Market for daily disposable contact lenses increases

Optometrists are reporting that daily disposable contact lenses are becoming more and more mainstream, largely due to positive patient feedback.

At press time, a poll on Healio.com/Optometry showed that nearly half of respondents said 25% of their patients were currently wearing daily disposables.

Other optometrists told Primary Care Optometry News that their numbers were as high as 80%, as they recommend daily disposable lenses to the majority of their patients.

“Daily disposables are one of the healthiest, most convenient and most comfortable contact lens options for patients,” Bridgitte Shen Lee, OD, the cofounder of Vision Optique, a private optometric practice in Houston, told PCON. “Every patient deserves to try them, and most will choose to wear the daily disposable modality. We – the doctors and the industry – should share that message with our patients and colleagues.”

Over the past several years, four of the major contact lens companies have released a variety of options for daily lens wearers and are continuing to develop even more options.

Alcon

Alcon introduced its Dailies Total1 in 2013 in the U.S., which is made of delfilcon A.

According to the company, the lens has a core water content of 33% and a surface water content of more than 80%. It is available from -0.50 D to -6.00 D in 0.25-D steps, from -6.50 D to -12.00 D in 0.50-D steps and from +0.50 D to +6.00 D in 0.25-D steps.

The company introduced its Dailies AquaComfort Plus Multifocal and Dailies AquaComfort Plus Toric in March 2014.

At the launch, Rick Weisbarth, OD, FAAO, Alcon vice president of professional affairs, explained that the multifocal contact lenses utilized a combination of Air Optix Aqua Precision Profile Design and parameters and Dailies AquaComfort Plus material, nelfilcon A. The lenses are available in distance powers of +6.00 D to -10.00 D in 0.25-D steps and three add powers.

Weisbarth also explained that the company utilized the design of the Focus Dailies Toric contact lenses and features of the Dailies AquaComfort Plus line. The lens design has scribe marks at 9 o’clock and 3 o’clock, as well as an OK indicator that can be used as a scribe mark at 6 o’clock. The lenses are available in cylinder powers of -0.75 D, -1.25 D and -1.75 D and provide 10 axes at plus and minus 20° of 90°and 180° in 10° increments.

Melissa Barnett, OD, FAAO, spoke with PCON about her experience with the toric lenses.

“Dailies AquaComfort Plus Toric contact lenses have been an integral part of my practice since they were introduced,” she said. “These lenses are comfortable and are available in a wide availability of parameters. Patients love the convenience of daily replacement contact lenses. In addition, Dailies AquaComfort Plus Toric contact lenses are an economical option with a good price point.”

Erickson explained that these lenses feature rotational stability, which is essential for clear vision in a toric lens.

“If a lens with cylinder rotates with the blink, vision will blur until the lens reorients itself,” she said. “Dailies AquaComfort Plus Toric contact lenses are stable lenses with double slab-off design so there is minimal rotation with the blink. The dual thin zones use the upper and lower eyelids to maintain rotational stability when blinking. The thin lens edge makes the lenses very comfortable.”

She recommended letting the lenses settle for about 5 to 10 minutes whenfitting.

“Settling time gives the most accurate information for fit, vision and subjective comfort,” Barnett explained.

She told PCON that about 32% of her patients are wearing daily disposables, and those in Dailies AquaComfort Plus Toric lenses have provided positive feedback.

“Patients are extremely happy with these lenses,” she said. “They describe the feeling as ‘fresh and clean.’ Patients also love the convenience of daily replacement contact lenses.”

Bausch + Lomb

Over the past 3 years, Bausch + Lomb has released its Biotrue OneDay and Biotrue OneDay for presbyopia daily disposable contact lenses.

Biotrue OneDay lenses were cleared by the FDA in June 2012, and Biotrue OneDay for presbyopia lenses were cleared in June 2014, according to press releases from the company.

Shen Lee spoke with PCON about her practice’s experience with daily disposable contacts.

