contact lens association of ophthalmologists, inc. eye ... brochure final.pdf · silicone hydrogel...

Contact Lens Association of Ophthalmologists, Inc.® • Eye & Contact Lens

May 4-5, 2012 • Riverside Hotel, Fort Lauderdale, FLMay 4-5, 2012 • Riverside Hotel, Fort Lauderdale, FL

Silicone Hydrogel Lenses– Ten Years Later

Friday, May 4, 2012 New River Ballroom

7:45 am Breakfast West Balcony

8:45 am Opening Remarks New River Ballroom

Session I: Contact Lens Materials/Surfaces and Support of the Tear Film Moderator: Desmond Fonn, DipOptom, MOptom

8:50am SurfacePropertiesandOcularCompatibilityofSiHyLenses•BrianTighe,PhD,DSc 9:20am BiocompatibilityintheDevelopmentofSiHyLenses•JeanJacob,PhD 9:50am DepositsonSiHyLenses•JasonNichols,OD,MPH,PhD,FAAO 10:10am Discussion

10:30 am Break

Session II: Contact Lens Care Moderator: Michael H. Goldstein, MD, MM

11:00am SolutionsforCareofSiHyLenses•MarkWillcox,PhD 11:20am UptakeandReleaseofCLCareComponentsIntoSiHyLenses•LyndonJones,OD,PhD,FCOptom,FAAO 11:40am SiHySolutionInteractionandInflammation•NicoleCarnt,PhD 12:00pm ImpactofSiHy/SolutionCombinationsonCornealEpithelialCells•MaudGorbet,PhD 12:20pm Discussion

12:50 pm Lunch East Balcony

Session III: Ocular Reaction to Contact Lens Wear (micro and macro) Moderator: Oliver D. Schein, MD, MPH

2:10pm EpidemiologyofCornealInfiltrateswithSiliconeHydrogelLenseswithCurrentUsePatterns •RobinChalmers,OD,FAAO,FBCLAandLorettaSzczotka-Flynn,OD,PhD

2:30pm HaveSiHyLensesEliminatedHypoxia?•DeborahSweeney,BOptom,PhD 2:50pm MicrobialAdhesiontoSiHyLenses•MarkWillcox,PhD 3:10pm Break 3:40pm EffectofSiHyLensesonEpithelialHomeostasis•DanielleRobertson,OD,PhD 4:00pm PathogenesisofMK:DoesLensMaterialMakeaDifference?•DavidEvans,PhD 4:20pm EpidemiologyofMKwithSiHyLenses•FionaStapleton,PhD,McOptom,DCLP,FAAO,FBCLA 4:40pm Discussion

5:10 pm Close

7:00 pm Dinner Champ Carr Room

Saturday, May 5, 2012 New River Ballroom

8:00 am Breakfast West Balcony

Session IV: Impact of Lens Wear Moderator: Michael H. Goldstein, MD, MM

8:40am AreSiHyLensesMoreComfortableThanHydrogels?•MichelGuillon,PhD,FCOptom,FAAO,FBCLA,CCTI 9:00am HaveSiHyLensesDecreasedDropouts?•KathyDumbleton,MSc,McOptom,FAAO(DipCL),FBCLA 9:20am WettabilityofSiHyLenses•NancyKeir,OD,PhD,FBCLA,FAAO 9:40am Break 10:10am NorthAmericanPostMarketSurveillanceofSiHyLenses•RobinChalmers,OD,FAAO 10:20am EWandDWInducedMechanicalComplicationsofSiHyLenses•MengLin,OD,PhD,FAAO 10:40am SiHyLenses:WhatisNeededintheNextDecade•PadmajaSankaridurg,BOptom,PhD,BrienHolden,PhD 11:00am Discussion

11:30 am Closing Remarks

Silicone Hydrogel Lenses – Ten Years Later Agenda

CLAO·2025WoodlaneDrive,St.Paul,MN55125-2998,USA·877.501.3937·www.clao.org2

CLAO·2025WoodlaneDrive,St.Paul,MN55125-2998,USA·877.501.3937·www.clao.org

SiHy Solution Interaction and Inflammation Nicole Carnt, PhD

Dailywearofsiliconehydrogellensesusingmarketedlenscaresolutionsresultsinvariedlevelsofanterioreyeinflammation.Thereareseveralpathways that may lead to corneal and conjunctival inflammationthat include mechanical, allergic and pathogen driven stimuli. Thehypotheses and evidence for these various models of inflammationwillbediscussedinthecontextofsiliconehydrogellensdesignsandmaterialsandlenscaresolutioncomponents.

North American Contact Lens Post-Market Surveillance Robin L. Chalmers, OD, FAAO, FBCLA

As30-nightcontinuouswearsiliconehydrogelandrigidgas-permeablelenseswereapproved into theUnitedStates in 2001, theFoodandDrugAdministrationmandatedlargepost-marketsurveillancestudiesin order to assess the risk of microbial keratitis under that wearingschedule. Since that time, the majority of these lenses are beingprescribed for daily or flexible wear and not for 30 night wear. Withdaily use, silicone hydrogel lenses have been exposed frequently tolenscareproducts,lenscasesandhandlingthatmayintroducesourcesofmicrobialcontamination thatcould influence theirsafetyprofile.Asummaryofpost-marketsurveillancemethodsandcurrentresultswillbereviewed.

