Focus Night & Day vs Acuvue

Discussion in 'Optometry Archives' started by karl1973, Oct 9, 2003.

  1. karl1973

    karl1973 Guest

    My brother has been wearing Acuvue lenses for over a decade. He's
    going to be getting an eye exam soon and was considering switching to
    Night & Day after seeing their commercials that promise greater
    breathability. He likes the idea of wearing a lens for 30 days rather
    than a week with Acuvue.

    How do these two brands of lenses compare? What issues should he
    consider when choosing between them? Is it really healthy to wear any
    lens for a full month?

    Does Night & Day block UV light like Acuvue does? This would seem
    relevant since my brother works outdoors in the sun all day.

    Thanks in advance for any replies.
     
    karl1973, Oct 9, 2003
    #1
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  2. karl1973

    Dr. Leukoma Guest

    wrote in
    The research I have seen on ultra-high DK contact lenses like Focus N&D has
    impressed me so much that I consider them my first choice for situations
    like overnight wear. The primary issue with respect to overnight wear of
    contact lenses is something called infectious keratitis and corneal ulcers.
    The research by Cavanagh and others has demonstrated how this might occur.
    It seems that the protective layer of the cornea becomes sick and atrophied
    under conditions normally found in overnight wear of low- to mid-DK lenses,
    and that this condition is quickly reversed and prevented by lenses with
    ultra-high DK. The proposed mechanism is that when the epithelium is
    compromised and rough, the bacteria stick to it and can form colonies,
    while in the normal healthy state, the epithelium is very smooth with tight
    junctions.

    With lenses like Focus N&D, overnight hypoxia is not statistically greater
    than baseline, i.e. without lenses. On the other hand, the cornea has been
    found to swell as much as 9% with other conventional lenses.

    DrG
     
    Dr. Leukoma, Oct 9, 2003
    #2
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  3. karl1973

    drfrank21 Guest

    I agree with the above but have to add that I have some patients who are
    re-fit into these lenses from other brands (especially if they have worn
    them for many yrs or any type of extended wear usage)that will have
    an initial awareness for a couple of weeks with the night and day lenses.
    A couple of patients have even told me they were very uncomfortable and
    wanted to switch back. But usually, that initial sensation will diminish
    if they give the night and day cl's a chance. So I've learned to counsel
    those patients of what they might experience.

    I assume it's due to the hypoxic effects of their corneas with their
    current cl's and that it's similar to a degree when we re-fit the
    old pmma rigid cl's into gas perms.

    frank

    frank
     
    drfrank21, Oct 9, 2003
    #3
  4. Ciba Night and Day has no UV protection, but is safe for overnight wear.

    Acuvue is too a low DK to be worn overnight without risks IMVHO.

    2-3 nights straight with Acuvue are already dangerous imho.

    In facts I have read somewhere that there is not a significant
    difference between wearing the lenses for 2-3 nights+days continuously,
    or 1+ weeks, as far as infections are concerned. In the sense that 2-3
    days are already dangerous if the lens is not adequate.


    Acuvue probably paid lots of money to have their lenses approved for
    overnight wear :-(((


    [Not a doc]
     
    Pipino Il Breve, Oct 10, 2003
    #4
  5. karl1973

    LarryDoc Guest

    You can determine who will become lens-aware by testing cornea
    sensitivity during re-fitting. (The good 'ole Q-Tip test. Or try Golmann
    tonom without anesthetic. Really. Especially on patients who sleep in
    anything other than si-hydrogels.)

    The cornea becomes "numb" from either of or the combination of two
    causes: hypoxia from low oygen permeability lenses and desensitizing due
    to extinction of nerve signals resulting from constant stimulus (lens
    position). I'd guess that hypoxia plays the larger role in soft lenses.

    Often the Night&Days feel great for the first few days to a week, then
    awareness increases, then goes away again. Speaks to the hypoxia first,
    then de-sensitizing later theory.

    I never have anyone overnight in anything other than silicone hydrogels.
    I look forward to a few months from now when we have more companies to
    deal with than just the current monolopy (USA).

