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At its fourth annual gathering at Vision Expo East, the Global Contact Lens Forum addressed developing technologies with research and development (R&D) scientists, evidence-based eye care, and contact lens practice settings.
New York- At its fourth annual gathering at Vision Expo East, the Global Contact Lens Forum addressed developing technologies with research and development (R&D) scientists, evidence-based eye care, and contact lens practice settings.
Moderator Scot Morris, OD, FAAO, ABO, discussed how contact lens manufacturers develop new technology with a panel of industry R&D representatives.
The panel included:
• George L. Grobe III, PhD, vice president of surgical and vision care R&D at Bausch + Lomb (B+L)
• Nancy Keir, senior director of new technologies R&D at CooperVision
• Kurt J. Moody, OD, FBCLA, FAAO, director of clinical new product development, vision care, at Johnson & Johnson Vision Care (JJVC)
• George Yao, PhD, global vision care R&D head at Alcon
• Vic McCray, MD, CEO, at Tangible Science
• Neal White, vice president of R&D at SynergEyes
Coming up with new ideas
Dr. Grobe says that all ideas at B+L begin with the patient and the doctor.
“Ideas may be inspirational goals, incremental goals, or a combination of the two,” he says. “Or they could come from defects in a material or a design and how to move forward to the next state. We come up with a budget, then decide which projects we’re going to fund. Should one project fall off, another one is waiting to go.”
Dr. Yao that Alcon looks to external and internal idea generating.
“It’s about small scale feasibility, then it goes to manufacturing,” he says. “It’s not just research development, it’s manufacturing and marketing early on. It’s joint team leadership.”
Dr. Moody says that JJVC attempts to mimic nature if patient and doctor needs focus on the contact lens material.
Dr. Yao wants anything new to ensure minimal interruption to the tear film as well as make the lens affordable to mass customers.
Thinking about new materials
Dr. Grobe says the hardest thing is keeping an open mind to a new idea.
White says top of mind is ensuring the material will do what contact lens prescribers need: fit a regular cornea and fit most patients.
Dr. McCray says it’s key to separate the underlying material from the surface product.
Keir looks for a material to make a clinical change and agrees that it’s about keeping an open mind.
Says Dr. Moody: “We’re still not addressing major obstacles. How can we take vision to the next level?”
Challenges with mass production
The best way to mass produce contact lenses is with a perfect marriage between engineering and materials, according to Dr. Yao.
“We need to start from clinical development and concept, then we need a full understanding of the chemical nature.”
JJVC produced four billion contact lenses in 2016, according to Dr. Moody, and the number is increasing because of daily disposables lenses.
“The key is making sure that each one is meeting the design intent,” he says. “You must be able to measure if you’re making what you plan to make.”
Industry challenges with eyecare practitioners
Says Dr. Moody: “Where is the future of contact lenses going to be? How will contact lenses be dispensed? That’s the challenge we face as a profession. We need to match the right patient with the right lens. We need to look to the future to see how that will occur.”
Dr. Yao claims one of the biggest challenges is high dropout.
According to Dr. McCray, it’s important to avoid forcing practitioners to change but instead to provide tools they need.
“When you do provide tools, that leads them in the direction their practice is already going. Doctors need education and tools to help patients to get into contact lenses or help patient retention. Industry must pay attention to what practitioners need.”
Says Mr. White: “Our problem is convincing doctors they can do things a different way. Then they find the worst patients to try things on. Start in the middle and work your way out.”
What practitioners want
Dr. Morris asked attendees what tools they need that industry could provide.
• A multifocal toric lens design for daily or monthly replacement
• Uniform packaging for easier trial lens storage
• Trial lenses turned into office displays to encourage patient discussion
• Fitting guides with additional fit information instead of simply numbers
• Drones to deliver trial lenses within the office
• Consultation services for all lenses, not just custom
• Consumer education around dry eye to help patients understand its relationship to successful contact lens wear
• Parameter expansion for toric daily disposables, including -2.75 D cylinder
• Toric cosmetic lenses
• Patient rebate for fitting fees when new products launch
Moderator Robert Davis, OD, FAAO, and panelists Loretta Szczotka-Flynn, OD, FAAO; Jeffrey Sonsino, OD, FAAO; Christine Sindt, OD, FAAO, discussed their experiences with research in clinical practice.
Dr. Davis shared four steps to evidence-based medicine:
• Frame the clinical question
• Find the evidence
• Assess the evidence
• Make a decision
Dr. Szczotka-Flynn shared tips for fellow ODs interested in clinical research:
• Find a passion. Look for cutting-edge topics or something no one else is doing. Start with clinical case reports, case series, or retrospective chart reviews. Consider beginning with simple prospective trials
• Join multi-center clinical study groups. These could be federally funded or industry funded.
For industry-funded groups, be prepared. This option is not for those who want to simply dabble in research. A dedicated study coordinator is critical to ensure adherence to recruitment, informed consent, strict protocol windows, source documentation, and timely data entry. Researchers in these groups must be willing to accept extensive monitoring, including from the U.S. Food and Drug Administration (FDA).
• Seek further education if it’s available. Training grants for clinical research, such as K grants from the National Institutes of Health (NIH), are an option.
• Collaborate. Remember that you’re only as smart as the team you surround yourself with, and set up a support network.
Dr. Sonsino discussed his interest in research beginning during his undergraduate years and his journey from research at Vanderbilt University to clinical research in private practice.
Dr. Sindt outlined her research process to address the needs of extremely visually impaired patients through bringing a concept to life through patent and FDA approval.
EyePrintPro is optically clear prosthetic scleral cover shell designed to match the exact contours of the individual eye. It provides improved vision and comfort for patients with extreme need.
Panelists from different practice modalities discussed their challenges, as moderated by Dr. Morris.
Dr. Davis, representing private practice, says his biggest challenge is insurance companies which control what patients he sees. Another challenge is his patients’ access to medications he prescribes due to lack of formulary inclusion.
Clark Chang, OD, MSA, MSc, FAAO, representing an ophthalmology setting, says his biggest challenge is getting comanaging surgeons to understand what you are able to do as an optometrist.
Says Dr. Sclafani: “As the only OD in a hospital setting, my services don’t have the same value; sometimes resources are limited to me such as lack of technicians. After the hospital changed contact lens inventory policies, I started a website for contact lens distribution so patients could get their lenses through the university.”