Epidemiology of Corneal Infiltrates with Silicone Hydrogel Lenses with Current Use Patterns Robin L. Chalmers, OD, FAAO, FBCLA and Loretta Szczotka-Flynn, OD, PhD

Assessmentoftherelativeriskandriskfactorsassociatedwithcornealinfiltrates has been a focus of contact lens research for decades.Prescribedandactualwearingschedulesforsiliconehydrogellenseshaveevolvedfromprimarily30-nightcontinuouswearlenseswhentheywerefirstapprovedtomostlydailywearoroccasionalovernightusenow.Lenseswornonadailybasisareexposedtolenshandling,lenscareproductsandthelenscaseenvironment,andallofthesefactorsmay influence the amount of microbial contamination that will drivecornealinfiltrates.Thistalkwillsummarizerecentepidemiologystudiesofcornealinfiltrateswithsiliconehydrogellensesandposepreventivestepsthatcouldbetakentoamelioratetheriskofinfiltrates.

Have Silicone Hydrogel Lenses Decreased Drop-outs? Kathy Dumbleton, MSc, MCOptom, FAAO, FBCLA

Discontinuationor“drop-out”fromcontactlens(CL)wearcontinuesto afflict the contact lens industry. Several studies have reportedthemostcommonreasonsfordiscontinuingweartobediscomfort,dryness,andtheonsetofvisualproblemsassociatedwithpresbyopia.However, since these studies were conducted, lens materials,modalitiesforlenswearandlensdesignshavechangedconsiderably.Specifically, it isnotknownwhethertheadventofsiliconehydrogel(SiHy) CLs has impacted the drop-out rate and the reasons fordiscontinuation. This presentation will review the literature relatingto CL drop-outs and compare these findings with the results froman internetbasedstudyevaluatingCLdrop-outwhichwasrecentlyconductedattheCentreforContactLensResearch.

Co-authorsofthepublication:CraigA.WoodsPhDMCOptomFAAOFACO,LyndonW.JonesPhDFCOptomDipCLPDipOrthFAAO(DipCL)FIACLEandDesmondFonnDipOptom,MOptom,FAAO

Pathogenesis of MK: Does Lens Material Make a Difference? David Evans, PhD

Microbial keratitis (MK) is a vision-threatening complication ofcontactlenswear.Theintroductionofsiliconehydrogellensmaterialswith increased oxygen transmission to the ocular surface has notsignificantly altered the incidence of MK. These data suggest thatalternate,oradditional,predisposingfactorsinvolvinglenswearmustbeaddressedtoreduceoreliminatetheseinfections.Thecontactlenscanprovideasurfaceformicrobialgrowthinsitu,andcanalsoinfluenceocularsurfacehomeostasisthrougheffectsonthetearfluidandcornealepithelium.Thus,itisintuitivethatfuturecontactlensmaterialscouldmakeasignificantcontributiontopreventingMK.Designofthe“right”material topreventMK requiresunderstanding theeffectsofcurrentmaterialsonbacterialvirulence in thecornea,andonocularsurfaceinnate defense. Current knowledge on each of these areas will bepresented,withdiscussionoffuturedirectionsneededtounderstandtheinfluenceoflensmaterialonMKpathogenesis.

Impact of SiHy Solution Combinations on Corneal Epithelial Cells Maud Gorbet, PhD

Multipurposesolutions(MPS)areuseddailytocleananddisinfectsiliconehydrogel(SiHy)contactlenses.InvitrostudiestypicallyinvestigateMPStoxicitybyincubatingdilutedMPSwithcells.However,interactionswithcontactlensmaterialsleadtopreferentialuptakeandreleaseofagentscontainedwithinMPS.OurinvitrostudieshavecomparedhowcornealepithelialcellsreacttodilutedMPSsolutionsandtoMPS-soakedlenses.InvitroresultsdemonstratethattheresponseofcornealepithelialcellstoMPSisaffectedbythetypeoflensestheMPSisreleasedfromandmaypotentiallybeinfluencedbythesurfacetreatment(orlackofit)ofSiHymaterials.Monolayerandstratified invitromodelsarecurrentlybeingusedtobetterunderstandthemechanismsofMPS-inducedcelltoxicity.HowtheseinvitromodelsmayfurtherassistinthedevelopmentofmorecompatibleMPSandintheassessmentoflens-MPSbio-incompatibilitywillbediscussed.

Are SiHy Lenses More Comfortable Than Hydrogels? Michel Guillon, PhD, FCOptom, FAAO, FBCLA, CCTI

Siliconehydrogelcontact lensesweredeveloped to fulfil theoxygenrequirements not met by conventional hydrogel contact lenses forovernightwear.However,theuseofsuchcontactlensesforextendedwearrepresentsaminorityuseestimatedatmostat15%ofallfittings.Further,contactdiscomfort,particularlyendofdaydiscomfort,atthistenyear reviewof theprogressmadewithsiliconehydrogelcontactlenses remain the major complaint. The key question to answer is,therefore, how much improvement in comfort has been achievedcomparedwithconventionalhydrogelcontactlenses.Thepresentationwillreviewthepublishedliteraturetoaddressthismultifactorialquestionin the context of the material properties, lens design, replacementfrequencyandinteractionwithlenscareproducts.

