comfort (Alcon Vision Care). Lenses were inserted at random orientation and evaluated using a slit lamp with an eyepiece protractor, 1, 3, and 20 minutes after insertion. The video images were then analyzed frame by frame to determine the time to reach final orientation settling position. Absolute rotation was analyzed using a linear mixed model for repeated measures on log-transformed data. All statistical tests were two-sided with type I error rate controlled at 5%.
METHODS: Registered wearers who entered the 1-DAY ACUVUE® TruEye® Brand Contact Lenses and 1-DAY ACUVUE® MOIST® Brand Contact Lenses Performance Overview (TEMPO) Registry (#NCT01467557) as habitual SCL wearers had recently been fit with narafilcon B lenses (1-DAY ACUVUE® TruEye® Brand), and 2-week surveys were analyzed. Recall of symptoms with habitual SCLs and recently prescribed DD SCLs were captured via electronic administration of the validated CLDEQ-8 symptom questionnaire as part of a larger survey. Change in response was tested with Wilcoxon Signed Rank test with significance at p<0.01. Maximum CLDEQ-8 score is 35, and change per item is shown (scale 0 to 4 or 5).
Kathrine Osborn Lorenz, OD, MS, FAAO, FBCLA; Youssef Toubouti, MS; Graeme Young, MPhil, PhD, FCOptom, DCLP, FAAO, FBCLA
RESULTS: The ASD lens showed significantly less absolute rotation (i.e. orientation closer to the zero position) at both 1 minute (6.7° vs 12.7°, p=0.0012) and 3 minutes (6.3° vs. 13.0°, p=0.0001) after insertion. However, there was no significant difference in absolute orientation between the two designs at the 20 minute assessment (5.4° vs 6.8°, p=0.43). CONCLUSIONS: Significant differences were noted in clinical performance between the two designs, with the ASD showing significantly less misorientation than the DTD 1 minute and 3 minutes after insertion.
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA; Lisa Keay, BOptom, PhD, MPH; William Gleason, OD; Roger Albright, MBA
RESULTS: Of the 436 registered wearers (67% female, mean age 34 ± 13 yrs, range 9-76 yrs), 34% entered the study wearing hydrogel DDs. Mean CLDEQ-8 score was 12.8 ± 7.1 at baseline and 8.4 ± 5.6 at 2-weeks, similar to “Very Good/Good” and “Excellent/Very Good” ratings in benchmark datasets. The largest effect occurred in intensity of discomfort at the end of the wearing time (-0.89 ± 1.44, p<0.0001), with 58% reporting improvement, 27% unchanged, and 14% worsening. Frequency of discomfort improved for 57% and worsened for 10% (-0.73 ± 1.06, p<0.0001). Late-day intensity of dryness (-0.65 ± 1.38, p<0.0001) and blurry, changeable vision (-0.65 ± 1.62, p<0.0001) were the next most responsive symptoms. CONCLUSIONS: Unselected habitual SCL wearers reported significant improvement in symptoms of discomfort, dryness, and blurry, changeable vision 2 weeks after being refit with narafilcon B lenses in this US post-market registry of DD SCLs. Reduction of SCL-related symptoms may be an important benefit of silicone hydrogel DD lenses.
Overall opinion of soft contact lenses
10
Lee Hall originally qualified as a Contact Lens Optician in 1995, working in both private and hospital practice over a nine-year period. He graduated in Optometry with a first-class honours degree in 2004 and went on to win the British Optical Association prize in 2005. He worked in private practice for a further three years whilst simultaneously acting as a Research Optometrist. Lee joined Visioncare Research Ltd, an independent optical research organisation in 2008, where he is responsible for the planning, execution and analysis of internal studies. He is currently undertaking his PhD, researching the use of medical imaging to improve soft contact lens fit dynamics.
10
A graduate of UC Berkeley School of Optometry, Dr Chalmers is an independent clinical trial consultant. She is ViceChair of the American Academy of Optometry Research Committee, and on the steering committee of the Fellows Doing Research (FDR) Special Interest Group. She is co-chair of the Contact Lens Assessment in Youth Study (CLAY) group, studying the safety of soft contact lens wear in teens and young adults. She serves as faculty for the AOA/AAO Summer Research Institute and on the Editorial Board of Contact Lens and Anterior Eye. Her contact lens areas of research interest are epidemiology of complications with contact lenses, and post-market surveillance of contact lens outcomes. She is the Principal Investigator of the TEMPO Registry of daily disposable lenses. She is also involved in research on dry eye and contact lens-related dryness symptoms. Dr Chalmers co-authored the development and validation of long and short forms of the Dry Eye Questionnaire (DEQ & DEQ-5) and Contact Lens Dry Eye Questionnaire (CLDEQ & CLDEQ-8).
