Clinical performance and Willingness To Pay for soft toric contact lenses in low and moderate astigmats.

PURPOSE: To determine clinical performance and the 'Willingness To Pay' for toric vs. spherical soft contact lenses in an astigmatic population. METHODS: In the clinical study, subjects with binocular low to moderate astigmatism (-0.75DC to -1.50DC) wore pairs of soft toric (Biofinity toric) and spherical (Biofinity) contact lenses in random sequence. Visual acuity (high and low contrast, monocular and binocular), subjective comfort and subjective vision were recorded. In the economics study, first subjects who had participated in the clinical study were presented with a series of randomised economic scenarios in order to determine their Willingness To Pay a premium (i.e. an increase) for toric lenses. Then, a similar set of scenarios were presented to a much larger group of online respondents and again, Willingness To Pay was established. RESULTS: For the four measures of visual acuity, the Biofinity toric lens out-performed the Biofinity spherical lens by 0.6 to 1.1 lines.. Subjective vision performance was statistically significantly better with the toric lens for the distance task only. Comfort scores were not significantly different. Similar findings for Willingness To Pay were established for the clinical subjects and for the online respondents. The Willingness To Pay premium (additional fee) for a monthly supply of toric lenses (over spherical lenses) was between £13 and £16, if a toric lens provides better vision and similar comfort, as shown in the clinical study. CONCLUSION: Consumers are willing to pay a monthly premium of around 50% to benefit from the typical experience of better vision and similar comfort for toric vs. spherical lenses. The level of additional cost for toric lenses compared to their spherical equivalents is less than this in the market, so eye care professionals should consider that toric lenses are delivering a greater clinical return than anticipated by wearers for the relatively small increase in price.

Exploring the factors which impact overall satisfaction with single vision contact lenses.

PURPOSE: To explore the impact of subjective factors (lens handling, comfort and vision) on overall single vision contact lens satisfaction. METHODS: Correlation analysis of a prospective, randomised, double-masked, bilateral crossover study involving 55 adapted lens wearers fitted with somofilcon A (SiHy) (clariti® 1 day, CooperVision) and etafilcon A (Hy) (1 DAY ACUVUE® MOIST, Johnson & Johnson Vision) was conducted. Subjective ratings of lens handling, comfort and vision collected after 1 week of lens wear for each lens type were correlated with overall satisfaction. Data were analysed by combining data for both lens types and also for each lens separately. RESULTS: For the combined analysis, significant correlations (p < 0.01) were found between subjective ratings of overall satisfaction and ratings of handing for application (r = 0.64), handling for removal (r = 0.50), comfort upon application (r = 0.59), comfort at end of day (r = 0.61), overall satisfaction with comfort (r = 0.88) and overall satisfaction with vision (r = 0.64). Correlation analysis of the per lens data showed that lens specific correlations of overall satisfaction with handling for lens application varied greatly with lens material (SiHy: r = 0.26, p = 0.05 vs Hy: r = 0.72, p < 0.01). Correlation strength of comfort upon application/at end of day with overall satisfaction also varied with lens material (Application: SiHy: r = 0.40 vs Hy: r = 0.61; End of day: SiHy: r = 0.76 vs Hy: r = 0.58; all p ≤ 0.01). CONCLUSION: Overall satisfaction was significantly correlated with the specific subjective evaluations of handling, vision and comfort. Correlations of overall satisfaction and ease of handling for each lens type suggest that, for habitual contact lens wearers, dissatisfaction with handling at the time of lens application can play a major role in overall dissatisfaction with a lens. Handling for application had a similar correlation (r) value as vision, suggesting that handling for application should not be underestimated when considering overall patient satisfaction.

Using face masks with spectacles versus contact lenses.

PURPOSE: To test the hypothesis that various subjective ocular and task-related parameters associated with wearing a face mask would be better in neophyte contact lens (CL) wear compared to habitual spectacle (Sp) wear. METHODS: Thirty participants were randomised to continue in Sp (n = 15) or wear somofilcon A daily disposable CL (n = 15) ('group'). A surgical face mask (Type II R) was worn for at least one hour per day on four or more days per week. After two weeks, participants completed the Quality of Life Impact of Refractive Correction Questionnaire (QIRC), a two-part face mask usability questionnaire and graded ocular-related symptoms using 0-100 visual analogue scales. RESULTS: There was no difference between groups for overall QIRC score but some individual question scores reflected better quality of life in the CL: 'outdoor activities', 'keep fit' and 'able to do things' (all p < 0.05). Differences in favour of the CL were seen for the following in the face mask usability questionnaire: 'breathing', 'heat', 'comfort on ears', 'overall comfort', 'walking', 'driving', 'reading', 'computer use', 'exercising' and 'socialising' (all p < 0.05). Significant differences were also seen for the 0-100 VAS symptoms probing vision quality in favour of the CL: glare, distance and near vision, fogging, restricted field of view and peripheral blur. CONCLUSION: This work supports anecdotal reports that CL are a better vision correction option than Sp when used in conjunction with a face mask. Participants reported a range of benefits to the CL/face mask combination for vision-related symptoms, breathing and heat-related symptoms and a number of day-to-day activities including walking, driving and exercising. All of the benefits relating to the CL are likely to result in improved adherence to face mask use. Overall, the findings of this work suggest that where possible, CL should be the preferred vision correction option for people using face masks.