Riverside Hotel, Fort Lauderdale, FL • May 4-5, 2012 Abstracts

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Silicone Hydrogel Lenses – Ten Years Later


Biocompatibility in the Development of SiHy Lenses Jean Jacob, PhD

In response to patient demands for extended contact lens wearingtimes,thecontactlensindustryhasdevelopednovelsilicone-hydrogellens materials which combine the enhanced oxygen permeabilityof silicone polymers with the water-based comfort of conventionalhydrogels. In thepast10yearssince thesuccessful launchof theseSiHy lenses, much has been learned about their ability to providethe biocompatibility necessary to sustain ocular health and comfort.A review of the unique physiological requirements for a successfulextendedwearlensandhowthefirstandcurrentSiHylensesaddressthemwillbeprovided.

Uptake & Release of Contact Lens Care Components into Silicone Hydrogel Lenses Lyndon Jones, PhD, FCOptom, FAAO

Contact lens solutions are highly complex mixtures of biocides(preservatives), surfactants and other agents designed to disinfect,clean and wet contact lenses. The commercialization of siliconehydrogel(SiHy)lenseshasresultedinuniquechallengestothecontactlenssolutionmanufacturers,asthepropertiesofthesematerialsdiffermarkedlyfromthoseseenpreviouslywithpolyHEMA-basedhydrogels.Historically, uptake and release of preservatives with low molecularweights into hydrogels, such as chlorhexidine and thimerosal, wasknowntoresultinallergicreactions,resultingincornealirritation,stinging,conjunctivalhyperaemia,developmentofcorneal infiltrates,palpebrallid changes and corneal staining. However, little is known about theinteraction of modern care systems with modern soft lens materials.Factorstobeconsideredwhenevaluatinguptakeandreleaseofcarecomponentsincludethewatercontent,charge,relativehydrophobicity,surfacetreatmentandporosityofthelensmaterial,inconjunctionwiththecharge/molecule, ionicity,molecularweightandhydrophobicityofthecarecomponentinquestion.Thesefactorscontroltheadsorptionand absorption of the solution components, resulting in a variety ofdifferences in the amount of the component being taken up into thelensmaterialandsubsequentlyreleasedontotheocularsurface.Thispresentationwillreviewcurrentknowledgeconcerningtheseinteractionsandinvestigatewhatclinicallyobservablecomplicationsmayarisefromtheseinteractions.Italsoreviewswhethercurrentmethodstodeterminetheseinteractionscouldbeimprovedupon.

Wettability of Silicone Hydrogel Contact Lenses Nancy Keir, OD, PhD, FBCLA, FAAO

Oneofthemajorbreakthroughsinthedevelopmentofsiliconehydrogelcontactlenseshasrelatedtotheabilityofmanufacturerstoovercomethe surface hydrophobicity that occurred with silicone elastomerlenses.However,thewettabilityofsiliconehydrogellensescontinuestobeof interestasapotential linkbetweeninvivolensperformanceandcontactlens-relatedcomfort.Thispresentationwillreviewsomeoftheknowledgewehavegainedintheareaofcontactlenswettabilityoverthepastdecadeandwilldiscussfutureresearchareasthatmaybepromising.

EW and DW Induced Mechanical Complications of SiHy Lenses Meng Lin, OD, PhD, FAAO

This talk will provide an overview of mechanical complicationsinducedbysiliconehydrogelcontact lenses—mucinballs, lidwiperepitheliopathy,meibomianglanddropouts,cornealerosions,superiorepithelial arcuate lesions, palpillary conjunctivitis, and conjunctivalepithelialflap.Effectsoflensmaterials,lens-wearingmodalities,ethnicand racial factors on these mechanical complications will also bediscussed.

Deposits on SiHy Lenses Jason Nichols, OD, MPH, PhD, FAAO

Theinteractionbetweenacontactlens,theocularsurface,andthetearfilm isvital forsuccessfulcontact lenswear. Ithas longbeenknownthat both organic and inorganic tear film and ocular surface-relatedcomponents deposit on contact lenses. Over the years, significantemphasishasbeenplacedonunderstandingtheinteractionbetweenprotein and lipid deposits on contact lenses. It has become well-recognizedthatthepolymercompositionofthecontactlensmaterialhas a significant impact on the trends associated with depositionpatterns. Likewise, other factors such as lens care, compliance andtheenvironmentallmayplaya role inobserved trends indepositionpatterns.Finally, it is important tonote themethodologyusedwhenstudying contact lens deposition, as the methodological approachused may lead to variability in findings compared to other studiesusingdifferingmethodologies.Goingforward,itisimportanttodevelopbothstandardizedanduniquemethodologiesthatleadtonewinsightsintocontactlensdepositionpatternsthatultimatelyareabletodetectassociationswithin-vivoperformanceandadverseevents.

