TOTAL30 Contact Lens with Drs. Erich Bauman and Jessica Crooker

[AdminWolf]

In this ODwire TV Episode, we discuss the TOTAL30 contact lens, including the science and technology behind the lens, how to use it in clinical practice, and why reusable lenses are still important in 2022.

Today's guests are Dr. Jessica Crooker and Dr. Erich Bauman.

Ask any follow-up questions about the lens in this discussion thread.

Thanks

 

[AdminWolf]

Thanks again to Drs. Bauman and Crooker, let's try to centralize discussion of the lens in this thread.

-- adam

 

[Lawrence Roth]

What do you tell a long term contact lens wearer that keeps ripping these?

 

[Michael I. Davis]

I have found this lens to be great for the first 10-14 days and then it gets dry for some patients. They tend to go back to their Air Optix Hydraglyde. This happens with both Opti-free and Clear Care.

Any suggestions? Not in every case but easily a third of them.

 

[Scott Blahnik]

I've been having the same kickback from patients as Michael.
Patients have been happy with their Air Optix Hydraglyde for years, and have not appreciated
my attempts to upgrade them to the Total 30.
The Total 30 for Astigmatism does not have the stability as the Air Optix Hydraglyde for Astigmatism and has not been a smooth transition either.

 

[Jeffrey Kiener]

I'm not sure that it's stability per se, but more that the coefficient of friction is so low that the lids can't orient the lens. That's speculation on my part.

I can see the pellicle coming off this lens in under 30 days...that was the design challenge for this lens, I believe.

 

[John Boer]

The Total 30 for Astigmatism does not have the stability as the Air Optix Hydraglyde for Astigmatism and has not been a smooth transition either.

Have they made it easier to find the damn toric markings on the Total 30?

 

[Matt Judd]

feedback has been low here as well. hopefully they dont d/c the air optix lenses

 

[Jeffrey Kiener]

I heard they will.

 

[Matt Judd]

I heard they will.

the "lecture" I sat thru from the OD in a state below TN, he said he had almost complete acceptance with the Total 30.

pts coming in with no complaints wearing a 2 week or monthly and didnt want to do dailies...

hed start asking specific questions about end of day dryness, climate change in the middle east, etc, and they would try them
and almost universally love them....

 

[Jeffrey Kiener]

Well, I'm no polymer chemist...

...but I do think they have something great in their DT1 technology. And it makes sense to try to bring that into a new market.

First it was the Precision Dailies or whatever...another sihy daily, and it's "fine". (Again, their HEMA Dailies is pretty successful, though. Everyone wants a sihy daily but without super-wetting, it's not really a needed product, IMHO. Daily HEMA works great.)

Then it seems the "shorter turf" approach they took to Precision 1 has been applied to the Total 30, but the question is how long those strands adhere to the core. Naked silicone is probably not that awesome a lens surface.

 

[Scott Blahnik]

I'm not sure that it's stability per se, but more that the coefficient of friction is so low

Sounds plausible to me, Jeff. Stability was the only word I could think of. Axis orientation would have been more descriptive.

 

[Jeffrey Kiener]

I've been trying like you to feel out the Total 30 because I'm expecting the end of Air Optix and I want to see if it's going to work. So far I'm undecided. They're very different lenses.

Plasma-treated sihy may be as inflexible as poster board by today's standards, and it's old as dirt (20 yrs), and it's not a first-choice material any longer. But there are those dry eye types that need the wetting that plasma coated provides.

The good news is that they'll probably never get rid of the Night and Day whatwith the patent they paid for. So it's really only the astigmats that will suffer.

 

[Matt Judd]

so you believe there is a surface additive on the lens (vs mixed in) and this can somehow 'come off' after a few weeks?

interesting. if this is true, there should be a way to measure it. perhaps a fluorescein pattern of a new lens vs 2 weeks old
vs 4 weeks old using a camera system like Dr. Thomas uses.

they claim "100% water" at the lens surface. 55% at the core with "gradient technology" that increases to ~100% at the surface. because as we all know, water in the eyes feels great....

then there is "celligent technology" on the surface that attracts water particles and deters larger molecules ie bacteria

lens has a low "surface" modulus

lens surface moisture, they have them ranked this way:
lowest: biofinity. 6 seconds
Oasys 9
vita 14
ultra 15
air optix hydraglyde 19
total 30 27

*Based on an in vitro study wherein wettability was measured using the iDDrop System (p<0.05). All lenses were tested in an indentical manner, soaked in a PBS (phosphate-buffered saline solution) for 16 hours plus/minus 2 hours (p<0.05).


based on this logic the biofinity should be significantly less comfortable than total 30...

 

[Jeffrey Kiener]

Only in patients with dry eye. With normal tears, Biofinity and Oasys are great. Vita is a sleeper, BTW, but whatever.

 

[Jeffrey Kiener]

 

[Scott Blahnik]

based on this logic the biofinity should be significantly less comfortable than total 30...

I suppose we should call this end of day comfort, vs. initial comfort.
Air Optix usually had a bit of initial discomfort, but many times beat out the competition at day's end, and was much more deposit resistant.

So, maybe one of the guest speakers could comment on whether the older material will truly be discontinued?
My rep (who is great!) says the Air Optix Colors will remain.

 

[Matt Judd]

I suppose we should call this end of day comfort, vs. initial comfort.
Air Optix usually had a bit of initial discomfort, but many times beat out the competition at day's end, and was much more deposit resistant.

So, maybe one of the guest speakers could comment on whether the older material will truly be discontinued?
My rep (who is great!) says the Air Optix Colors will remain.

personally I used to only be able to wear proclear lenses. everything else drove me nuts. of course, I never took my contacts out from 13-20 something. ended up doing ortho-k for the last many years.

similar to progressive lens marketing, Im not buying all these lens things. but could be wrong