An investigation into disposal and recycling options for daily disposable and monthly replacement soft contact lens modalities.

PURPOSE: To examine the annualised waste and end-of-life disposal options with two representative soft contact lens (CL) modalities. METHODS: The component parts of two representative soft CL modalities were catalogued, separated, weighed and inspected for material identification: somofilcon A soft CLs (clariti elite, CooperVision Inc.) used with multi-purpose solution (MPS) (All in one Light, CooperVision Inc.) and somofilcon A CLs (clariti 1 day, CooperVision Inc). Using a model that assumed compliant wear and care of CLs, the mass of material solid waste generated by CL use over a year was calculated. Disposal options were explored using household and specialist recycling streams in order to develop recommendations for responsible disposal of CL waste. RESULTS: Full-time daily disposable (DD) CL wear generates 1.06 kg of waste annually compared to 0.83 kg generated by reusable-monthly replacement daily wear ('reusable') CLs. Plastic was the dominant material in both modalities. With full-time use of DD CLs, 64% of waste by mass was plastic blister trays. For full-time use of reusable CLs, where figures from lens and MPS packaging are combined, plastics accounted for 67% of waste by mass. MPS bottles alone made up almost half the waste (45%) associated with full-time reusable CL wear. CONCLUSION: Full-time DD wear generates 27% more waste annually than full-time reusable lens wear. Reusable CL wearers can recycle 78% of waste at home. DD lens wearers have access to recycling options that allow them to recycle 100% of CL related waste. Full-time CL lens wear represents just 0.20-0.26% of the 412 kg of household waste generated per person, per year in the United Kingdom. Worn CLs should never be disposed of down the sink or lavatory. CL wearers should be aware of responsible end-of-life recycling and disposal options for all CL waste.

The association of comfort and vision in soft toric contact lens wear.

PURPOSE: This work set out to investigate if there was an association between subjective comfort and both subjective and measured vision during the use of contemporary daily disposable soft toric contact lenses. METHODS: Thirty-eight habitual soft contact lens wearers wore each of three daily disposable toric lenses for one week in a prospective, crossover, randomised, single-masked study. The following clinical measures were recorded at dispensing and follow-up visits: biomicroscopy scores, lens fitting (including rotation and rotational stability), high and low contrast visual acuity, subjective vision quality and subjective ocular surface comfort. Subjective scores were collected using 0-10 numerical grading scales. Comfort scores were analysed using a linear regression model with age, sex, visit, phase of crossover ('phase'), lens type, lens rotation, lens rotational stability, visual acuity, cylinder power and subjective vision quality as factors of interest and then refined using backward stepwise regression. RESULTS: Thirty six participants (31.1 ± 13.5 years) completed the study. Comfort scores were found to be associated with subjective vision quality (F = 127.0 ; p < 0.0001), phase (F = 7.2; p = 0.001) and lens type (F = 4.9; p = 0.009). Greater comfort scores were observed with greater subjective vision quality scores. Visual acuity was not statistically significant in the model. CONCLUSION: This work suggests that symptoms of ocular discomfort may be more intense if there is also perceived visual compromise in daily disposable soft toric lenses. There was a stronger positive correlation between comfort and subjective vision quality compared with comfort and measured visual acuity.

Changes in accommodative micro-fluctuations after wearing contact lenses of different optical designs.

PURPOSE: Accommodative micro-fluctuations (AMF) are small dioptric changes during accommodation. The aim of this study was to evaluate and compare changes in AMF when wearing silicone hydrogel contact lenses of two different optical designs. METHODS: A multi-centre, randomised, cross-over, non-dispensing study was conducted on 68 adapted contact lens wearers aged 25-35 years to compare AMF responses to a spherical and aspheric silicone hydrogel (comfilcon A) lens designs. A Righton Speedy "i" series Auto Refractometer in accommodation analyser mode was utilized before and after reading a standard text in font size 8 on an iPhone 5 for 20 min at a 25 cm viewing distance. Phone screen brightness was set by automatic adjustment mode and ambient illumination was controlled at all sites. RESULTS: Mean ± SD AMF change from before to after the reading task was 2.25 ± 5.6 and 0.13 ± 5.7 (relative values) for the spherical and aspheric lens designs, respectively. The difference was statistically significant (P = 0.017, Paired t-test). CONCLUSIONS: The smaller change in AMF when using an aspheric lens design suggests reduced ciliary muscle stress when reading print on a smart phone at a close distance for short periods (20 min). Contact lens wearers who frequently use digital devices and are experiencing eye strain may benefit from switching from a spherical design to one that incorporates aspheric optics.