Effect of SiHy Wear on the Corneal Epithelium and Risk for Microbial Keratitis Danielle M. Robertson, OD, PhD

Previousstudiesusinganimalmodelsandhumanclinical trialshavedemonstrated that theuseof lowoxygen transmissiblecontact lensmaterials induced corneal epithelial surface damage resulting inincreasedPseudomonasaeruginosa(PA)adhesionandinternalizationintosurfacecornealepithelialcells,leadingtothetestablepredictionsthat(1)MKriskisgreatestduringthefirst6monthsofwear;(2)thereisnodifferencebetween6and30nightextendedwear;and(3)thatincreasedlens oxygen transmissibility would reduce the reported incidenceof infection. Subsequent epidemiological studies have confirmedthe first two predictions; however, increased oxygen transmissibilitywithsiliconehydrogel lenswearhasnotalteredtheoverall incidenceof MK. In this review, clinical and basic studies that investigateepithelialalterationsandbacterialadhesion tocornealepithelialcellsfollowingwearofSiHy lensesandexposure tochemicallypreservedmultipurposesolutions(MPS)willbeexamined.Thecollectivefindingssuggestthatevenintheabsenceoflens-relatedhypoxia,someMPSinduceocularsurfacechangeswhichareassociatedwithanincreaseinPAadherence in thecornealepithelium. Inagreementwith thesefindings,newepidemiologicaldatahavedemonstratedthattheuseofMPSisassociatedwithanincreasedriskforcontactlens-relatedMK.

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Silicone Hydrogels: What is next? Sankaridurg P, Lazon de la Jara P and Holden BA

Significantadvancesofthepastdecadewithsiliconehydrogellenseshavemade themtheprimarymode fornewcontact lenswear.Theirdominanceinthemarketplaceisdrivenlargelybytheeliminationofthestructuralandphysiologicalchangesinducedbycontactlensinducedhypoxia,asexemplifiedbythereductioninespeciallylimbalredness.On the other hand, end of day dryness and discomfort still drivesmanytodiscontinuefromlenswear.Evidencealsoshowsthattherateof serious adverse events such as microbial keratitis have not beenimpactedwithsiliconehydrogellenses.Moreoverthereareadditionalchallengesrelatingto‘staining’andinfiltratesassociatedwithsolutionincompatibilitywithlensmaterials.Ontheotherhand,thetechnologicaladvancesenabledbythehighoxygenplatformpresentopportunitiesforexpandingtheuseofcontactlensesinareasthathadlimiteduptakeinthepastsuchasastigmatism,presbyopiaandimportantly,myopiacontrol.Thechallengesandopportunitiesfacingthefieldandhowweneedtoaddressthesechallengeswillbediscussed.

The Epidemiology of Microbial Keratitis with Silicone Hydrogel Contact Lenses Fiona Stapleton, BSc, MSc, PhD

IIt was widely anticipated that following the introduction of siliconehydrogelcontactlenses,theriskofmicrobialkeratitiswouldbelowerthanwithhydrogelcontactlenses.Largescaleepidemiologicalstudieshaveconfirmedhoweverthattheabsoluteandrelativeriskofmicrobialkeratitis is unchanged with silicone hydrogel materials. Key findingsinclude:1)Theriskofinfectionwith30nightscontinuoususeofsiliconehydrogel contact lenses is equivalent to 6 nights of hydrogel lensextendedwear;2)Occasionalovernightlensuseisassociatedwithagreaterriskthandailylensuseindependentofmaterialtype;3)Whiletherateofvision lossduetocorneal infection issimilar to thatseenwithhydrogelcontact lenses, there issomeevidencefor lessseverediseasewithextendedwearsiliconehydrogellensuse;4)Thespectrumofcausativeorganismsissimilarforbothlenstypes;and,5)Modifiableindependent risk factors for infection includeovernight lensuse, thedegreeofexposure,failingtowashhandspriortolenshandling,storagecasehygienepracticeandInternetpurchase.

The unchanged absolute risk of disease therefore suggests factorsother than hypoxia are relevant in the pathogenesis of contact lensrelatedmicrobialkeratitis.Epidemiologicalstudiesremainimportantintheassessmentofrisksassociatedwithnewmodalitiesandmaterials.Indesigningfuturestudies,specificconsiderationofanearlyadoptereffect and further investigation of the impact of second generationsiliconehydrogelmaterialsiswarranted.

Have Silicone Hydrogels Eliminated Hypoxia? Deborah Sweeney, BOptom, PhD

Goodlawwasoneof thefirst individuals tohypothesize thatcontactlenses act as a barrier to the eyes’ anterior oxygen supply. We arenowwellawarethatinadequateoxygen,orhypoxia,canresultinthedevelopmentofanumberofcontact lens-relatedcomplications.Thedevelopment of silicone hydrogels focused on meeting the oxygentransmissibilityrequirementsforovernightwear.Thebenefitsofthesematerials for continuous wear have been demonstrated and studieshave also confirmed similar advantages with daily wear of siliconehydrogels.Thispaperwillreviewcornealoxygenrequirementsandtheresearchthathasindicatedthatmostcontactlenswearerswhowearsiliconehydrogelsexperiencefewercornealhypoxiarelatedproblems.

Surface Properties and Ocular Compatibility of Silicone Hydrogels Brian Tighe, PhD, DSc

The last decade has been very significant for the development ofcontact lensmaterials.Themost importantfeatureofthisperiodhasbeentheappearance,increasingdiversityandmarketgrowthoftheso-calledsiliconehydrogels.Bothnameandoxygentransportpropertiesareadirect consequenceof the inclusionof a significantproportionof siloxygroups,whichcontain theelement silicon linkeddirectly toboth oxygen and carbon atoms. Because of their enhanced oxygenpermeability,theinitialfocusofsiliconehydrogelswasextendedwear.Developmentsinbothmaterialsscienceandproductiontechnologyinthelastdecadehaveenabledtheiruseinbothscheduledreplacementdailywearanddailydisposablemodalities.

