Why don’t we fit more multifocal contact lenses?1 Is it chair time, that patient’s won’t pay or the higher degree you need to know how a translatingalternating-diffractive-concentric bifocal works?
Instead we too often settle for monovision.1 We might be thinking the multifocal entry add is too strong for a young presbyope. It all seems okay until the add creeps up and that feeling of monovision ‘fighting eyes’ arrives, leaving us wondering what to do…
Welcome Air Optix Aqua Multifocal
It’s a simultaneous vision, centre near, aspheric design – which essentially means the patient sees with both eyes, at all distances.2 You get the smooth back surface of a single vision lens and the comfort and overnight wearing flexibility of the Air Optix Aqua silicone hydrogel material (Dk/t 138 at -3.00).
Three adds (versus two for PureVision Multi-Focal3) provides a soft entry for new presbyopes. The fitting is the same as the Air Optix Aqua sphere, so if your patient already wears the sphere, the transition to the multifocal is easy. When the prescription changes, it’s also less confusing, because the add power is reliably the same across the Rx range. A MED is the same effective addition for a +3.00 or a -3.00.
Built for ease, but does it work? Air Optix Aqua Multifocal has been evaluated locally since January 2009 and the results show outstanding optometrist and patient satisfaction. Many are asking ‘is this the lens that delivers on the promise?’
Australian and New Zealand Experience4
35 local practitioners evaluated the lens with neophyte and experienced lens wearers (aged 39 years and above and with <1.00 DC). Practitioners completed a simple questionnaire at the first aftercare and tracked their overall conversion rate.
Results
The sample was typical of optometric practice (n = 208, mean age 52 +/-6 years, 71 per cent female, with a mean Rx -0.50 ± 3.25DS (from +6.00 to -9.00DS) and -0.25DC. 38 per cent of patients were new to contact lenses and 31 per cent (64 patients) were already wearing multifocal CLs. The Air Optix Aqua add powers dispensed were 29 per cent LO, 44 per cent MED and 27 per cent HI.
Patient satisfaction was very high for overall vision and improvement to quality of life, with 78 per cent of patients saying they were very satisfied or somewhat satisfied with their vision, and 74 per cent either strongly agreeing or somewhat agreeing their quality of life was improved (Figures 1 and 2). This result, that three out of every four patients reported a positive impact to their quality of life, is an extraordinary outcome for a multifocal contact lens.
Similar results were found for end-of-day comfort and overall physiology, with top two box scores (strongly agree and somewhat agree) reaching 86 per cent and 94 per cent respectively.
Which Patients?
Apart from selecting patients with suitable eyes (<1.00 DC, average pupil size and corneas which are not too steep), success will be further enhanced for motivated patients, with realistic visual expectations. The ‘secret’ is to let the patient experience the lens. Many optometrists in the local evaluation suggested Air Optix Aqua Multifocal is flexible enough to offer to any presbyope, but it obviously works better in some. John Adam, from Remuera, New Zealand, said: “It’s fantastic. I’m offering it to most patients over 45 – spectacle or contact lens wearers. The key is to get it on the eye and let them experience it for a few hours. One lady summed it up nicely as ‘incredibly liberating’, reminding me why I fit contact lenses in the first place.”
Peter Rose, from Nowra, said: “It’s a very impressive lens and material, but I think success is more likely if you start patients early. If they’ve only worn spectacles, and worn them for a long time, they might have unrealistically high expectations.”
If you want to be part of the “liberation” of your presbyopic patients, plan to give them something more than spectacles, monovision or surgery. This pre-market evaluation shows that Air Optix Aqua Multifocal is performing to be your “something more”. When you first think about presbyopia, think long-term. You’re establishing and further enhancing your expertise and relationship with your patient. There are a lot of relationships out there to be made.
| Start ‘liberating’ your presbyopes… |
|---|
…with Air Optix Aqua Multifocal:
|
| Pre-market evaluation |
|---|
|
This pre market evaluation suggests Air Optix Aqua Multifocal will quickly become the first choice contact lens presbyopic option for practitioners: Easy to fit – 95 per cent of patients were reported as ‘easy to fit’ (strongly or somewhat agree). Minimal chair time – an average 1.6 trial lenses per eye were needed to reach the final prescription (1.4 for LO and MED adds). Prescribing and purchase intent – 75 per cent of fittings led to a prescription being dispensed and 70 per cent of patients said they would buy the lenses (Figures 3 and 4) including 32/37 habitual PureVision Multi-Focal wearers. Strong patient interest if “asked” – for every ten patients that the practitioner personally asked to try Air Optix Aqua Multifocal, seven accepted a trial fitting. Presbyopic lens of choice – 85 per cent of practitioners said Air Optix Aqua Multifocal is now their lens of choice versus monovision, and 93 per cent versus other multifocal contact lenses. |
Jenny Saunders is an optometrist and medical writer who consults for the ophthalmic and medical device industries. Helen Gleave is an optometrist, with a special interest in contact lenses and also the Professional Affairs Manager for Ciba Vision Australia and New Zealand. Air Optix is a trademark of Ciba Vision.
References:
- Ciba Vision data on file, 2005.
- Ciba Vision data on file, 2008.
- www.bausch.com retrieved 11/5/09.
- Ciba Vision data on file, 2009.