Eye care professionals' perceptions of the benefits of daily disposable silicone hydrogel contact lenses.

PURPOSE: To gain a better understanding of eye care professionals' (ECPs) perceptions regarding the benefits of silicone hydrogel (SiH) daily disposable contact lenses (DDCL), particularly with respect to health, comfort and patient satisfaction. METHODS: A survey was conducted with 300 ECPs in the United States, United Kingdom and Japan during November 2017. The survey comprised 34 statements relating to SiH DDCLs, to which the ECPs provided their level of agreement using a 6 point Likert scale. A minimum of 70% agreement was set to define majority agreement. Categories of statements included Health, Comfort, Patient Experience, and Standard of Care. RESULTS: ECPs rated the highest levels of agreement to perceptions within the Patient Experiences and Health categories. The six statements receiving the highest ratings were "Silicone hydrogel 1 day lenses satisfy today's patients' demanding lifestyles" (93% agreement); "Silicone hydrogel 1 day lenses are the best choice to safeguard my patients' eye health related to contact lens wear" (92%); "Silicone hydrogel 1 day lenses provide the best benefits to my patients" (92%); "Silicone hydrogel 1 day lenses provide better long term eye health for my patients than hydrogel 1 day lenses" (91%); "Silicone hydrogel is the healthiest lens material for my daily disposable patients" (90%); and "Silicone hydrogel 1 day lenses provide a better wearing experience for my patients than hydrogel 1 day lenses" (90%). CONCLUSION: ECPs perceive that SiH DDCLs offer long-term eye healthand comfort for the patient and although the ECPs surveyed would not necessarily prescribe SiH DDCLs to all their patients, they would prescribe them to most of their patients. The results support the premise that while ECPs consider SiH 1 day contact lenses as the current "standard of care"; the principal barrier continues to be the perceived higher cost of these lenses.

Estimating the annual economic burden of illness caused by contact lens-associated corneal infiltrative events in the United States.

OBJECTIVES: The aim of this study was to estimate the annual cost of illness caused by contact lens-associated corneal infiltrative events (CL-CIEs) among soft CL wearers in the United States. METHODS: This study was conducted in the United States. The study population was comprised of daily wear contact lens users in the United States, which number approximately 35 million. A comprehensive review of the medical literature for data on the annual incidence of CL-CIEs was conducted. Cost estimates were drawn from the literature and published tariffs. The perspective of the study was a U.S. healthcare perspective and because of the short duration of most CL-CIEs, no discounting was performed. The main outcome measure involved the total annual number of persons with CL-CIEs and associated direct and indirect costs. RESULTS: In the United States in 2010, it was calculated that a total of 32,031 nonsevere and 17,248 severe CL-CIEs occurred, respectively. The cost per nonsevere and severe CL-CIEs was estimated to be $1,002.90 and $1,496.00, respectively. Overall, the total estimated direct and indirect cost of nonsevere CL-CIEs and severe CL-CIEs in the United States in 2010 was estimated to be $58 million. CONCLUSIONS: This study estimated the economic burden of illness imposed by CL-CIEs on both the healthcare system and individual patients in the United States. Strategies designed to minimize the occurrence and impact of CL-CIEs, such as using improved lens care regimens and lens case management, the use of daily disposable lenses, and more efficacious ocular antibiotics may be beneficial in reducing this economic burden.

Multipurpose solutions and rates of biocidal efficacy.

OBJECTIVE: To investigate the hypothesis that reasonable levels of disinfection are achievable over relatively short exposure durations of microorganisms to multipurpose solutions, this study examined the stand-alone disinfection efficacy at 10, 20, and 30 min of five different multipurpose solutions products, each against five different pathogens eye care practitioners may encounter in their contact lens practice. METHODS: ReNu MultiPlus, ReNu Multi-Purpose, AQuify, OptiFree Express, and OptiFree RepleniSH were evaluated for their microbiocidal efficacy using the stand-alone method at 10, 20, and 30 min of exposure to either Fusarium solani, Candida albicans, Staphylococcus aureus, Serratia marcescens, or Pseudomonas aeruginosa. RESULTS: Solutions which showed significantly higher rates of disinfection at 30 min were ReNu MultiPlus against Fusarium solani and Candida albicans, and both ReNu MultiPlus and AQuify against Staphylococcus aureus and Serratia marcescens. There were no statistically significant differences at 30 min amongst solutions against Pseudomonas aeruginosa. CONCLUSIONS: The product attribute of rapid rate of disinfection may give a greater level of assurance to practitioners when patients are noncompliant and do not follow the recommended time period for lens disinfection. The results of this study, however, should not be interpreted as a recommendation to use any of the solutions tested for a disinfection period less than the recommended soak time. Patient compliance with recommended lens care regimens is essential in minimizing the risk of contamination of contact lenses and lens care accessories.