July 17, 2023
VANCOUVER, Canada — At THE Myopia Meeting held here June 11, 2023, Vishakha Thakrar, OD, FAAO, FSLS, of Vaughan Vision Centre, presented on behalf of Johnson & Johnson Vision. She started by acknowledging that “there is a shift towards incorporating more myopia management techniques within the practice itself.” Still, “many people come into our practices, and they have no idea that we can manage myopia and we can reduce the progression.” To overcome this, she looks to “companies like Johnson and Johnson Vision to help grow global awareness.”
Dr. Thakrar then discussed the ACUVUE Abiliti suite of myopia management therapies and the ways that they’ve been beneficial to her patients.
“I had the benefit of being able to fit the ACUVUE Abiliti 1-Day Soft Therapeutic Lenses for Myopia Management for about a year and a half now. The lens was first introduced to me in December 2021, and when I was asked to do this talk, I thought to myself, ‘Let me look at the examination data of my Abiliti patients over the last year and a half to see what I can share.’ I think it’s very important to use our own clinical experience to support the studies.”
Breaking Down the Abiliti 1-Day Lens
While Johnson & Johnson Vision currently offers two myopia management therapies — Abiliti 1-Day Soft Therapeutic Lenses and Abiliti Overnight Therapeutic Lenses — Dr. Thakrar’s presentation focused on the daily disposable lens.
Collaborating with international partners, the Johnson & Johnson Vision research team pioneered a sophisticated technology that delivers more plus power and more myopic defocus over a wider area.
We, as clinicians, have been successful with several designs, but you’ll see with this specific design how the lens can incorporate higher plus in the treatment areas. This lens has proven efficacy, it has a novel technology called RingBoost Technology, and it is a pediatric inspired lens, meaning it’s a smaller silicone hydrogel lens with a steeper base curve.”
Dr. Thakrar then moved into discussing the design of the Abiliti 1-Day lens. To do so, she started by describing the design of a dual-focus lens.
“With a dual-focus lens — we’ve seen it with multifocals, we’ve seen it with myopia control — light enters, and it converges along the line of sight in front of the retina, and this works well. Since the convergence of the light is in front of the line of sight, there is a limitation to the amount of plus power that can be added to that lens. This particular dual-focus design is actually simulating a +2.00 defocus. Up to +2.00D, a child can adapt relatively easily, but if you try to put a +4.00 or a +5.00 treatment zone in the lens, it would be much more difficult.
“The Abiliti 1-Day lens is different. It uses a section of a torus, and that torus section redirects the light and instead of converging it in front of the retina along the line of sight, it makes a circular, doughnut pattern around the line of sight. The treatment rings incorporate a +7.00, and in the middle, there’s a dot right in the center of the lens that is a +10.00 boost. The small +10.00 dot is suppressed by the patient’s brain, so the blur is not perceived by the patient. With regards to the +7.00 circular pattern surrounding the line of sight, rather than being on the line of sight, the patient still has excellent distance vision.
“So, when researchers observed the patients in the group between the ages of 7 and 12, 95% of them had 20/20 vision monocularly, and I found that clinically as well. I found that successful patients saw 20/20 monocularly right off the bat. This lens is very much designed for the 7- to 12-year-old.
“I do have teenagers in the lens, and one thing I notice, with respect to chair time, is if I put the lens on the eye, I will know within a couple of minutes if they’ve adapted to the lens or not. I don’t feel like I need to go through the adaptation that you tend to have with multifocal lenses. I love that it’s a silicone hydrogel lens as well, because as Canadians, we’ve been so progressive in fitting silicone hydrogel daily disposable lenses.”
Dissecting Six-Month Data
In as little as six months, Abiliti 1-Day reduced axial elongation by 0.105mm on average. The six-month data is very promising there.
“Bringing it back to my own practice, if I were to look at all of the patients that I have seen with Abiliti for the last year and a half, axial length changes have been minimal, and refractive error changes have almost been nothing — which is unheard of. That’s very promising in my opinion.”
The Patient Experience
Dr. Thakrar wrapped up her presentation talking about the patient experience with the ACUVUE Abiliti 1-Day Soft Therapeutic Lenses.
“In terms of fitting, patients have had all-day comfort with the Abiliti lenses. They’ve been able to easily put in the lens and take it out. It’s an OASYS 1-Day material, which is senofilcon A.
“With a very comprehensive myopia management practice, we have to look at the lifestyle of the child. If, for example a 6-year-old patient presents to your practice whose parents are not very knowledgeable in myopia management, they’re likely a fantastic candidate for spectacle lenses. A 9-year-old in the same situation may want to wear contact lenses or may be active in sports. Studies show that the longer a child is in myopia control treatment during the day — glasses, contact lenses, etc., the better the myopia control effect. So, if a child is participating in sports several hours a day, it may make sense to put them in a myopia control contact lens. I think we very easily migrate to glasses — it’s easy, they work very, very well, but I think we really have to pinpoint the lifestyle of the child before we determine the best method to use.
“We also have to work with parents in terms of our treatment recommendations. We have to give them tools to make myopia management part of their children’s daily routines. Maybe that looks like walking to school to get more time outdoors, or have them thinking about how they take breaks from screens and near work — go get a glass of water, go talk to a friend — whatever it may be. We can incorporate breaks and routines, and really need to listen and communicate well to our patients.”