Materials > Menicon Z
This section will feature a closer look at the benefits of the newest enhancements in lens materials. This month our focus is the Menicon Z material, featuring an article from Dr. Randall Sakamoto, from our Feburary 2008 Newsletter "New Happenings".
UPGRADING YOUR GP PATIENTS
By Randall Sakamoto, OD, PhD
Most practitioners are upgrading their soft contact lens patients to Si-Hy lenses. However, the majority of practitioners are not choosing to upgrade their GP patients to the Hyper Dk/t oxygen materials. This January, Valley Contax has become a Menicon affiliated lab in order to offer its doctors access to the Menicon Z material (Dk=175). It is without question the most permeable GP material on the market and is the only one to boast a 30-Day Continuous Wear Approval from the FDA. The bottom line is that this is the only material in the GP material family on par with Oasys, Biofinity, and O2Optix as far as oxygen transmission. Menicon Z is the ONLY GP material in the Hyper Dk/t category (Figure 2) along with the Si-Hy counterparts. So why not upgrade your patients into the most permeable GP material in the same way that you upgrade your soft lens patients? GP fitting remains the most profitable lens for practitioners. Valley joins the ranks of the selected labs in North America able to carry this material. It is available in all designs, including Paragon Z-CRT as well.
Most practitioners are weary of newer higher oxygen materials. The two biggest fears are loss of lens wettability and flexure. Menicon Z is extremely wettable. All Z lenses will come plasma treated without an extra charge. Menicon technology has helped make plasma treatment an industry standard. Now all lens materials from Boston and Paragon are available with plasma treatment upon request. The Menicon Z lens will not flex. Menicon Z has a hardness similar to Medium Dk/t lenses. There is absolutely no flexure problem with this material in any standard or custom design that you may wish to order it in. (Figure 3). In fact, impact resistance is even better than a Medium Dk/t lens (Figure 4).
Valley Contax is proud to be able to offer the Menicon Z material in any design and encourages everyone to get familiar with it. Don’t leave your GP patients with lenses created in the 1970s-80s. Keep them up to date and at the top of the oxygen curve with the Menicon Z material. Remember Menicon Z materials work the best with either Menicare GP (available exclusively through doctors offices) or with the Optimum GP lens care system. And don’t forget to use Menicon Progent for the most thorough protein removal for any GP lens. All available through Valley Contax. Next issue, fitting and clinical tips with Menicon Z.
UPGRADING YOUR GP PATIENTS, PART II
Randall Sakamoto, OD, PhD
In my last article I discussed the fallacy that all higher Dk GP materials are inherently easier to warp or flex. Menicon Z is the unique exception to this rule. Wettability is very good and lens flexure is not an issue with this unique material. So how do we go about fitting the most permeable GP lens in the world on your existing GP patients? The most helpful marketing tool is the Dk graph, Fig 1. I keep this graph at in all my examination rooms. I make a point of explaining to all my current GP patients that my practice is on the cutting edge and that I primarily fit the Menicon Z because it is the most permeable and therefore the healthiest lens for my patients. Showing this graph to my patients is the best way to impress on them the difference and benefits of this lens. I have had the privilege of fitting the Menicon Z material for over 12 years. About 50% of patients will feel an immediate difference in comfort when upgraded to the Menicon Z material. The other 50% will feel as good as they did with their previous lenses. Either way, the practitioner has the peace of mind that he/she has provided the patient with the most transmissible lens which enables the cornea to perform at its maximum when it comes to bacterial resistance and threat of corneal infection.
Once the patient has been convinced that they will be receiving the best care and the best lens from me, I proceed with the fitting. When the new lenses arrive and the patient comes in for the dispensing, I have the lenses inserted. My first question is the comfort question. “How do the Menicon Z lenses feel in comparison to their old lenses?” Even if they answer that there is not a noticeable comfort improvement, that is OK. You can discuss the possibility of longer wearing times, less discomfort/dryness at the end of the day, ability to take naps or occasionally sleeping in the lens (remember Menicon Z is the only GP lens approved for up to 30 days continuous wear). Once I have ascertained that the lenses fit well and the vision is good, I schedule the patient for a 1 week follow-up visit. Here is the “Clinical Pearl”. I explain to the patient that if for any reason the vision or comfort changes with their new lenses in 3-5 days, not to worry. I will be seeing them for the 1 week follow up visit. Why might the comfort or the vision change? I go on to explain, that with the Menicon Z, the patient is getting from 2-7 times more oxygen to their corneas than their previous lenses allowed. From years of wearing a lower Dk GP lens, the corneas tend to steepen over time. Within a few days of switching to Menicon Z the cornea can actually flatten causing the lens fit to be less than ideal. I reassure the patient that should this happen, I will refit them during the followup process to maintain the best fit and best vision parameters for the patient.
In about 20-30 % of patients switching to Menicon Z from another GP lens, their corneas flatten about 0.25 D. resulting in a less than ideal fit. I simply look at the fluoroscein pattern and then refit the patient with the latest parameters to maintain the best fit. The patients are amazed that I have indeed predicted that their eyes would change. They feel even more impressed that you are so knowledgeable about the contact lenses and their eyes. In some cases, a patient may feel a decrease in comfort, but no change in the K’s are manifested, fluoroscein pattern looks acceptable. In this case, I would flatten the BC by 0.25D anyway. In such cases, the central K’s aren’t changing but the mid-periphery may be flattening.
I hope these pearls are helpful for you to keep you GP patients on the cutting edge with you and your practices. Valley Contact Lenses is proud to be offering the Menicon Z materials in any design that practitioners may request. Stay tuned for my next article: What Solutions Do I Use for Menicon Z?