Inconsequence,sincetheinitiallaunchofsiliconehydrogel(SiHy)lensestherehasbeenaconsiderablebroadeningintherangeofcommercialSiHy properties, with some fifteen SiHy materials variants currentlyavailable.EWCisinfluentialandthedecadehasseenaprogressiverise,encompassing materials from 24% to 74%. Moduli have decreasedover thesameperiod from1.4MPa to0.3MPa,butnotsolelyasaresultofEWCchanges.SurfacepropertiesdonotcorrelatedirectlywithEWC,andingeniousapproacheshavebeenusedtoachievedesirableimprovements (e.g. greater lubricity, lower contact angle hysteresis).Thisisdemonstratedbycomparingthehysteresisvaluesoftheearliest(>40o)andthemostrecent(<10o)coatedSiHys.Arguably,thechangesthat have taken place have been strongly influenced by practitionerfeedbackbasedonclinicalexperience.

Although there have been undeniable property developments,conventionalandsilicone-basedmaterialsstillshowmarkeddifferences,particularlyinsurfaceproperties.Thedifferenceischaracterizedinsuchareasasproteindeposition,lipiddepositionandcoefficientoffriction.An underlying contributory factor is the difference in surface energyof the constituent polymers. Surface energies are made up of bothpolarandnon-polarcomponents,whichcanbereadilyquantifiedandexpressedintermsofthefractionalpolarityofthesurface.Whereastheaveragepolarfractionofconventionalhydrogelsis0.54,witharangeof±0.09,theaveragepolarfractionofSiHysis0.22,witharangeof±0.17.

Thesearchforimprovedcomforthasbeenanongoingquest,butithasbecomeapparentthatsimpleimprovementsinwettabilityandreductioninlensmodulushaveonlybroughtlimitedsuccessinthisrespect.Oncethephysicalcausesofdiscomfortassociatedwiththelens(forexampleedge-related factors, defects and physical imperfections) have beenminimised, we are faced with the problem of making the indwellinglens resemble, as closely as possible, the surface and lubricationcharacteristicsofthenonlens-wearingeye.Itisclear,however,thatwecannevermatchthebehaviourofthenaturalsystem,simplybecausethelensitselfisseveraltimesthickerthanthetearfilm.

Itisusefultoidentifytwodistinctinfluencesoncontactlenscomfort.Thefirstisthemismatchofindividualpatienttearchemistryandcontactlensmaterial,whichislargelyavoidable.Thesecond-theinterferenceofthelenswithoculardynamics-ismorecomplexandisanimportantcurrentareaofcontactlensresearch.Consequenteffectsarenotlinkedtoanysingleuniversallyapplicablediscomfortmarker,butappeartobebestcharacterisedasacumulativeburdenwhichincreaseswithweartime. There isgrowingevidence that links thedynamicsof lens-eyeinteractionwithbiochemicalconsequencesthatareknownto inducediscomfortinotherbodysites.Theserelatetositesoftissue-materialinteractions involving anterior and posterior lens surfaces separatelyandmayholdthekeytoimprovementsinendofdaycomfort.

Riverside Hotel, Fort Lauderdale, FL • May 4-5, 2012 Abstracts

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Silicone Hydrogel Lenses – Ten Years Later


Solutions for Care of Silicone Hydrogel Lenses Mark Willcox, PhD

Siliconehydrogel(SiHy)lensesaremostcommonlyprescribedforuseasdailywear lenses.However,as lensesof this typewereoriginallydevelopedforuseasextendedwearlenses,thedevelopmentofcaresolutionsforthemlaggedbehind.Inrecentyearsseveralmanufacturershave released new versions of multipurpose disinfecting solutions(MPDS)designedtobeusedwithsiliconehydrogelandotherlenstypes.The new solutions contain alternative combinations of agents (e.g.PHMBandpolyquad;Alexidineandpolyquad),alternativesurfactants(e.g.polyoxyethylene-polyoxybutylenecopolymer;sulfobetaine;tetronic904), or conditioningagents (e.g. hyaluronan), aswell asa return totheinclusionofEDTAintheirformulations.Thesechangesarelikelytohaveimpactsonthemicrobiologyoflensesandlenscases,theabilitytokillpotentialpathogens,aswellas theclinicalperformanceof theSiHy/MPDScombinations. Forexample, theexchangeofnonanoyl-ethylenediaminetriaceticacidforethylenediaminetriaceticacid(EDTA)intheformulationsofEXPRESS®RepleniSH®vs.EXPRESS®EverMoist/PureMoist®appearstohaveincreasedthestandaloneactivityagainstyeasts and Acanthamoeba trophozoites. Exchanging disinfectants,surfactants and buffers in COMPLETE® Easy Rub® vs. RevitaLensOcuTec™ has increased the stand alone activity against Fusariumsolanii.TheseandotherdataonthemicrobicidalactivitiesofMPDSincombinationwithSiHylenseswillbepresentedanddiscussed.

