Dr. Mile Brujic practices in Bowling Green, OH. He also owns Optometric Insights, a service providing career coaching to optometrists. He has received honorarium for speaking, writing, participating in an advisory capacity or research from: Akorn, Alcon L
Evolving technologies have offered patients opportunities to wear contact lenses more comfortably and conveniently than in previous years. This has been brought about through the evolution of daily disposable contact lens options.
These have traditionally been available in a wide range of spherical lens options providing this demographic of patients opportunities to benefit from these technologies.
Daily disposables have continued to be utilized at increasing rates by practitioners for several reasons.
First, daily disposables provide a hygienic wearing experience for patients by placing a new lens on their eyes every day, avoiding the chance for microbes to adhere to the lens.
Next, because patients are wearing a new lens every day, deposition on the surface of the lenses that can accumulate and can cause irritation are minimized because of the daily replacement modality.
Finally, because there is no cleaning and disinfection required with daily disposable lenses, compliance with this modality of lens is likely the highest of any lens-wearing option.
Fortunately, the companies that have created these technologies have now extended their lines into astigmatic and presbyopic correcting options for us to prescribe to our patients.
Here we will review the current options that are available to help optimize the wearing experience to our patients requiring toric or presbyopia correction.
Alcon produces Dailies AquaComfort Plus Toric lens. The lens is made of nelfilcon A and is 69 percent water.1
This lens leverages the dual-thin design to help stabilize the lens. It has markings at the three and nine o’clock positions that allow the clinician to determine if the fit is appropriately aligned.
Additionally, the lens has an “OK” marking located 90 degrees from the toric lens markings (Figure 1). The back of the “K” is exactly 90 degrees from the markings at three and nine o’clock. When the lens is viewed at the slit lamp, it will be located at the six or 12 o’clock position.
Alcon also produces daily disposable lenses in a multifocal modality. These lenses are available on the Dailies AquaComfort Plus platform and nn the Dailies Total 1 platform.
Dailies Total 1 is a silicone hydrogel lens made of delefilcon A ,which is 33 percent water.2 Interestingly, this describes the core of the lens. The surface of the lens is a different in consistency than the core of the lens,and is 80 percent water.2
The design of the multifocal is the same in both Dailies AquaComfort Plus and Dailies Total 1 platforms.3 It is an aspheric design with near optics located at the center of the lens and progresses to distance optics away from the center of the lens. It is available in low, medium, and high add designs.
Bausch + Lomb
Bausch + Lomb produces Biotrue ONEday lens. This lens design features surface active technology. The lens is made of nesofilcon A and is 78 percent water. The lens retains 98 percent of the water throughout the day because of the interaction of the surface active technology which retains moisture within the lens. This technology is available in both toric and multifocal technologies.4
Biotrue ONEday for Astigmatism’s design is balanced utilizing a peri-ballast.4 This will keep the powers stable on the eye. There is a small vertical laser edged mark located at the six o’clock position. Additionally, there is a second small line-an axis indicator-located along the superior portion of the lens (Figure 2).
The second line is laser edged but is less noticeable than the line at the six o’clock position. It will be present at the axis of the lens, giving the practitioner an opportunity to confirm that the patient is wearing a lens with the correct axis.
The multifocal is a near center-distance periphery design. It is a three-zone progressive design that provides visual consistency at near, intermediate, and distance. Biotrue ONEday for Presbyopia is available in both low and high add powers which provides appropriate transition from early to more advanced levels of presbyopia.
CooperVision produces clariti. It is a silicone hydrogel lens made of somofilcon A, which is 56 percent water. The Dk/t of the lens is 86.5 This material is used for clariti 1 day, clariti 1 day toric, and clariti 1 day multifocal.
The toric lens design is prism ballasted which stabilizes the lens on the ocular surface. It has a laser edged mark located at the six o’clock position when the lens is appropriately aligned.6
The multifocal lens is available in both low and high add powers. The design is center near, which progresses to distance vision away from the center of the lens. It is critical to know the patient’s dominant eye when fitting this lens in order to optimize the fit. Per this lens design’s fitting guide, the initial powers selected for the patient are based on the patient’s distance refractive error. Myopes and emmetropes follow one strategy, and hyperopes follow a slightly different strategy.7
Johnson & Johnson Vision
Johnson and Johnson Vision produces two daily disposable toric contact lenses.