    --LB

    --
    Dr. Larry Bickford, O.D.
    Family Practice Eye Health & Vision Care

    The Eyecare Connection
    http//www.eyecarecontacts.com
    larrydoc at m a c.c o m
     
    LarryDoc, Oct 10, 2003
    #5
  6. Ah, Larry, I think you just answered a question that I posted in this
    newsgroup 3 weeks ago (in the thread "What happens as the eyes adapt
    to new RGP lenses?"), which nobody gave me an answer to. I guess that
    in the week or two that it takes to adapt to RGP lenses, this
    "extinction of nerve signals" thing must be happening, rather than the
    hypoxia explanation (since RGPs have high oxygen permeability). I've
    read that you need to wear RGP lenses consistently to maintain
    adaptation, and now I wonder if the same thing applies to silicone
    hydrogels?

    One more thing--are Focus Night and Days the only silicone hydrogel
    currently available in the U.S.?

    Lothar
     
    Lothar of the Hill People, Oct 10, 2003
    #6
  7. karl1973

    LarryDoc Guest

    To a degree, yes, and in fact any lens, rings on your finger, new
    sneakers, earings, etc.

    Actually, there is some neurological memory of these things, so,
    although consistent wearing is a good idea, most people can do no harm
    if they take a few days off. This is especially true of soft lenses, as
    they pose a lesser degree of physical pressence.
    Sadly, but temporarily, this is true. I think we can expect J&J, Cooper
    and B&L to be in the USA market by the end of the first quarter of next
    year--- with more parameters and designs from which to choose. Pretty
    exciting, eh?

    --LB

    --
    Dr. Larry Bickford, O.D.
    Family Practice Eye Health & Vision Care

    The Eyecare Connection
    http//www.eyecarecontacts.com
    larrydoc at m a c.c o m
     
    LarryDoc, Oct 10, 2003
    #7
  8. Indeed it is! More competition among the manufacturers has got to be
    a good thing too, although I expect to see plenty of patent
    infringement suits. One design that I wouldn't expect to see anytime
    soon is a daily disposable silicone hydrogel, but that's just my
    guess. I would greatly welcome a greater selection of parameters
    though.

    Lothar
     
    Lothar of the Hill People, Oct 10, 2003
    #8
  9. karl1973

    Kimi Guest

    Yes. This is exciting. I'm very interested in switching to a 30 day
    night & day lens so perhaps I'll wait until more is available.
     
    Kimi, Oct 20, 2003
    #9
  10. karl1973

    Yeechang Lee Guest

    Of course, they were saying such things a year ago, too.

    When additional choices *do* become available, I really hope a weekly
    wear version is one of them. I've had fine results with wearing
    Acuvues on a six-day in, one-day out routine for the past three years
    (Had my annual exam just yesterday!), but am always looking for
    theoretically safer alternatives. I've even tried Night & Day lenses
    before (see
    <URL:http://groups.google.com/groups?selm=>),
    and given what I keep reading here about the improved oxygen
    permeability, nerve sensitivity, and the initial adjustment period I
    may try again. That said, whatever the lens material I'd always prefer
    the opportunity to take a weekly break without the hassles of cleaning
    and storage.
     
    Yeechang Lee, Nov 16, 2003
    #10
  11. karl1973

    Dr. Leukoma Guest

    It is well-established that the incidence of bacterial keratitis is about
    1/500 per year in people who sleep in Acuvue and similar lenses. About 13%
    of those have some vision loss because of scar formation in the visual
    axis. This is a small number if you believe in continuous wear, or an
    unacceptably large number if you don't. Silicone-hydrogels are purportedly
    even safer.

    What if it was shown(and I am not saying that it has been, yet) that there
    was no difference in terms of safety between removing a particular type of
    lens weekly and removing the lens monthly, or even bimonthly? Do most
    consumers "really" want to remove their lenses weekly, or are they, like
    their doctors, conditioned to think that this is a prudent thing to do?

    IMHO, I do not think that the "holy grail" of contact lenses is either a
    daily or weekly disposable lens, but rather a true continuous wear lens
    that did not adversely impact the corneal physiology or safety when worn
    over a period of weeks or months. I don't know when the industry will get
    there, but I think that the time is fast approaching.

    DrG
     
    Dr. Leukoma, Nov 16, 2003
    #11
  12. Check out the following very interesting article on that topic:

    http://www.siliconehydrogels.com/editorials/previous_editorial_judith.asp

    Lothar
     
    Lothar of the Hill People, Nov 16, 2003
    #12
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