1-Day Acuvue Moist Multifocal: Pearls and Patient Experiences

Charles A McBride

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Well, I can only speak to my experience -- I think Charlie tried me in literally every 1-day MF that was out there. There were all busts, for me at least. There is something very different about the design of this lens, which is what the talk above gets into.

I think we did try them all. The new ones won't work for you because they aren't multifocal but the DT1 in plus and the Oasys 1-day (which has been a very positive surprise so far) is waiting for you to test out as well. At your convenience of course. :)
 

AdminWolf

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I think we did try them all. The new ones won't work for you because they aren't multifocal but the DT1 in plus and the Oasys 1-day (which has been a very positive surprise so far) is waiting for you to test out as well. At your convenience of course. :)

Oh, I'll give the new ones a shot. :) (I got to try to the Oasys out at Academy for a few minutes -- very comfortable, would love to see how it does after an entire day.)

I suspect that either or both of those materials are going to be turned into MF products as soon as it is feasible. It is nice to see a flurry of new, good products after what seemed like a long period of relative stasis in the industry.
 

Allan Panzer

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Thanks for the webinar, I learned two things that I will try.
1. the binocular modified loose lens over-refraction in where one eye is not occluded but fogged with +1.00 and the other eye is fine tuned.

2. because the lens design is specific to each power, a change from -3.00 mid to -3.25 mid is not just a power change but an image size change and depth of focus change. Not sure how much this matters but I will pay closer attention.

I am interested in trying #1 above.
I haven't had a chance to watch it yet. My son was in a play that night.

As usual, we all need to support our special children.


Binocular fog...remember way back that was called a Humphrey balance.

Hadn't thought of using it with multifocal soft lenses. I have so far had little problem with the lens.It seems to work or not work...cylinder has and is always a problem.

Will watch webinar ASAP

IMG_1605.JPG


IMG_1604.JPG
 

Scott Blahnik

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My last patient of the day was an MD who wore Air Optix Multifocals (MED add ou) with reading glasses for fine print.
I tried the AV Moist MF in the Mid add power ou, then plussed up the non-dominant to improve near. It was OK but not great.
So, I tried the Haas approach: used the high add and overplussed by .75 in the non-dominant: worked like a charm!
I'm going to try to listen to the archived webinar on my phone, on the commute home as it's a 1 hr drive. I wonder if that will work?
 

Charles A McBride

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My last patient of the day was an MD who wore Air Optix Multifocals (MED add ou) with reading glasses for fine print.
I tried the AV Moist MF in the Mid add power ou, then plussed up the non-dominant to improve near. It was OK but not great.
So, I tried the Haas approach: used the high add and overplussed by .75 in the non-dominant: worked like a charm!
I'm going to try to listen to the archived webinar on my phone, on the commute home as it's a 1 hr drive. I wonder if that will work?

I had to go back and review the Haas Method. I'll give it a go.
 

AdminWolf

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I'm going to try to listen to the archived webinar on my phone, on the commute home as it's a 1 hr drive. I wonder if that will work?
Should work perfectly as long as you have 4G
 
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Greg Luce

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Is it Haas Approach, technique or Method?
Help us out Dan!

I was two for two today, one guy was -0.25 one eye -1.50 other eye with +1.75 Add.
He walked out with -0.25Med and -1.50 Mid as per the guide.
I tried the modified fogged binocular over refraction and we stayed with the guide.

Last doctor said, you have perfect natural monovision, people pay a lot for that. He was no longer happy.

Vision, it's what I like to do.

BTW, his IOP was 40 OD and 17 OS. He said I have always been that way, I said I don't care, you are not allowed to be that way. Wonder how much NFL he has lost?
We'll see, out of network, some providence carve out discount not plan, he gets to go to the school.
 

AdminWolf

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Apologies Allan, Med a as in Medium I presume. My iPhone got the worst of me
Autocorrect is awful for any technical terms, i'm surprised Apple doesn't make industry-specific dictionaries that you can add to your phone... for a price :)
 

Matt Judd

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Autocorrect is awful for any technical terms, i'm surprised Apple doesn't make industry-specific dictionaries that you can add to your phone... for a price :)
Once google does so, Apple will follow. One day this will all be clear Adam :)
 

Jeff Eger

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Is it Haas Approach, technique or Method?
Help us out Dan!

I was two for two today, one guy was -0.25 one eye -1.50 other eye with +1.75 Add.
He walked out with -0.25Med and -1.50 Mid as per the guide.
I tried the modified fogged binocular over refraction and we stayed with the guide.

Last doctor said, you have perfect natural monovision, people pay a lot for that. He was no longer happy.

Vision, it's what I like to do.

BTW, his IOP was 40 OD and 17 OS. He said I have always been that way, I said I don't care, you are not allowed to be that way. Wonder how much NFL he has lost?
We'll see, out of network, some providence carve out discount not plan, he gets to go to the school.
Dr. Luce, What is Haas approach? Please refrain from abbreviations for me.KISS-keep it somple stupid(i am the stupid one on abbreviations everyone seems to understand as second nature).:) Thanks
 

Greg Luce

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Jeff,
I don't know, Dr. Haas has described his technique for using this lens for his personal use. Some, on this tread were calling it the Haas technique method or whatever.

I was jokingly asking whether it was a technique or method or whatever.

If you go back and read Dr. Haas' description will be clear. It is not an actual thing, at least not yet. Just something sort of fun in the context of this tread.
 