1-Day Acuvue Moist for Astigmatism is a hydrogel lens composed of etafilcon A, which is 58 percent water. It is stabilized on the eye utilizing Blink Stabilized technology.8
Regions at superior and inferior portions of the lens that are thinned in order to optimize its interaction with the superior and inferior lid (Figure 3). Additionally, 1-Day Acuvue Moist for Astigmatism features zones of stability that help with stabilization.
More recently, Johnson & Johnson Vision has offered Acuvue Oasys 1-Day with HydraLuxe for Astigmatism. This lens has a similar design to 1-Day Acuvue Moist for Astigmatism, but features a silicone hydrogel material. It is created of senofilcon A, which is 38 percent water.9
The company’s multifocal lens design is 1-Day Acuvue Moist Multifocal. It is a near center-distance periphery lens. The lens offers 183 optical designs based on varying pupil characteristics of patients with varying refractive errors-the company calls it pupil size-optimized design. It is available in low, mid, and high add designs.10
Visioneering Technologies, Inc
Visioneering Technologies produces NaturalVue Multifocal. This lens is made of etafilcon A, which is 58 percent water. The lens design is based on extended depth of focus. It features a center distance-near periphery with one universal extended depth of focus design add power.11
With the number of daily disposable designs available for both toric and multifocal patients, it is incumbent upon ODs to offer these options. With the convenience and health options that daily disposables offer, ODs are able to provide patients with convenient options to correct their visual needs.
1. Alcon. Dailies AquaComfort Plus Toric Contact Lenses. Available at: https://www.myalcon.com/products/contact-lenses/dailies/aquacomfort-plus-toric-parameters.shtml. Accessed 11/14/18.
2. Alcon. Dailies Total 1 Multifocal Water Gradient Contact Lenses. Available at: https://www.myalcon.com/products/contact-lenses/dailies/dtmulti1-parameters.shtml. Accessed 11/14/18.
3. 2. Alcon. Dailies AquaComfort Plus Multifocal Contact Lenses. Available at: https://www.myalcon.com/products/contact-lenses/dailies/aquacomfort-plus-multifocal-parameters.shtml. Accessed 11/14/18.
4. Bausch + Lomb. Biotrue Oneday Contact Lenses. Available at: http://www.bausch.com/ecp/our-products/contact-lenses/myopia-hyperopia/biotrue-oneday-contact-lenses. Accessed 11/14/18.
5. CooperVision. Clariti 1 day. Available at: https://coopervision.com/practitioner/our-products/clariti-1-day-family/clariti-1-day. Accessed 11/14/18.
6. CooperVision. Clariti 1 day toric. Available at: https://coopervision.com/practitioner/our-products/clariti-1-day-family/clariti-1-day-toric. Accessed 11/14/18.
7. CooperVision. Clariti 1 day multifocal. Available at: https://coopervision.com/practitioner/our-products/clariti-1-day-family/clariti-1-day-multifocal. Accessed 11/14/18.
8. Johnson & Johnson Vision. 1-Day Acuvue Moist Brand Contact Lenses for Astigmatism. Available at: https://www.jnjvisionpro.com/products/1-day-acuvue-moist-astigmatism. Accessed 11/14/18.
9. Johnson & Johnson Vision. Acuvue Oasys 1-Day with HydraLuxe Technology for Astigmatism. Available at: https://www.jnjvisionpro.com/products/acuvue-oasys-1-day-astigmatism. Accessed 11/14/18.
10. Johnson & Johnson Vision. 1-Day Acuvue Moist Brand Multifocal. Available at: https://www.jnjvisionpro.com/products/1-day-acuvue-moist-multifocal. Accessed 11/14/18.
11. Visioneering Technologies, Inc. NaturalVue Multifocal Lens Specifications. Available at: https://vtivision.com/products/naturalvue-multifocal-lens/naturalvue-multifocal-lens-specifications/. Accessed 11/14/18.