Microbial Adhesion to Silicone Hydrogel Lenses Mark Willcox, PhD

Therelativelackofsuccessofsiliconehydrogellensesinreducingtheincidenceofadverseevents,includingeventssuchasmicrobialkeratitis,contactlens-inducedacuteredeye,andotherinfiltrativeeventsislikelyduetotheadhesionofmicrobestothese lenses.BacteriaappeartoadhereinhighernumbertosiliconehydrogellensesthanconventionalHEMA-basedhydrogelcontactlenses,atleastinvitro.Similarly,siliconehydrogel lenses appear to promote the penetration of certain fungalhyphae (Fusarium sp.) into their surfaces compared to conventionalHEMA-based lenses. Furthermore, first generation silicone hydrogellenses adhere more, 13-18 times more, Acanthamoeba trophozoitescompared to HEMA-based lenses. Acanthamoeba adhere in highernumberstosiliconehydrogellensesevenafterwearorafteradhesionof bacteria to the lenses. Adhesion of Acanthamoeba to secondgenerationsiliconehydrogellensesisgenerallyequivalenttoadhesiontoHEMA-basedlenses.RecentdatafromexperimentsconductedattheBrienHoldenVisionInstitutehaveevaluatedtheadhesionofstrainsof P. aeruginosa and S. aureus to various silicone hydrogel lenses.The adhesion of strains of P. aeruginosa was always greater (9x105to3x106CFU/lens)comparedtostrainsofS.aureus(3x104to4x105CFU/lens).TheadhesionofP.aeruginosastains tosiliconehydrogellensessplitthelensesinto2distinctgroups,butthiswasnotrelatedtotheclassificationoflensesas1st,2ndor3rdgeneration.Rather,thesplitappearedtoberelatedtothehydrophobicityofthelenssurface,withbacteriaadhering less to themorehydrophobicsurface lenses.Theaffectoflenswearwasalsoexamined.Whilstdifferentstrainsofbacteriacanbehavedifferently,overall,dailydisposablecontact lenswearresultedinincreasednumbersoftotalcellsofS.aureusbuthadless overall effect on total numbers of P. aeruginosa. Lens wear didnotaffecttheviablenumbersofS.aureusadheredtolenses,butdidaffectviablenumbersofP.aeruginosa,andthiswascontactlenstypedependent.Thislatterfindingmaybeassociatedwiththeadsorptionoftheantimicrobialproteinlactoferrintolenssurfaces.

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Nicole Carnt, PhD, graduated from UNSW in Optometry in1989 and worked in private practice in Australia and the UKbeforetakingapositionwiththeCCLRUin1999,whereshehasheldavarietyof roles. In recentyears,shehasbeenPrincipalInvestigator on BHVI Matrix studies, an ongoing evaluation ofsilicone hydrogel and solution combinations. She is currentlyundertaking a PhD on Epidemiology of Contact Lens RelatedInfection and Inflammation, with particular interest in patientfactors,suchasrisktakingbehaviour,complianceandgenetics.

Robin L. Chalmers, OD, FAAO, FBCLA, is a graduate of UCBerkeleySchoolofOptometry,Dr.Chalmersisanindependentclinical trial consultant. She is Vice-Chair of the AmericanAcademyofOptometryResearchCommitteeandco-chairoftheContactLensAssessmentinYouthStudy(CLAY)groupstudyingthesafetyofcontactlenswearinteensandyoungadults.SheservesasfacultyfortheAOA/AAOSummerResearchInstituteandon theEditorialBoardofContactLensandAnteriorEye.Hercontactlensareasofresearchinterestareepidemiologyofcomplicationswithcontactlenses,andpost-marketsurveillanceofcontactlensoutcomes.

Kathy Dumbleton, MSc, McOptom, FAAO (Dip CL), FBCLA, graduated in Optometry from the University of Wales. Shecompleted a pre-registration year at Moorfields Eye Hospitaland receivedanMSc inVisionScience from theUniversityofWaterloo, Canada. Kathy is Head of Clinical Logistics at theCentreforContactLensResearch,UniversityofWaterloo.SheisafellowoftheBritishContactLensAssociation,adiplomatoftheCorneaandContactLensSectionoftheAmericanAcademyofOptometry,acouncilmemberoftheInternationalSocietyforContact Lens Research and president-elect of the AmericanOptometricFoundation.Herresearchinterestsincludetheocularresponsetocontactlenses,complianceandthemeasurementofoculardiscomfort.

David J. Evans, PhD, obtained his PhD in PharmaceuticalMicrobiology from the School of Pharmacy, University ofManchester. After a post-doctoral fellowship at HarvardMedicalSchool,he joined theclinical facultyat theSchoolofOptometry, University of California, Berkeley. Currently, heis a Professor of Biological and Pharmaceutical Sciences atthe College of Pharmacy, Touro University California, and anAssociate Research Scientist at the University of California,Berkeley.Dr.Evans’researchinterestsincludethepathogenesisofPseudomonasaeruginosainfections,mucosalsurfaceinnateimmunity,andantimicrobialtherapy.

Desmond Fonn, Dip. Optom, M. Optom.,isProfessorEmeritusand the founding Director of the Centre for Contact LensResearch at the School of Optometry, University of Waterloo,Waterloo,Ontario,Canada.He isagraduateof theSchoolofOptometryinJohannesburg,SouthAfricaandtheUniversityofNewSouthWalesinSydney,AustraliawherehealsoservedasaconsultantfortheCorneaandContactLensResearchUnit.HecurrentlyservesasEditor-In-ChiefofEye&ContactLens.