11
9
pOSTER
PRESENTATION
Orientational Performance of Two Daily Disposable Toric Soft Lens Designs
Change in the 8-Item Contact Lens Dry Eye Questionnaire (CLDEQ-8) Before and After Refitting With Silicone Hydrogel Daily Disposable Contact Lenses
Lee A. Hall, BSc (Hons), MCOptom, FBDO CL
Robin L. Chalmers, OD, FAAO, FBCLA
PURPOSE: To compare the clinical performance of two daily disposable toric soft contact lens designs with respect to orientation after random insertion.
PURPOSE: To describe soft contact lens (SCL) wearers’ responses to the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) in a large registry of patients recently fit with daily disposable (DD) SCLs.
METHOD: This was a 40-subject, one-visit, single-masked (subject), randomized, bilateral crossover study comparing two lenses utilizing different methods of stabilization; an “accelerated stabilized design” (ASD), 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM (Johnson & Johnson Vision Care, Inc.) and a “dual thin” design (DTD), DAILIES® Toric All Day Comfort (Alcon Vision Care). Lenses were inserted at random orientation and evaluated using a slit lamp with an eyepiece protractor, 1, 3, and 20 minutes after insertion. The video images were then analyzed frame by frame to determine the time to reach final orientation settling position. Absolute rotation was analyzed using a linear mixed model for repeated measures on log-transformed data. All statistical tests were two-sided with type I error rate controlled at 5%.
METHODS: Registered wearers who entered the 1-DAY ACUVUE® TruEye® Brand Contact Lenses and 1-DAY ACUVUE® MOIST® Brand Contact Lenses Performance Overview (TEMPO) Registry (#NCT01467557) as habitual SCL wearers had recently been fit with narafilcon B lenses (1-DAY ACUVUE® TruEye® Brand), and 2-week surveys were analyzed. Recall of symptoms with habitual SCLs and recently prescribed DD SCLs were captured via electronic administration of the validated CLDEQ-8 symptom questionnaire as part of a larger survey. Change in response was tested with Wilcoxon Signed Rank test with significance at p<0.01. Maximum CLDEQ-8 score is 35, and change per item is shown (scale 0 to 4 or 5).
Kathrine Osborn Lorenz, OD, MS, FAAO, FBCLA; Youssef Toubouti, MS; Graeme Young, MPhil, PhD, FCOptom, DCLP, FAAO, FBCLA
RESULTS: The ASD lens showed significantly less absolute rotation (i.e. orientation closer to the zero position) at both 1 minute (6.7° vs 12.7°, p=0.0012) and 3 minutes (6.3° vs. 13.0°, p=0.0001) after insertion. However, there was no significant difference in absolute orientation between the two designs at the 20 minute assessment (5.4° vs 6.8°, p=0.43). CONCLUSIONS: Significant differences were noted in clinical performance between the two designs, with the ASD showing significantly less misorientation than the DTD 1 minute and 3 minutes after insertion.
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA; Lisa Keay, BOptom, PhD, MPH; William Gleason, OD; Roger Albright, MBA
RESULTS: Of the 436 registered wearers (67% female, mean age 34 ± 13 yrs, range 9-76 yrs), 34% entered the study wearing hydrogel DDs. Mean CLDEQ-8 score was 12.8 ± 7.1 at baseline and 8.4 ± 5.6 at 2-weeks, similar to “Very Good/Good” and “Excellent/Very Good” ratings in benchmark datasets. The largest effect occurred in intensity of discomfort at the end of the wearing time (-0.89 ± 1.44, p<0.0001), with 58% reporting improvement, 27% unchanged, and 14% worsening. Frequency of discomfort improved for 57% and worsened for 10% (-0.73 ± 1.06, p<0.0001). Late-day intensity of dryness (-0.65 ± 1.38, p<0.0001) and blurry, changeable vision (-0.65 ± 1.62, p<0.0001) were the next most responsive symptoms. CONCLUSIONS: Unselected habitual SCL wearers reported significant improvement in symptoms of discomfort, dryness, and blurry, changeable vision 2 weeks after being refit with narafilcon B lenses in this US post-market registry of DD SCLs. Reduction of SCL-related symptoms may be an important benefit of silicone hydrogel DD lenses.
