Contact lens may provide alternative to laser surgery

A new generation of more comfortable contact lenses that can stay in the eyes for as long as 30 days is gaining in popularity.

The lenses are so much easier to wear than their predecessors that some optometrists on the Mainland are reporting patients who had been considering laser eye surgery are choosing to use the new lenses instead.

The Food and Drug Administration approved the lenses earlier this year for round-the-clock wear for as long as a month. But the lenses are so new, not many people are aware of their benefits.

"There's less dryness, less redness, increased comfort," said optometrist Anne Matsushima, who runs a private practice in Kaimuki.

New technology is behind the two most advanced lenses on the market, made from different materials and having different qualities: CIBA Vision's Focus Night & Day soft lenses and Menicon Co.'s Menicon Z rigid gas-permeable lenses.

Contact lens wearers such as Mark Muranishi now have the option of a lens approved for continuous wear for as long as a month. Jeff Widener • The Honolulu Advertiser

"(She) wanted me to try them because she knows that I sleep with my contact lenses," said Min, who had been wearing disposable lenses designed to be worn for as long as a week. "I was trying to stretch it out as long as I could. I was just being lazy."

Min, an accountant for a hotel, said her eyes feel and look better since the switch six months ago. And Matsushima said Min's eyes had grown redder and more irritated after using the old lenses for seven or eight years.

Marvin Baum, president of the Hawaii Optometric Association, believes the new lenses are revolutionary, if not a cure-all.

"Some people will probably be able to wear this lens for 30 days and have no trouble," he said. "Some can't even sleep with them comfortably for one night."

"It's not a panacea," added Baum, who works in private practice at Fusato and Baum in Moanalua Shopping Center.

Costing $200 to $500, including fittings, they are a little pricier than many soft lenses, but still cheaper than laser eye surgery, which costs $1,000 to $2,000 per eye in Hawai'i.

Not all optometrists believe patients will choose the new contacts over laser surgery, no matter how comfortable. But the lenses do offer an option for users who tire of daily cleaning, insertion and removal, Matsushima said.

Extended-wear lenses were approved by the FDA in the 1970s, but by the 1980s some wearers were developing corneal infections and ulcers, prompting the federal government to pull back to approving wear for a maximum of seven days.

Matsushima said the new lenses are safer because they allow more oxygen to reach the eye, and less bacteria binds to the lens. Most people who are beginning to wear contacts opt for the new-generation lenses, especially the CIBA lenses, Matsushima said. The higher oxygen transmission significantly reduces the risk of corneal infection, she said.

The Menicon offers clearer, sharper vision even to people with astigmatism, but the lens is rigid, so it takes longer to build up wearing time, said Carl Moore, president of the California Concise Contact Lens Co., which manufactures the Menicon Z lens and distributes the CIBA Vision lens.

The CIBA lenses are easier to wear and correct nearsightedness, but won't help astigmatism.

While the first generation of hard contact lenses transmitted no oxygen, soft lenses transmit oxygen at an industry rating of 10 or 15. By comparison, the Menicon lenses rate 175, Moore said.

"We have lots of customers in Hawai'i," Moore said. "I think the value of the lens is that it's the healthiest lens out there."

Dr. Tyrie Jenkins, who has a general opthalmological practice in Honolulu, much of it in laser eye surgery, considers the lenses an alternative mostly for those who are not contemplating surgery.

She said her patients come in ready for a change, determined to leave glasses and contacts behind. "They want to be able to work out and go swimming and never have to put anything in their eye again," said Jenkins, who specializes in opthalmological refractive surgery and treatment of cataracts.

Dr. Rhoads Stevens, who works in private practice at The Queen's Physicians Office Building, urges caution with any type of contact lens.

"Contact lenses are not just a simple fashion alternative to glasses," Stevens said. "They are medical devices that can have potentially blinding consequences."

Stevens is cautious about the new technology, noting that it took years for extended-wear lenses to show widespread problems.

"It may be the next best thing since sliced bread, but we don't know," he said.

For now, he won't recommend that his patients sleep with lenses, even the new ones.

"I appreciate that's humbug," he said, "just like putting on your seat belt is humbug and putting on a helmet before you get on a bike."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.