“We started fitting single-use only daily disposable contact lenses back in 1999 when we first opened,” she said. “We believe that daily disposable contacts are the healthiest choice for our patients. So we share that belief with our patients and have fitted almost every single daily disposable contact lens that has come into the market over the past 17 years.”

She continued: “We have been at about 70% dailies in our contact lens business for the past several years. Through May of this year, we are at 77% dailies because of all the new single-use daily disposable contacts (especially the multifocals and torics) that have been introduced into the market.”

Shen Lee said that her practice’s experience with Bausch + Lomb’s Biotrue OneDay lenses has been positive.

“Our experience with the Biotrue OneDay lens has been great,” she said. “Our patients love the comfort and vision, doctors enjoy how easy they are to fit, and staff have fun showing patients the savings with the year supply purchase of this lens.”

Biotrue OneDay lenses are made with HyperGel, a material that offers the benefits of silicone and traditional hydrogels – high levels of comfort, water content and oxygen, according to Bausch + Lomb.

“They are very comfortable for all-day use and last longer at the end of the day,” Shen Lee explained. “The HyperGel polymer material mimics the natural human tear layers and, in addition, has built-in moisture retention properties.”

According to the company, Biotrue OneDay lenses are made of nesofilcon A and consist of 78% water, which is the same composition of the cornea. They are available in +6.00 D to -6.50 D in 0.25-D steps and -7.00 D to -9.00 D in 0.50-D steps.

Specific to the Biotrue OneDay for presbyopia lenses is a three-zone progressive design that allows for distance, intermediate and near vision. These lenses were recently expanded with the addition of a high add power range; they are now available in +6.00 D to -9.00 D in 0.25-D steps.

Shen Lee said that the Biotrue OneDay lenses are a first choice for many of her patients, and the fitting process is easy.

“We use this lens as our first dailies choice for new lens wearers, especially children,” she said. “We also use this lens as a first choice to convert new monthly hydrogel contact lens patients who are not in a daily disposable modality or patients in older-generation single-use hydrogel contact lens material.”

For practitioners who opt to use the Biotrue OneDay lens, she recommended letting the lens speak for itself.

“The key is to share the belief that daily disposable contact lenses are the healthiest option and tell patients to try them for 10 days straight,” Shen Lee suggested. “Most patients who try them for a week or longer will convert to dailies modality.”

She added that the only improvement she would like to see to the lens is an increase in availability.

“We need this material in -12 D to +8 D, in multifocal high add with +0.25 D increments and in a full range of torics,” Shen Lee told PCON.

CooperVision

CooperVision began offering its Clariti 1 day lenses in 2014 after the company acquired Sauflon.

The lenses are made of silicone hydrogel and feature high water content and high oxygen transmissibility, according to CooperVision. The company announced increased availability of Clariti 1 day lenses in November 2014. They are now available in sphere, toric and multifocal options.

Steven Rosinski, OD, described his experience with the products, which he has used in his office since fall 2014.

“They are unique in that they are the only silicone hydrogel 1-day contacts that are available as a sphere, toric and multifocal and at the cost of a hydrogel 1-day,” he said. “The material is a third-generation silicone hydrogel that has no surface modifications to increase its wettability and comfort, as it is inherent within the design of the lens due to the unique material. Additionally, they are a class 2 UV blocker.”

Rosinski explained that the lenses are easy to handle, which is beneficial for new 1-day patients.

“Patients have been very pleased,” he said. “The optics associated with the multifocal are superior.”

He also recommended following the fitting guide to save time and ensure a proper fit.

“It is amazing how many doctors try their own modifications – especially for the multifocal,” Rosinski said. “The fitting guide is there for a reason – use it. With regard to the toric lens, it is very fast at orienting to the 6:00 position and very stable, helping to reduce chair time. I typically only need to wait a minute or two and can check vision. In today’s world, those extra few minutes saved add up.”

He said the only changes he would like to see to the lenses is an increase in the amount of lenses in the toric lens trial pack from five to 10, similar to the sphere and multifocal packs.