Overall opinion of soft contact lenses
10
Lee Hall originally qualified as a Contact Lens Optician in 1995, working in both private and hospital practice over a nine-year period. He graduated in Optometry with a first-class honours degree in 2004 and went on to win the British Optical Association prize in 2005. He worked in private practice for a further three years whilst simultaneously acting as a Research Optometrist. Lee joined Visioncare Research Ltd, an independent optical research organisation in 2008, where he is responsible for the planning, execution and analysis of internal studies. He is currently undertaking his PhD, researching the use of medical imaging to improve soft contact lens fit dynamics.
10
A graduate of UC Berkeley School of Optometry, Dr Chalmers is an independent clinical trial consultant. She is ViceChair of the American Academy of Optometry Research Committee, and on the steering committee of the Fellows Doing Research (FDR) Special Interest Group. She is co-chair of the Contact Lens Assessment in Youth Study (CLAY) group, studying the safety of soft contact lens wear in teens and young adults. She serves as faculty for the AOA/AAO Summer Research Institute and on the Editorial Board of Contact Lens and Anterior Eye. Her contact lens areas of research interest are epidemiology of complications with contact lenses, and post-market surveillance of contact lens outcomes. She is the Principal Investigator of the TEMPO Registry of daily disposable lenses. She is also involved in research on dry eye and contact lens-related dryness symptoms. Dr Chalmers co-authored the development and validation of long and short forms of the Dry Eye Questionnaire (DEQ & DEQ-5) and Contact Lens Dry Eye Questionnaire (CLDEQ & CLDEQ-8).
11
11
PRESENTATION
PRESENTATION
Daily Disposable Contact Lenses: A Potential Option for ‘Problem’ Reusable Lens Wearers
There Are How Many Contact Lenses in What?!
Michael Spyridon, PhD
Janelle Routhier, OD, FAAO, FBCLA, ABO Diplomate
Sheila Hickson-Curran BSc (Hons), MCOptom, FAAO, FBCLA; Graeme Young, MPhil, PhD, FCOptom, DCLP, FAAO, FBCLA
PURPOSE: To estimate the prevalence of “problem” reusable contact lens (CL) wearers and examine the effect of fitting them with daily disposable (DD) lenses. METHODS: Part I: 364 reusable CL wearers with no evidence of ocular abnormality were included in this analysis. Patients with frequent or constant dryness or irritation, reduced comfortable wearing time (CWT), ≥ grade 2 of conjunctival injection (0-4 scale), or ≥ grade 3 corneal staining (0-15), were regarded as “problem.” Part II: 235 “problem” patients were fitted with etafilcon A (etaA) (n=107) or nelfilcon A (nelA) (n=128) DD-CLs and reassessed 1 week later. The “problem” population included 154 patients identified in Part I and 81 patients with objective signs of dry eye recruited in separate trials. RESULTS: Part I: 42% (154/364) of the reusable CL wearers were classified as “problem” patients, and 75% of them reported reduced CWT, 43.5% dryness, and 10.7% irritation. Problematic conjunctival injection or corneal staining was observed in approximately 10% of patients. Part II: The prevalence of dryness and reduced CWT were decreased from 51.9% to 33.2% (p=0.001) and from 88.6% to 47.2% (p=0.041), respectively, with DD-CLs, while no significant differences were noticed in irritation, conjunctival injection or corneal staining. Following refitting, higher proportions of patients reported symptoms with nelA than etA CLs: dryness (44.5% vs 31.7%, p=0.052), irritation (21.9% vs 11.7%, p 0.05), reduced CWT (55.4% vs 37.3%, p=0.04). The prevalence of conjunctival injection was also significantly higher in the nelA group (10.9% vs 1.8%, p=0.003), while corneal staining although trended higher in nelA-fitted patients, the difference between the two materials did not reach significance (17.1% vs 9.34, p>0.05). CONCLUSION: Symptoms experienced by reusable soft CL wearers could be alleviated with daily disposable CLs, while the lens material plays also a key role.
