Bausch + Lomb's Zenlens ECHO scleral lens launches in the US

Bausch + Lomb Corporation announced the U.S. commercial launch of the newest addition to its scleral lens-focused lineup: the Zenlens ECHO.

Let’s start with Zenlens—what is it?

B+L’s Zenlens brand of scleral lenses are designed with the company’s proprietary SmartCurve technology and intended to fit a wide range of patient parameters, including:

Spherical and toric peripheral curves
Prolate and oblate lens shapes
Four diameters for irregular and normal-shaped corneas:
- 14.8-mm lens for horizontal visible iris diameter (HVID) measurements less than 11.7 mm
- 15.4-mm lens for HVID measurements less than 11.8 mm
- 16.0-mm lens for HVID measurements less than 11.7 mm
- 17.0-mm lens for HVID measurements less than 11.8 mm

Quick refresh: SmartCurve technology aims to simplify scleral lens fittings by enabling eye care practitioners (ECPs) to customize the shape of a lens for patients’ specific needs.

And what patients are these best suited for?

Patients with:

Astigmatism
Refractive error
Ocular surface disease (OSD)
Corneal scarring
Irregular astigmatism
Radial keratotomy (RK)

What other features make this brand unique?

Per B+L, Zenlens also offers customization features, along with:

Advanced peripheral system (APS)
- Provides a gradual landing zone that’s adjustable in 30-micron steps for all four quadrants of a lens edge (independently) via Quad Sym Technology
  - This technology enables ECPs to flatten or steepen the edge treatment differently in all four quadrants to match the peripheral cornea.
- Allows more accurate landing on the scleral and reduces:
  - Compression
  - Impingement
  - Air bubbles
  - Conjunctival impression rings
Bi-Elevation
- Addresses varying elevation in the limbus to create an even, 360° landing on the sclera
  - Reduces occurrence of:
    - Lens decentration
    - Chamber fogging
    - Lens impingement
    - Conjunctival impression rings

Any other accommodation technology?

Yes! The Zenlens brand also incorporates B+L’s MicroVault technology, which is intended to specifically accommodate for “pinguecula or other peripheral elevations that may be irritated by a lens pressing against them,” according to B+L.

Significance of its name: This tech is designed to create a flute or ripple within the lens that “vaults over the obstruction precisely” via CAD/CAM technology.

How about for multifocal prescriptions?

The company’s use of multifocal optics involves decentering optics that align the near zone over the visual axis — instead of the center of the cornea.

Why the near zone: B+L noted that this design has “shown to provide clear vision in soft contacts” by having the multifocal lens place the near-zone slightly nasal and superior for each eye.”

I think I’m up-to-date on Zenlens. Now tell me about this ECHO.

Zenlens ECHO is designed as a non-prosthetic, custom scleral contact lens technology that fits an array of corneal shapes and sizes.

Included among this array: patients with advanced ocular conditions (corneal degeneration and specific postoperative conditions)

Exactly what kind of conditions?

Corneal degeneration:

Terrien’s marginal degeneration
Advanced pellucid marginal degeneration (PMD)
Salzmann nodular degeneration (SND)
Keratoconus

Postop:

Tilted graft (penetrating keratoplasty [PKP])
Post-refractive ectasia
RK

Trauma:

Chemical burns
Conjunctival abnormalities

Gotcha. And how does it compare to other lenses?

Standard impression-based and freeform lenses are often associated with costly expenses and/or additional training or equipment.

The comparison: This Zenlens is capable of being used with such clinical practice technologies as slit lamp, optical coherence tomography (OCT) scanning, profilometry, or a Bi-Elevation (see above) fitting set.

The key: No extra training or certification is needed for it.

Can you specify elevations?

Yes, for each quadrant, you may choose from:

Base curve
Sagittal height (SAGS)
Advanced APS values (an upgrade from the regular Zenlens)
Limbal clearances
Mid-peripheral zone

See here for a visual.

Nice! So where can I purchase this for my clinic?

Click here (and scroll all the way down) to request details about adding this lens to your practice.