Matt Judd

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So my first fit today. Comfortable. Decent distance v/a. 1M @ near. will be overplussing non-dominant eye and see if works. Started with HIGH ADD OU, full minus

Prior MF was 5 to 6 pt at near with same distance (20/20-). However, the one-day modality will be beneficial
 

Jeff Eger

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Jeff,
I don't know, Dr. Haas has described his technique for using this lens for his personal use. Some, on this tread were calling it the Haas technique method or whatever.

I was jokingly asking whether it was a technique or method or whatever.

If you go back and read Dr. Haas' description will be clear. It is not an actual thing, at least not yet. Just something sort of fun in the context of this tread.
I read it. I think I understand it?
 

Dan Haas

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I didn't really mean to be so controversial. I guess I do what ever works.

What is really good about all the center near bifocal contacts is the outstanding midrange vision, what's challenging is either end: long distance and very near. Young presbyopes are easy, right off the fitting guides but for the absolute presbyope like me cheating the dominate for distance and the non for near, usually with a stronger add and slight over plus on the non giving both eyes the beautiful midrange clarity, has worked for me all along with lenses from all the makers.

Compared to monovision, binocularity is special. If I use just one eye vision seems blurred distance and near compared to having both open which makes all distance better. If you're not there yet you'll have to take my word for it and use the fitting guides, if you're a boomer like me and you're trying to fit these lenses without personally wearing them I suggest you experiment with yourself, the best thing about our profession is we can practice on ourselves, unlike surgery or proctology!
 
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Jeff Eger

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I didn't really mean to be so controversial. I guess I do what ever works0
What is really good about all the center near bifocal contacts is the outstanding midrange vision, what's challenging is either end: long distance and very near. Young presbyopes are easy, right off the fitting guides but for the absolute presbyope like me cheating the dominate for distance and the non for near, usually with a stronger add and slight over plus on the non giving both eyes the beautiful midrange clarity, has worked for me all along with lenses from all the makers.

Compared to monovision, binocularity is special. If I use just one eye vision seems blurred distance and near compared to having both open which makes all distance better. If you're not there yet you'll have to take my word for it and use the fitting guides, if you're a boomer like me and you're trying to fit these lenses without personally wearing them I suggest you experiment with yourself, the best thing about our profession is we can practice on ourselves, unlike surgery or proctology!
thanks Don
Glad I an not a practicing Proclologist. Then I would have a Shty outlook on life.:)
 

Mike Alvarez

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Hadn't thought of using it with multifocal soft lenses. I have so far had little problem with the lens.It seems to work or not work...cylinder has and is always a problem
CVUE Advanced Hydrovue Toric Multifocals work fairly well. They're custom lenses, but you can get free trials.
 

AdminWolf

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Just thought I'd post that I'm trying these lenses more and more and having success.
Interesting that this conversation has such a long tail! Question for everyone -- as tech has moved forward, has the proportion of people who can't tolerate SiHy lenses dropped? Where does that leave a lens like Moist?
 

Mike Alvarez

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Still my personal favorite (followed closely by Total One MF)
Agreed. I think the AV design is better, but DT1 is such a great material it really improves the lenses performance.
 

Charlie Turner

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Interesting that this conversation has such a long tail! Question for everyone -- as tech has moved forward, has the proportion of people who can't tolerate SiHy lenses dropped? Where does that leave a lens like Moist?


For Under 40's, patients care about in order:
1. Comfort
2. Vision
3. Convenience

For Over 40's, it flips just a hair:
1. Vision
2. Comfort
3. Convenience

'Need' of a SiHy is predicated on vision performance in a multifocal. Once my team of docs and I circled around 1 Day Moist as our go-to lens, and adopted simple fit guide, our multifocal business has taken off. Total 1 is our 2nd place lens, and we maybe have to use it 10% of our fits.

Pre-Moist, we were probably 60/40 monovision over multifocal. Now, we are 90% multifocal. Because I got all docs on board with fit guide, our techs do most of our follow-ups.
 
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Scott Blahnik

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My personal experience was that after about an hour's wear time the lenses became gummy and decentered.
In a moment of frustration I marched all the fitting sets to the dumpster. I use only the DT-1 MF now, with limited success. I was hoping for the AV design to emerge in the Oasys material?
 

Mike Alvarez

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My personal experience was that after about an hour's wear time the lenses became gummy and decentered.
In a moment of frustration I marched all the fitting sets to the dumpster. I use only the DT-1 MF now, with limited success. I was hoping for the AV design to emerge in the Oasys material?
Over refraction can make a big difference with DT1 MF. I’ve had a few patients with a +1.25 over refraction.
 
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James D. Williams O.D.

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For Under 40's, patients care about in order:
1. Comfort
2. Vision
3. Convenience

For Over 40's, it flips just a hair:
1. Vision
2. Comfort
3. Convenience

'Need' of a SiHy is predicated on vision performance in a multifocal. Once my team of docs and I circled around 1 Day Moist as our go-to lens, and adopted simple fit guide, our multifocal business has taken off. Total 1 is our 2nd place lens, and we maybe have to use it 10% of our fits.

Pre-Moist, we were probably 60/40 monovision over multifocal. Now, we are 90% multifocal. Because I got all docs on board with fit guide, our techs do most of our follow-ups.
Care to share your fit guide?
 

Charlie Turner

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Care to share your fit guide?

We follow the manufacturer's fit guide exactly. We keep the pocket size guide in all exam rooms and cl room.
My staff knows what changes we would make as docs on f/u, so docs do not typically see cl checks.

Basically, by fitting right on the guide, you should only have 1 f/u at most.
 
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