12
Melissa De Freitas, BSc; Sheila Hickson-Curran, BSc(Hons), MCOptom, FAAO, FBCLA
PURPOSE: To determine and compare the amount of daily disposable (DD) contact lenses (CL) it takes to reach the equivalent amount of material in commonly used plastic items. METHODS: A leading DD lens was dehydrated using an isotemp vacuum oven at 56˚C for 19 hours, and the dry weight was measured on a Metler Toledo scale. Commonly used items such as a water bottle, CL case, CL solution bottle and credit cards were also measured for comparison purposes and the equivalent weights calculated. RESULTS: The calculated weight of a year supply of dehydrated DD lenses (730) weighed 11.36 g or 0.40 oz. This is equivalent to the average weight of 2.3 credit cards. The average weight of a multipurpose solution (MPS) CL case is the equivalent of over a 4 year supply of lenses, while a peroxide case has a weight equal to more than 8 years worth of lenses in it. It takes over a 2.5 year supply of DD lenses to equal the average weight of the material in one bottle of CL solution. A 20 oz bottle of water has the equivalent weight of 1,586 dehydrated CLs or a 2.17 year supply. CONCLUSIONS: If patients are concerned about throwing a lens away every day, doctors can reassure them it’s not the lenses that have a large impact, but the solution bottles and cases needed to store reusable lenses. Doctors can also use real world examples to compare how many lenses are equivalent to common items such as water bottles and credit cards. Although there is more packaging waste associated with DD CLs, it is possible to recycle some of that material (plastic and cardboard only) by following the specific guidelines of one’s city recycling program and seeking further information on how to recycle #5 Polypropylene plastic in one’s area. YEAR SUPPLY OF DD LENSES IN COMMON PLASTIC ITEMS
12
13
Mike Spyridon works as Research Associate at Visioncare Research Ltd, a UK-based company specializing in eye-care clinical research. After spending a few years in bench-based science, Mike entered clinical trials and has been contracted by VISTAKON® Division of Johnson & Johnson Vision Care, Inc., to manage a number of Medical Affairs projects. In his role, he conducts epidemiological research and divides his time between medical writing and organizing clinical research.
Janelle is Manager of Medical Affairs at Johnson & Johnson Vision Care, Inc. She graduated from Michigan College of Optometry, where she went on to complete a Cornea and Contact Lens Residency. Before joining Johnson & Johnson Vision Care, Inc., Dr Routhier focused on complex specialty contact lens fitting and soft and rigid gaspermeable custom lens design while she was on the adjunct clinical faculty at Michigan College of Optometry and in practice. Dr Routhier is a Fellow of the American Academy of Optometry, a Diplomate of the American Board of Optometry, and a Fellow of the British Contact Lens Association.
11
PRESENTATION
PRESENTATION
Daily Disposable Contact Lenses: A Potential Option for ‘Problem’ Reusable Lens Wearers
There Are How Many Contact Lenses in What?!
Michael Spyridon, PhD
Janelle Routhier, OD, FAAO, FBCLA, ABO Diplomate
Sheila Hickson-Curran BSc (Hons), MCOptom, FAAO, FBCLA; Graeme Young, MPhil, PhD, FCOptom, DCLP, FAAO, FBCLA
PURPOSE: To estimate the prevalence of “problem” reusable contact lens (CL) wearers and examine the effect of fitting them with daily disposable (DD) lenses. METHODS: Part I: 364 reusable CL wearers with no evidence of ocular abnormality were included in this analysis. Patients with frequent or constant dryness or irritation, reduced comfortable wearing time (CWT), ≥ grade 2 of conjunctival injection (0-4 scale), or ≥ grade 3 corneal staining (0-15), were regarded as “problem.” Part II: 235 “problem” patients were fitted with etafilcon A (etaA) (n=107) or nelfilcon A (nelA) (n=128) DD-CLs and reassessed 1 week later. The “problem” population included 154 patients identified in Part I and 81 patients with objective signs of dry eye recruited in separate trials. RESULTS: Part I: 42% (154/364) of the reusable CL wearers were classified as “problem” patients, and 75% of them reported reduced CWT, 43.5% dryness, and 10.7% irritation. Problematic conjunctival injection or corneal staining was observed in approximately 10% of patients. Part II: The prevalence of dryness and reduced CWT were decreased from 51.9% to 33.2% (p=0.001) and from 88.6% to 47.2% (p=0.041), respectively, with DD-CLs, while no significant differences were noticed in irritation, conjunctival injection or corneal staining. Following refitting, higher proportions of patients reported symptoms with nelA than etA CLs: dryness (44.5% vs 31.7%, p=0.052), irritation (21.9% vs 11.7%, p 0.05), reduced CWT (55.4% vs 37.3%, p=0.04). The prevalence of conjunctival injection was also significantly higher in the nelA group (10.9% vs 1.8%, p=0.003), while corneal staining although trended higher in nelA-fitted patients, the difference between the two materials did not reach significance (17.1% vs 9.34, p>0.05). CONCLUSION: Symptoms experienced by reusable soft CL wearers could be alleviated with daily disposable CLs, while the lens material plays also a key role.