Michael H. Goldstein, MD, MBA,isCo-DirectoroftheCorneaServiceat theNewEnglandEyeCenter/TuftsMedicalCenterinBostonwhereheisanAssistantProfessorofOphthalmologyatTuftsUniversitySchoolofMedicine.Dr.GoldsteincurrentlyservesasPresidentasCLAO.He isalsothePresident for theMassachusettsMedicalSocietyandtheVicePresidentfortheTuftsMedicalCenterMedicalStaff.Inaddition,heistheChairoftheAAO’sCorneaPOCPanelandteachesthecorneasectionfortheAAO’sboardreviewcourse.He,also,currentlyservesasteamophthalmologistfortheBostonCeltics.

Maud Gorbet, PhD, isanassistantprofessor in the facultyofengineeringattheUniversityofWaterlooandiscross-appointedwiththeSchoolofOptometry.Shealsoworksincollaborationwith theCentre forContactLensResearch.Abio-engineer intraining, sheobtainedherPhD inchemical engineeringat theUniversity of Toronto (Canada) and working in industry until2007.Herresearchfocusesonunderstandingcellinteractionsand inflammatory response with ophthalmic materials usingbothinvitroandexvivomodels.Partofherresearchprograminvolvesthedevelopmentofbetterinvitromodelsandtoolstoassessbiocompatibility.

Michel Guillon, PhD, FCOptom, FAAO, FBCLA, CCTI, is Clinical DirectorofOTGResearch&ConsultancyandofMichelGuillonSportsVision.HeispastPresidentoftheInternationalSocietyforContactLensResearchandcurrentexecutivemember,pastEuropeanPresidentoftheInternationalAssociationofContactLensEducators.HeisamemberoftheMedicalandScientificBoardof theTearFilmandOcularSurfaceSocietyandof theEditorial Boards of Eye & Contact Lens and Contact Lens &Anterior Eye Journals. Dr Guillon has published numerousscientificpapers,co-editedamajortextbookoncontactlensesandisaco-inventoronseveralEU,USandworldpatents.

Jean T. Jacob, PhD, is Director of Research Development fortheLouisianaStateUniversitySchoolofMedicine,ProfessorofOphthalmologyandNeuroscience,andDirectorofResearchattheLSUEyeCenterofExcellence.SheisalsoAdjunctProfessorof Biomedical Engineering at Tulane University. She receivedher undergraduate degree in biochemistry at the Universityof California, Riverside and her doctoral degree in biomedicalpolymer science from Tulane University. Dr. Jacob is currentlya Vice-President of the International Society of Contact LensResearch and chairs the biannual Symposium on the MaterialScienceandChemistryofContactLenses.

Lyndon Jones, PhD, FCOptom, FAAO, is a Professor at theSchool of Optometry and Director of the Centre for ContactLensResearchat theUniversityofWaterloo.Hegraduated inOptometryfromtheUniversityofWalesin1985andgainedhisPhD from the Biomaterials Research Unit at Aston University,Birmingham,UKin1998.HeisaFellowandDiplomateoftheAmericanAcademyofOptometry (AAO)andthecurrentChairoftheResearchCommitteeoftheAAO.Hehasauthoredover250refereedandprofessionalpapers,onetext-bookandgivenover600invitedlecturesatconferencesworldwide, inover30countries.

Nancy Keir, OD, PhD, FBCLA, FAAO, is Head of Clinical Operations at the Centre for Contact Lens Research at theSchoolofOptometry,UniversityofWaterlooinOntario,CanadawheresheoverseestheclinicaltrialsconductedattheCentre.She graduated with an OD degree from Waterloo in 2000and subsequently undertook a part-time PhD on the impactof customised LASIK on higher order aberrations and visualperformance,whichwasgainedin2008.NancyisalsoaSeniorClinicalScientistandhasbeen theLead Investigator for trialsinvestigatingSCLdesign,lenscare,anteriorsegmentphysiologyandcomfortandhasparticular interests in theassessmentofopticalqualityandinvivowettabilityofSCLs.

Meng C. Lin, OD, PhD, isanAssociateProfessoratUniversityofCalifornia,Berkeley.SheisalsothefoundingDirectoroftheClinical Research Center and Co-Chief of the Ocular SurfaceClinic.Herresearchfocusisondryeyes,rheologypropertiesoftearandmeibumlipids,andeffectsofcontactlensontheocularsurfaceintegrity.Shealsoinvestigatesfundamentaldifferencesin racialandethnicocularanatomyandphysiologyaswellastheirresponsestoophthalmicdevices.

Riverside Hotel, Fort Lauderdale, FL • May 4-5, 2012 Faculty Biographies

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Riverside Hotel, Fort Lauderdale, FL • May 4-5, 2012 Faculty Biographies


Jason J. Nichols, OD, MPH, PhD, FAAO, was appointedthe Kevin McDaid Vision Source Professor at the Universityof Houston, College of Optometry in 2011. He received hisundergraduatedegreeinBiologyfromHopeCollege(1995),andDoctor of Optometry (1999), Master’s in Public Health (2003,epidemiology)andPhD(2004)allfromtheOhioStateUniversity.HewasonthefacultyatOhioStateUniversityfrom2004-11asatenuredassociateprofessor.HeiscurrentlyEditorofContactLensSpectrumandContactLensesToday®,whosepublicationsreachover50,000eye-carepractitionersworldwide.