CooperVision also announced a new lens at Optometry’s Meeting in Seattle in June: MyDay silicone hydrogel daily disposable contact lenses.

“MyDay provides excellent comfort, handling and optics,” Kerry Gelb, OD, said of the new contacts. “They are equal to or better than other silicone hydrogel 1-days regarding, comfort, vision and handling and are very resistant to dehydration.”

As detailed by the company, the MyDay lenses are made with Smart Silicone chemistry, which consists of 4.4% silicon, allowing for more moisture and oxygen permeability. Additionally, the lenses have a modulus of 0.4 MPa, are naturally wettable and have built-in UV protection filters.

They are available in sphere powers from +6.00 D to -10.00 D, in 0.50-D steps after +5.00 D and -6.00 D.

Gelb reported that the contacts have received positive feedback from his patients.

“As so many of my patients are already wearing 1-day lenses, it is easy to upgrade them to newer technology,” he said. “Patients want to learn about new technology, and I always present that technology to them. As 1-days are already the safest option, the biggest improvement that MyDay provides is excellent optics and improved comfort, especially end-of-day comfort.”

According to the company, CooperVision has begun limited distribution of MyDay in the U.S. It expects to begin shipping nationwide by fall 2015.

Johnson & Johnson

Johnson & Johnson Vision Care Inc. (JJVCI) launched the first disposable soft contact lens in 1987 and has released several in the past year.

JJVCI’s 1-Day Acuvue Define contact lenses with Lacreon technology were launched in the U.S. in 2014.

Cindy Szeto, OD, told PCON that she has had great success with the lenses and that her patients enjoy incorporating them into their beauty regimens.

“The 1-Day Acuvue Define lens is in a whole new category of eye enhancement lenses that heighten the appearance and brightness of the eye without changing the eye’s natural coloring,” she said. “The lenses create a clearly defined limbal ring and use iris-inspired designs with light-effect patterns to naturally highlight the eyes.”

Szeto continued: “The lenses are also based on the 1-Day Acuvue Moist platform, which is a top seller in our office, making it a seamless transition for existing 1-Day Acuvue Moist patients to shift to these lenses.”

The lenses are available in three different effects: Natural Sparkle, Natural Shimmer and Natural Shine, and Szeto said she typically begins with the medium effect.

“Depending on the patient’s eye color, I will start with Natural Shimmer,” she said. “If they want less definition, I’ll move to Natural Sparkle, which offers less impact, and if they want more definition, I’ll move to Natural Shine, which offers the most dramatic definition to the limbal ring.”

According to JJVCI, 1-Day Acuvue Define lenses are made of etafilcon A and are available in plano and for vision correction, from +1.00 D to -9.00 D.

Szeto explained that she tends to keep appointments with 1-Day Acuvue Define patients lighthearted and fun.

“The lenses are ideal for anyone looking for a beauty boost; they are available for those who need vision correction or plano wearers,” she said. “With these lenses, you’re able to experiment with your beauty look in a way that was not possible before with other lenses on the market. I love introducing the lenses to new patients; they are oftentimes thrilled to find out that there are daily disposables available at a great price point.”

The company launched a new lens, 1-Day Acuvue Moist Brand Multifocal, at Optometry’s Meeting in June.

According to the JJVCI, the lenses feature an optical design that allows them to optimize the pupil. They are available in 61 distance powers, +6.00 D to -9.00 D in 0.25-D steps, and in three add powers, low, mid and high.

“The 1-Day Acuvue Moist Brand Multifocal contact lenses are very unique lenses that account for the natural change in pupil size according to age and refractive power,” Arti Shah, OD, told PCON. “Some other lenses take more of a one-size-fits-all approach, so it is great that I am able to accommodate my presbyopic patients with a more customized approach. The pupil optimization technology in the lenses addresses the complex correction and precision needs of my patients.”