12
Melissa De Freitas, BSc; Sheila Hickson-Curran, BSc(Hons), MCOptom, FAAO, FBCLA
PURPOSE: To determine and compare the amount of daily disposable (DD) contact lenses (CL) it takes to reach the equivalent amount of material in commonly used plastic items. METHODS: A leading DD lens was dehydrated using an isotemp vacuum oven at 56˚C for 19 hours, and the dry weight was measured on a Metler Toledo scale. Commonly used items such as a water bottle, CL case, CL solution bottle and credit cards were also measured for comparison purposes and the equivalent weights calculated. RESULTS: The calculated weight of a year supply of dehydrated DD lenses (730) weighed 11.36 g or 0.40 oz. This is equivalent to the average weight of 2.3 credit cards. The average weight of a multipurpose solution (MPS) CL case is the equivalent of over a 4 year supply of lenses, while a peroxide case has a weight equal to more than 8 years worth of lenses in it. It takes over a 2.5 year supply of DD lenses to equal the average weight of the material in one bottle of CL solution. A 20 oz bottle of water has the equivalent weight of 1,586 dehydrated CLs or a 2.17 year supply. CONCLUSIONS: If patients are concerned about throwing a lens away every day, doctors can reassure them it’s not the lenses that have a large impact, but the solution bottles and cases needed to store reusable lenses. Doctors can also use real world examples to compare how many lenses are equivalent to common items such as water bottles and credit cards. Although there is more packaging waste associated with DD CLs, it is possible to recycle some of that material (plastic and cardboard only) by following the specific guidelines of one’s city recycling program and seeking further information on how to recycle #5 Polypropylene plastic in one’s area. YEAR SUPPLY OF DD LENSES IN COMMON PLASTIC ITEMS
12
13
Mike Spyridon works as Research Associate at Visioncare Research Ltd, a UK-based company specializing in eye-care clinical research. After spending a few years in bench-based science, Mike entered clinical trials and has been contracted by VISTAKON® Division of Johnson & Johnson Vision Care, Inc., to manage a number of Medical Affairs projects. In his role, he conducts epidemiological research and divides his time between medical writing and organizing clinical research.
Janelle is Manager of Medical Affairs at Johnson & Johnson Vision Care, Inc. She graduated from Michigan College of Optometry, where she went on to complete a Cornea and Contact Lens Residency. Before joining Johnson & Johnson Vision Care, Inc., Dr Routhier focused on complex specialty contact lens fitting and soft and rigid gaspermeable custom lens design while she was on the adjunct clinical faculty at Michigan College of Optometry and in practice. Dr Routhier is a Fellow of the American Academy of Optometry, a Diplomate of the American Board of Optometry, and a Fellow of the British Contact Lens Association.
13
PRESENTATION
PRESENTATION
Demonstrating the Ability to Detect Change Using CLUE: Contact Lens User Experience™
Patient, Practitioner and Parent Motivation for Choosing Daily Disposable Contact Lenses by Age for New and Existing Lens Wearers
Michael L. Henderson, MS
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA
PURPOSE: Clinical trials measure change over time and a patient-reported outcome (PRO) instrument must have the ability to yield a consistent and reproducible estimate of the true treatment effect, while also detecting true changes equally as gains or losses. This study examined the PRO instrument CLUE: Contact Lens User Experience™ for these properties, while measuring contact lens comfort and vision domains.
Purpose: To describe the reasons for lens choice cited by eye care practitioners (ECPs), patients and parents of children by age and wearing status at registration in the 1-DAY ACUVUE® TruEye® Brand Contact Lenses and 1-DAY ACUVUE® MOIST® Brand Contact Lenses Performance Overview (TEMPO) Registry (#NCT01467557) – a large, observational registry of patients newly fit with 2 brands of daily disposables (DD).