Danielle M. Robertson, OD, PhD, isanAssistantProfessorofOphthalmologyattheUniversityofTexasSouthwesternMedicalCenter.Dr.RobertsonisaDiplomateintheAmericanAcademyofOptometry,aFellowintheBritishContactLensAssociationandservesontheeditorialboardforEye&ContactLens.Dr.Robertson was a two-time Ezell Fellow and a recipient of aScientificCareerDevelopmentAwardfromResearchtoPreventBlindness.Dr.Robertsonhasreceivedscientificresearchawardsfromnumerous foundationsand iscurrentlysupportedby theNIH/NEI tostudymolecularmechanisms that regulatecornealepithelialrenewal.

Padmaja Sankaridurg, PhD, BOptomisProgramLeader,MyopiaProgramattheBrienHoldenVisionInstituteandtheVisionCo-operativeResearchCentre,Sydney,Australia.ShewasawardedherBOptdegreefromtheEliteSchoolofOptometry,Chennai,India in 1989 and PhD. in 1999 from the University of NewSouth Wales, Australia. After working for a number of yearsat theL.V.PrasadEye Institute, Indiaas theChiefofContactLensServices,shetookupapositionattheBrienHoldenVisionInstitute(formerlytheInstituteforEyeResearch)andtheVisionCooperative Research Centre. She is also a Senior VisitingFellowattheUniversityofNewSouthWales,Australia.

Oliver D. Schein, MD, MPH, MBA, istheBurtonE.GrossmanProfessor of Ophthalmology and Vice Chair for Quality andSafety at the Wilmer Eye Institute at the Johns HopkinsUniversity School of Medicine with a joint appointment in theDepartmentofEpidemiologyattheBloombergSchoolofPublicHealthatJohnsHopkinsUniversity.Dr.ScheinreceivedhisMDfromJohnsHopkinsUniversity in1981,hisMPHin1984,andhisMBAin2005.Hecompletedaresidencyininternalmedicineand a fellowship in preventive ophthalmology at Hopkinsfollowed by a residency in ophthalmology and a fellowship incorneaandexternaldiseaseattheMassachusettsEyeandEarInfirmarywherehejoinedthefacultyatHarvardMedicalSchoolbeforereturningtoHopkins.HejoinedWilmer’sDanaCenterforPreventiveOphthalmologyanditsCorneaandAnteriorSegmentServicein1990.

Fiona Stapleton, BSc, MSc, PhD, McOptom, DCLP, FAAO, FBCLA, GradCertOcTher,graduated inOptometry from theUniversityofCardiff,Walesin1985andhassinceworkedinacademic,hospitaland private optometric practice. She was awarded her PhD in1991fromCityUniversityandMoorfieldsEyeHospitalinLondonforherresearchonthepathogenesisandepidemiologyofcontactlens-relateddiseaseandcompletedapost-doctoralfellowshipatUniversityCollegeLondon.SheisProfessorandHeadofSchoolofOptometryandVisionScience,UniversityofNewSouthWales,Sydney,NSW,Australia,andaSeniorResearchAssociate,BrienHoldenVision Institute,UniversityofNewSouthWales,Sydney,NSW,Australia.

Deborah Sweeney, BOptom, PhD, is the Associate Pro-ViceChancellor, Research at the University of Western Sydney withresponsibilityfortheHealthandScienceCluster.DeborahreceivedherBachelorofOptometryfromUNSWin1980,andcompletedherPhDin1992.ShehasheldvariousexecutiveroleswithintheCornea&ContactLensResearchUnit,SchoolofOptometryandVisionScience,UNSWand the CRC for Eye Research & Technology and the Vision CRCandwasDirectorofResearchfortheCollegeofHealthandScienceatUWS.Sheisactiveinnationalandinternationalorganizations,andholdsexecutivepositions in the InternationalAssociationofContactLensEducators;theKeratoprosthesisStudyGroup;VisionCareNSW,theCRCAssociationand the InternationalSocietyofContact LensResearch,andisaDirectorontheBoardforVision2020Australia.

Brian Tighe, PhD, DSc, is Professor of Polymer Science at AstonUniversity,UK.HeisaMemberofseveralEditorialBoardsincludingContactlens&AnteriorEye,theFounderandDirectorofAstonBio-MaterialsResearchUnitandhas received theUKSociety for Biomaterials Presidents Prize, BCLA Gold Medal,ISCLR Reuben Medal, the Institute of Materials ChapmanMedal, European Contact & Intraocular Lens ManufacturersTechnologyAwardandtheAstonUniversityChancellor’sMedalforbiomaterials,particularlycontactlensmaterials,research.

Mark Willcox, PhD, is a Fellow of the BCLA and AAO. He isPresidentoftheISCLR.ProfWillcoxhasspecialisedintheareasof ocular microbiology, contact lenses, tear film biochemistryand corneal immunology. His research has examined theinteractions of the normal microbiota of the eye with contactlensesand theeffectofcontact lenseson the tearfilm.He isrecipientoftheDistinguishedResearchonCorneaandContactLens,UniversityofHoustonCollegeofOptometry(2006),BCLAMedal (2011) and Max Schapero Memorial Lecture Award ofAmericanAcademyofOptometry(2011),CCLSADistinguishedServiceAward(2011).

This Symposium is supported through an unrestricted educational grant to CLAO from Vistakon, Johnson & Johnson Vision Care, Inc. (JJVCI).

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