She continued: “These lenses were designed on the original 1-Day Acuvue Moist platform, which means long-lasting comfort with the Lacreon technology, infinity edge design and low modulus. The lenses also provide Class 2 UV protection.”

Shah said that the fitting process has been simple and has produced a high rate of success.

“When fitting my patients, I start with my most current refraction,” Shah detailed. “After vertexing their distance prescription, I determine their dominant eye with a +1.00 D blur tolerance test. With this multifocal lens, I look at their sensory dominance and not their sighting dominance. Following the fit guide, I look at the add power that was determined from the refraction to make my initial lens selection. It is suggested to wait 10 minutes after inserting the lenses, but I rarely find the need to wait more than a few minutes.”

She estimated that 80% of the time she fits her patients in the first selected contacts, with the other 20% only needing one additional adjustment. Shah stressed that the Acuvue guide plays a crucial role in a successful fitting.

“I’ve been receiving phenomenal feedback from my patients,” she said. “One of my patients, a 60-year old female, said that the lenses ‘gave her back her 39-year-old eyes.’ The lenses provide patients with both visual comfort and physical comfort that they may not have been able to experience with other multifocal lenses on the market.”

The lenses are now available nationwide.

Daily disposables more mainstream

In a study published in Clinical and Experimental Optometry in 2013, Efron and colleagues reported that daily disposable lens prescribing has seen a stable increase between 1996 and 2011.

The authors explained that various factors would continue to influence the market, including newer lenses that focused on increasing water content.

“We believe that innovations such as these, coupled with the greater convenience and undoubted health benefits of daily disposable lenses, will continue to drive the contact lens field toward a true single-use-only, disposable lens market,” the authors wrote. “We predict that daily disposable lenses may well constitute over 80 percent of worldwide sales of contact lenses by 2020.”

The optometrists interviewed for this article all expressed excitement for the increase in daily disposable contact lenses.

“Daily disposables certainly are becoming more mainstream – we joke that once people go daily, they don’t go back,” Szeto explained. “Patients share their positive experiences with their friends and family, and as more people see the benefits – health, comfort and convenience, there’s less pushback on cost. We no longer have to present a long list of pros and cons to our patients; they come in asking for daily disposables.”

Shah echoed her colleague’s sentiments.

“The daily disposable market share is continuing to grow and is steadily becoming a popular option,” Shah said. “I’ve seen an uptick in daily disposable fitting patterns among doctors in the U.S. and within my practice. ‘Single-use lenses,’ as I say to my patients, provide exceptional comfort and vision. Single-use lenses are the ultimate when it comes to not only convenience, but also ocular health. I am excited for the trend and increased adaptation to continue.” – by Chelsea Frajerman Pardes

• Reference:
• Efron N, et al. Clin Exp Optom. 2013;96(1):58-64.

• For more information:
• Melissa Barnett, OD, FAAO, can be reached at drbarnett@ucdavis.edu.
• Kerry Gelb, OD, can be reached at drkmg20000@gmail.com.
• Steven Rosinski, OD, can be reached at drrosinski@crozeteyecare.com.
• Arti Shah, OD, practices full-scope optometric care at Elander Eye Care in Los Angeles. She can be reached at artishahod@yahoo.com.
• Bridgitte Shen Lee, OD, can be reached at drbshenlee@iTravelCE.com.
• Cindy Szeto, OD, is a partner at Drs. Hall & Szeto Optometry in San Francisco. She can be reached at cinszeto@gmail.com.

Disclosures: Barnett is a consultant for Acculens, Alcon, Allergan, Bausch + Lomb, CooperVision, NovaBay, Vistakon and Zeiss. Gelb reported no financial disclosures. Rosinski reports no relevant financial disclosures. Shah is a professional affairs consultant for JJVCI, clinical research optometrist for AcuFocus and a consultant for SynergEyes. Shen Lee is a consultant for Alcon, Bausch + Lomb, CooperVision, JJVCI, OcuSoft and Essilor. Szeto was paid to consult on the 1-Day Acuvue Define launch.