METHODS: A total of 250 clinical trial subjects (ages 30 to 45) that were myopic habitual wearers of daily wear silicone hydrogel contact lenses were recruited into one (202) or two (24) of a series of 4 clinical trials with similar study design. PRO measurements were collected with the CLUE™ instrument for each subject’s habitual lens (baseline) as well as at dispensing and follow-up. Subjects in each trial were dispensed (masked) the same daily wear silicone hydrogel lens. This work examined the effect of fitting the lens on subjects who were habitual wearers of the lens (55.6%) or being switched to the lens (44.4%), while maintaining the same contact lens power in each eye. Subjects were masked to the lens dispensed in the trial.
METHODS: Reasons for choice of hydrogel or silicone hydrogel DD lenses (etafilcon A or narafilcon B) were analyzed by age (≤15 yrs “children” vs >15 yrs) and for new and existing wearers—851 existing (59 [7%] children) and 151 new wearers (65 [43%] children) at registration. Endorsement of multiple options was allowed. Data was analyzed with Sign Rank Test within and across groups for age and wear status (% of ECPs “Strongly Agree” and % of wearers/parents “Strongly Agree”/“Somewhat Agree” are shown).
Danielle Boree, MS; Kristy Canavan, OD; RJ Wirth, PhD; Terri L. Henderson, MS
RESULTS: Subjects who were habitual wearers of the study lens had a measured improvement from baseline to first wear cycle dispensing of 13.37 (95% confidence interval 8.69, 18.06) for comfort and 8.42 (4.65, 12.18) for vision. The first wear cycle follow-up was similar to baseline with 0.82 (-4.19, 5.83) for comfort and -0.24 (-4.35, 3.88) for vision. Subjects who were being switched to the study lens had a measured improvement from baseline to first wear cycle dispensing of 23.07 (17.43, 28.71) for comfort and 9.54 (4.99, 14.10) for vision. The first wear cycle follow-up had an improvement from baseline of 10.10 (3.99, 16.21) for comfort and 5.71 (0.56, 10.87) for vision. CONCLUSIONS: The CLUE™ instrument detects changes for subjects switching lenses or receiving a fresh pair of their habitual lens for vision and comfort domains. CLUE™ demonstrates equivalence when comparing worn lenses from the trial follow-up visit to the baseline of habitual wearers for vision and comfort domains.
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Robin L. Chalmers, OD, FAAO; William Gleason, OD; Roger Albright, MBA; Lisa Keay, BOptom, PhD, MPH
RESULTS: For new and existing wearers ECPs top choice was patient convenience with DDs (89% and 86% new and existing, respectively, and 95% for new children). For all new wearers, compliance with hygiene (85%) and a high success rate (84%) followed. Reduction of dryness and redness was cited more often for existing adults than children (p=0.02). Compared to adults, existing child wearers differed on motivations for DDs—they had more often always worn DDs (56% vs 28%, p<0.0001) and reported less dryness with prior lenses (47% vs 60%, p=0.048). Existing wearers’ top reason was ECP recommendation of DDs (94%), then DD ease of use (92%), and no cleaning required (89%). Parents of 102 children cited DD lenses’ ease of care and convenience (96%), ECP recommendation (92%), and comfort (86%) as their top reasons. CONCLUSIONS: Practitioners in this large registry strongly consider patient convenience and ease of compliance with hygiene as reasons to recommend these brands of DD lenses, regardless of patient age. Existing patients consider ECP recommendation and clean lenses every day as top motivators to choose DD lenses.
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15
Michael Henderson is the Manager of Biostatistics for Johnson & Johnson Vision Care, Inc. based in Jacksonville, Florida. He has over 10 years of experience with the design and analysis of clinical trials for contact lens development. Over this time, he has worked extensively with the science of patient-reported outcomes including the development of new survey instruments for contact lens users. He has a Bachelor of Science in Mathematics and Master of Science in Statistics from the University of Georgia.
Sheila Hickson-Curran is Director of Medical Affairs for Johnson & Johnson Vision Care, Inc. in North America and is responsible for technical and clinical communications based upon clinical and scientific evidence. Sheila earned her optometry qualifications from the City University London, United Kingdom, and has clinical practice, teaching and research experience spanning five countries. She joined VISTAKON® in 1995 as a Research Optometrist, with positions of increasing responsibility in Research & Development. She is the Co-Inventor of the BLINK STABILIZED™ Design used in ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, and 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM, for which she won a Johnson Medal, the highest award for innovation in Johnson & Johnson. Sheila is the Co-Inventor of other contact lens designs, and has multiple patents and publications in the field of contact lenses. Sheila is a Fellow of the American Academy of Optometry.
