Bausch + Lomb Corporation (B+L) is introducing its latest addition to the U.S. commercial market: Arise, a cloud-based orthokeratology (ortho-k) lens fitting system.
Let’s start with the basics.
Arise is designed to “streamline the (ortho-k) lens design process” by syncing directly with diagnostic tools (specifically topographers) that capture 3D images of the eye to generate “precise lens designs” to treat myopia—all without needing a fitting set.
The time this takes: Mere “seconds,” according to B+L.
Break this process down for me.
The user-friendly system utilizes advanced algorithms for clinicians to perform three main steps*:
- Capture
- Eyecare professionals (ECPs) upload corneal images from a topographer with CloudLink software
- Design
- The software used advanced algorithms to analyze thousands of datapoints and recommend a custom lens design (more on that later)
- Evaluate
- ECPs then ascertain topography, lens centration, and fluorescein
- Then: If the lenses are acceptable, they are then dispensed to the patient; if adjustments are needed, a post-wear follow-up protocol should be followed
- ECPs then ascertain topography, lens centration, and fluorescein
*Note: This information is based on the United Kingdom’s (UK) Arise system (already commercially available).
Go on …
Arise is designed for “lens fitters of all experience levels” and to evaluate lens centration and patient progress via an overnight outcome map library (with potential adjustment recommendations available after overnight wear).
Circle back to that custom lens design.
The lenses used to create such customization are the first FDA-approved ortho-k lens design with toric peripheral curves, B+L noted.
About these lenses: Originally approved in 2004, Boston Orthokeratology (oprifocon A) shaping lenses are indicated for overnight wear only to reduce myopic refractive error in non-diseased eyes, specifically for a wide range of patients:
- Low-to-moderate myopes: –1.00D to –5.00D
- Low astigmatism: up to –1.50D cylinder
How it does this: By applying slight pressure to the center of the cornea when a patient is asleep to purposely flatten its shape.
- And once removed: The cornea maintains this flattened shape for “most or all of the wearer’s waking hours.” See a visual of how this works.
Get into its specifications.
See here for the lenses’ safety information (including contraindications) and warnings.
As for potential adverse events (AEs) associated with the lenses’ use during clinical trials, B+L reported:
- All eyes that showed acuity reductions were documented as returning to normal vision, except two eyes of one subject with severe corneal staining that showed ≥2 lines loss of best spectacle-corrected visual acuity (BSCVA).
Anything else to note about these lenses?
Yes! They’re also part of the Bausch + Lomb Vision Shaping Treatment (VST) process, which temporarily reduces myopia “up to 5.00 diopters (D) with eyes having astigmatism up to 1.50(D)” and can only be disinfected via a chemical disinfection system.
About the VST process: This non-surgical, modern ortho-k process uses customized shaping lenses to gently reshape (flatten) the central front surface of the eye (the cornea) to reduce myopia.
Got it. Now back to Arise … how does it improve ortho-k management?
The system—currently available in the UK and Europe—is credited with enabling three key advantages for ECPs in their clinical workflow:
- Reduced chair time (as no fitting set is needed)
- Minimized number of lens refits (thanks to the customized and adjustable lens design)
- Availability to accommodate increased volume of fittings and follow-ups
This represents a stark contrast to traditional orth-k lens fitting methods, which can be complex and time-consuming, according to Yang Yang, president, Global Vision Care, Bausch + Lomb.
So! How can I add this to my workflow?
And check out what else the company has been up to as of late (including, speaking of lenses, an e-commerce online ordering platform).