Offset Multifocal Optics with OptiSync Technology

[AdminWolf]

Offset Multifocal Optics with OptiSync Technology
with Drs. Matthew Lampa and Stephanie Ramdass

Soft contacts frequently decenter temporally, which can lead to sub-optimal visual outcomes.

In this ODwire.org webinar, Drs. Matt Lampa and Stephanie Ramdass discuss the science behind this decentration, and how the NEW OptiSync Technology allows you to offset the multifocal optics from the center of the lens and target alignment with the patient's visual axis.

 

[AdminWolf]

Thanks to the folks at SpecialEyes, Dr. Lampa & Dr. Ramdass and everyone who turned out for the show, it was fun!

If you have any questions, feel free to post them here.

The randomly selected Amazon Echo raffle winner: --- Dr. Audrey Nguyen! (be on the lookout for an e-mail from us!)

-- ad

 

[AdminWolf]

So let me ask everyone this question -- it looks like Dr. Petito has identified an important factor in determining whether or not a MF contact fit might fail -- Angle Kappa. OMDs take the measurement routinely for IOL placement, but i'm curious as to how many of you are taking it with you MF contact patients? (ie, if you have an OPD, do you routinely capture this data?)

 

[Richard Pagan]

angle kappa never, but IMHO that has little to do with multifocal failure. Mostly multifocals fail because they are multifocals.

 

[Steve Silberberg]

angle kappa never, but IMHO that has little to do with multifocal failure. Mostly multifocals fail because they are multifocals.

That is not true Rich. The angle makes a difference and any decentration of the lens makes a failure inevitable. I have seen many a fit from other offices decenter which is OK for spheres but dooms MFs.

 

[Richard Pagan]

That is not true Rich. The angle makes a difference and any decentration of the lens makes a failure inevitable. I have seen many a fit from other offices decenter which is OK for spheres but dooms MFs.

I'm not saying angle kappa doesn't matter, just that it isn't the main problem

 

[AdminWolf]

I'm not saying angle kappa doesn't matter, just that it isn't the main problem

To put it another way, when you’ve run into problems with visual quality and MFs, have you tried measuring angle kappa then? (And if not, how can you tell it isn’t contributing?)

 

[Richard Pagan]

To put it another way, when you’ve run into problems with visual quality and MFs, have you tried measuring angle kappa then? (And if not, how can you tell it isn’t contributing?)

no, but that's besides my point. My point is that multifocal optics are...artificial, unnatural, foreign. Eyeglasses are a whole different animal, whereas contacts are more like refractive sx, IOLs, etc. In the latter case, the eye will always struggle to resolve competing points of focus present in multifocal optics, and nothing will totally "fix it". Granted centration, pupil size, etc all play a role, and adjusting for them might help, but in the end the optics are what they are.

BTW didn't see the webinar but what method did they use to measure angle kappa?

 

[AdminWolf]

BTW didn't see the webinar but what method did they use to measure angle kappa?

Fast-forward to 45:00 where they discuss different techniques for measuring misalignment. For Angle Kappa, they talk about the Oculus Keratograph and the Marco OPD III Scan.

 

[AdminWolf]

BTW, attached a PDF document here about how to determine misalignment. Can be helpful.

 

[Richard Pagan]

Fast-forward to 45:00 where they discuss different techniques for measuring misalignment. For Angle Kappa, they talk about the Oculus Keratograph and the Marco OPD III Scan.

I doubt even one OD has an OPD scanner, and using topo for angle kappa is like shooting from the hip IMO.

 

[AdminWolf]

I doubt even one OD has an OPD scanner, and using topo

?? the OPD is an incredibly popular instrument! It is an all-in-1 AR/keratometer/pupillometer/topographer/aberrometer/swiss army knife/dessert topping/floor wax. Lots of offices have them b/c they save space, and can provide a ton of information relatively quickly.

 

[Larry Greidinger]

I doubt even one OD has an OPD scanner, and using topo for angle kappa is like shooting from the hip IMO.

Local Lenscrafters use it routinely.

 

[AdminWolf]

Local Lenscrafters use it routinely.

The device does a lot, I suspect people only routinely use a fraction of its capabilities, which is why I was wondering if folks frequently just store the angle kappa value when people are being scanned.

 

[Larry Bickford O.D.]

Speaking as a wearer.

My multifocal vision is FAR from "artificial, unnatural, foreign", Rich. It's nearly perfect at all distances and that's NOT correcting a diopter of ATR astig. I find that my PALs, perfectly done Zeiss Individual 2 or Solidar 4K---that's what I find weird and foreign. I use them only to find my contact lenses. (Farsighted presbyopia sucks.)

As to the decentration issue: a definite problem. I had a patient yesterday. Tried B&L's Ultra Presby, Biotrue MF, Alcon Dailies MF and Alcon DT1 MF. -6 with 2 add. A little oblique cyl, r and l. The DT1 worked perfectly! The others all failed terribly. The DT1 centered and the other three did not.

Had a patient today. +2 with 2 add. No cyl. Biotrue worked perfectly, all the others failed. Biotrue centered, others did not.

So any of you who complain that you can't be successful with MF it is specifically because you are not fitting them correctly.

Consider that I have a 90% success rate initially and probably close to 80% longer term.

Yes, it's a pain in the butt to trial and error with these things but it is what it is. It takes more chair time. Charge for it.

How many of you even care if a spherical soft lens decenters? Does it matter? I say it does. Do you A/B two different brands/designs to see what yields the best acuity? It matters. Sometimes the more comfortable lens provides the best optics, sometimes it is the "this feels terrible" lens that is clear and sharp.

One size, one design does not fit all.

 

[Charles A McBride]

I listened to most of the lecture and may have missed it. I'd be grateful of a definition of the nodal point in regards to the pupillary axis. Thank you. -Charlie

Charles McBride, O.D.
Beaverton, OR

 

[Richard Pagan]

?? the OPD is an incredibly popular instrument! It is an all-in-1 AR/keratometer/pupillometer/topographer/aberrometer/swiss army knife/dessert topping/floor wax. Lots of offices have them b/c they save space, and can provide a ton of information relatively quickly.

my bad I did not know it had those other functions

 

[Richard Pagan]

Speaking as a wearer.

to each their own

 

[Lindsay McCorkle]

I listened to most of the lecture and may have missed it. I'd be grateful of a definition of the nodal point in regards to the pupillary axis. Thank you. -Charlie

Charles McBride, O.D.
Beaverton, OR

Dr. McBride, thanks for watching the webinar and thanks for your comment. I’m not sure I fully understand your question but I’ll do my best in responding.

It’s my understanding that the pupillary axis can be defined as a line perpendicular to the cornea that intersects the center of the entrance pupil. If that line continues posterior towards the retina, it could potentially intersect with the visual axis at the rear nodal point. I hope this response answers your question.

You have me intrigued as to your perspective. If you’d like to discuss this further, please call 866.404.1060 and ask for myself or Korinne. We were both on the webinar and we’d be more than willing to brainstorm this further Thanks again!!

 

[Diane Robbins-Luce]

Well done, I especially like Dr. Lampa's description and visual aides regarding why contact lenses decenter temporally in most cases.