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PRESENTATION
PRESENTATION
Demonstrating the Ability to Detect Change Using CLUE: Contact Lens User Experience™
Patient, Practitioner and Parent Motivation for Choosing Daily Disposable Contact Lenses by Age for New and Existing Lens Wearers
Michael L. Henderson, MS
Sheila Hickson-Curran, BSc (Hons), MCOptom, FAAO, FBCLA
PURPOSE: Clinical trials measure change over time and a patient-reported outcome (PRO) instrument must have the ability to yield a consistent and reproducible estimate of the true treatment effect, while also detecting true changes equally as gains or losses. This study examined the PRO instrument CLUE: Contact Lens User Experience™ for these properties, while measuring contact lens comfort and vision domains.
Purpose: To describe the reasons for lens choice cited by eye care practitioners (ECPs), patients and parents of children by age and wearing status at registration in the 1-DAY ACUVUE® TruEye® Brand Contact Lenses and 1-DAY ACUVUE® MOIST® Brand Contact Lenses Performance Overview (TEMPO) Registry (#NCT01467557) – a large, observational registry of patients newly fit with 2 brands of daily disposables (DD).
METHODS: A total of 250 clinical trial subjects (ages 30 to 45) that were myopic habitual wearers of daily wear silicone hydrogel contact lenses were recruited into one (202) or two (24) of a series of 4 clinical trials with similar study design. PRO measurements were collected with the CLUE™ instrument for each subject’s habitual lens (baseline) as well as at dispensing and follow-up. Subjects in each trial were dispensed (masked) the same daily wear silicone hydrogel lens. This work examined the effect of fitting the lens on subjects who were habitual wearers of the lens (55.6%) or being switched to the lens (44.4%), while maintaining the same contact lens power in each eye. Subjects were masked to the lens dispensed in the trial.
METHODS: Reasons for choice of hydrogel or silicone hydrogel DD lenses (etafilcon A or narafilcon B) were analyzed by age (≤15 yrs “children” vs >15 yrs) and for new and existing wearers—851 existing (59 [7%] children) and 151 new wearers (65 [43%] children) at registration. Endorsement of multiple options was allowed. Data was analyzed with Sign Rank Test within and across groups for age and wear status (% of ECPs “Strongly Agree” and % of wearers/parents “Strongly Agree”/“Somewhat Agree” are shown).
Danielle Boree, MS; Kristy Canavan, OD; RJ Wirth, PhD; Terri L. Henderson, MS
RESULTS: Subjects who were habitual wearers of the study lens had a measured improvement from baseline to first wear cycle dispensing of 13.37 (95% confidence interval 8.69, 18.06) for comfort and 8.42 (4.65, 12.18) for vision. The first wear cycle follow-up was similar to baseline with 0.82 (-4.19, 5.83) for comfort and -0.24 (-4.35, 3.88) for vision. Subjects who were being switched to the study lens had a measured improvement from baseline to first wear cycle dispensing of 23.07 (17.43, 28.71) for comfort and 9.54 (4.99, 14.10) for vision. The first wear cycle follow-up had an improvement from baseline of 10.10 (3.99, 16.21) for comfort and 5.71 (0.56, 10.87) for vision. CONCLUSIONS: The CLUE™ instrument detects changes for subjects switching lenses or receiving a fresh pair of their habitual lens for vision and comfort domains. CLUE™ demonstrates equivalence when comparing worn lenses from the trial follow-up visit to the baseline of habitual wearers for vision and comfort domains.
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Robin L. Chalmers, OD, FAAO; William Gleason, OD; Roger Albright, MBA; Lisa Keay, BOptom, PhD, MPH
RESULTS: For new and existing wearers ECPs top choice was patient convenience with DDs (89% and 86% new and existing, respectively, and 95% for new children). For all new wearers, compliance with hygiene (85%) and a high success rate (84%) followed. Reduction of dryness and redness was cited more often for existing adults than children (p=0.02). Compared to adults, existing child wearers differed on motivations for DDs—they had more often always worn DDs (56% vs 28%, p<0.0001) and reported less dryness with prior lenses (47% vs 60%, p=0.048). Existing wearers’ top reason was ECP recommendation of DDs (94%), then DD ease of use (92%), and no cleaning required (89%). Parents of 102 children cited DD lenses’ ease of care and convenience (96%), ECP recommendation (92%), and comfort (86%) as their top reasons. CONCLUSIONS: Practitioners in this large registry strongly consider patient convenience and ease of compliance with hygiene as reasons to recommend these brands of DD lenses, regardless of patient age. Existing patients consider ECP recommendation and clean lenses every day as top motivators to choose DD lenses.
14
15
Michael Henderson is the Manager of Biostatistics for Johnson & Johnson Vision Care, Inc. based in Jacksonville, Florida. He has over 10 years of experience with the design and analysis of clinical trials for contact lens development. Over this time, he has worked extensively with the science of patient-reported outcomes including the development of new survey instruments for contact lens users. He has a Bachelor of Science in Mathematics and Master of Science in Statistics from the University of Georgia.
Sheila Hickson-Curran is Director of Medical Affairs for Johnson & Johnson Vision Care, Inc. in North America and is responsible for technical and clinical communications based upon clinical and scientific evidence. Sheila earned her optometry qualifications from the City University London, United Kingdom, and has clinical practice, teaching and research experience spanning five countries. She joined VISTAKON® in 1995 as a Research Optometrist, with positions of increasing responsibility in Research & Development. She is the Co-Inventor of the BLINK STABILIZED™ Design used in ACUVUE® ADVANCE® Brand Contact Lenses for ASTIGMATISM, ACUVUE® OASYS® Brand Contact Lenses for ASTIGMATISM, and 1-DAY ACUVUE® MOIST® Brand Contact Lenses for ASTIGMATISM, for which she won a Johnson Medal, the highest award for innovation in Johnson & Johnson. Sheila is the Co-Inventor of other contact lens designs, and has multiple patents and publications in the field of contact lenses. Sheila is a Fellow of the American Academy of Optometry.
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PRESENTATION The “Pantry Load” Effect – Can It Help Drive More Compliant Contact Lens Replacement? Cristina Schnider, OD, MSc, MBA, FAAO, FBCLA Anne Marie Jedraszczak, MA
PURPOSE: It is well documented that many contact lens (CL) wearers tend to “stretch” when it comes to adhering to practitioner-prescribed replacement intervals. The methodology used in quantifying stretching behavior can lead to a wide variety of stretch scenarios, but data from JJVCI indicates that ~80% of wearers of 2-week and monthly prescribed lenses do not regularly replace CLs as recommended, and that actual replacement times often exceed recommended by 1-2 weeks for both groups. This research looked at various behaviours of CL patients in 1 US and 1 Canadian study, and investigated the impact of the number of lenses on hand on actual replacement frequency. METHODS: Wearers of 2-week CL brands (n=587) and monthly brands (n=217) in the US, and purchasers of 6-packs (n=119) and 24-packs (n=35) of a 2-week CL brand in Canada were surveyed weekly over an 18 week period as to when they replaced their lenses, how many lenses they had on hand, and for general perceptions of the wearing experience. Compliant replacement was defined as within 15 days for 2-week (2W) lenses and 31 days for 1-month (1M) lenses. RESULTS: At the study onset, 51% of 2W and 40% of 1M wearers in the US study stated a tendency to stretch replacement schedules (NS). During the study, 84% of 2W and 78% of 1M wearers actually “stretched” (3.3wks & 5.6wks between replacements overall; 3.7wks & 6.3wks for stretchers - NS). However, for all wearers, the % who replaced on time was 28.7% when they had less than a 6 month supply in reserve, and 39.4% (p<0.05) when they had over 6 months of lenses. The effect was significant for both users of 2W and 1M lenses. In the Canadian study, users of the 24-pack option were 4X more likely to always replace their lenses on time, and for the less compliant patients, the time to replace was reduced nearly 1 week. CONCLUSION: Ensuring that patients have an adequate supply of lenses on hand can reduce the tendency to wear lenses beyond their intended replacement interval. 24-Pack purchasers tend to rate their lenses more positively than 6-pack purchasers
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65%
79%
69%
79%
Cristina is Senior Director, Professional Communications for Johnson & Johnson Vision Care, Inc. She received her doctor of optometry from Pacific University College of Optometry, a Master of Science in Clinical Research from the University of New South Wales in Australia, and a Master of Business Administration from the University of Florida. She is a Fellow, a Contact Lens Diplomate, and a member of the leadership team in the Section on Cornea, Contact Lenses, and Refractive Technologies of the American Academy of Optometry. Cristina is also a council member for the International Society for Contact Lens Research, and has spoken and published in several languages on topics related to cornea and contact lenses.