GlobalCONTACT - 02/2021

ISSN:1386 0194

2

2021 (87)

Technology • Poroelasticity in soft contact lenses

Fitting Background • “Mind the gap”

Business + Marketing • Family businesses: successful handover

Modern modalities require boundless imagination and limitless capabilities. Optimum Infinite changes the paradigm of Hyper Dk materials providing immeasurable opportunities to support your speciality lens designs.

Interview

optimum-infinite.com

• Jerome Legerton • Alan Bennett • William Lee

Hyper Dk

Tailored Modulus

Inherently Wettable

Eyepress Fachmedien GmbH Saarner Str. 151, 45479 Mülheim a. d. Ruhr

NOW AVAILABLE AT YOUR APP STORE 01_Titel.indd 1

29.06.21 16:44

World Leader in GP Materials Decades of Trusted Quality Global Recognition of Boston Brand Name Support for our Laboratory Partners Educational Resources for Eye Care Professionals

Visit us at www.fit-boston.eu 2018_12_19_bl_anzeige.indd 2 !AZ.indd 4

19.12.18 10:57 12.03.19 13:49

LETTER FROM THE EDITOR

Of opportunities and crises How will we look back on this time in a few years? I will not

Utopia? Not at all. This technology is already beyond prototype

be the only one to owe you this answer for a while, because

status and has the first devices in use. This possibility was

we are not yet out of the woods in this crisis. Even if the

created by a joint venture between Zeiss and Telekom.

situation is easing, it has left clear traces. And that on several levels.

Another interesting possibility in this field is eMacula, which we present in this issue. Here, contact lenses play a big role

The economic situation of eye care practitioners was

in binocular vision and in experiencing the brave new world

determined by several factors, including how much a business

of mixed reality. Read our interview with Jerry Legerton

was affected by the corona crisis. It turned out that the services,

starting on page 26.

range of products and the modalities decided how much turnover could be made. The possibility of online reorders

For now, use our print edition – and if that's too old-fashioned

also helped some practices not only to keep their heads above

for you, feel free to use our GlobalCONTACT app with further

water, but to do good business.

content directly on your smartphone or tablet. You’re welcome. ■

This crisis has also – and this could be foreseen quite early – brought technologies forward as if on steroids. Even if the classic contact lens fitter could hardly use home offices, video conferencing or digital consultations with his customers, websites were updated, possibilities for online bookings were set up, appointments were made and virtual visits to trade fairs or even online classes for further education were taken.

Let's look a little further outside the box: imagine you put on your prescription glasses, have just read an article in GlobalCONTACT – a sudden buzz tells you that an email has just come in. A tap on your temple – and a virtual rectangular display appears crisply sharp at a distance of about 1-2 m in

SILKE SAGE

front of you, with the email that has just come in. If someone

Editor-In-Chief

is sitting opposite you at this moment, they will only notice

silke@global-cl.com

that you have changed your gaze by a few degrees. Immediately afterwards, you use this display to select a new song from your Spotify playlist while looking at your photo stream from your last holiday.

GlobalCONTACT 2-21

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25.06.2020 17:38:13 08.06.21 14:19

CONTENT

ISSN:1386 0194

LETTER FROM THE EDITOR 3

Opportunities and crises Silke Sage

2

INTERNATIONAL NEWS

2021 (87)

Technology • Poroelasticity in soft contact lenses

Fitting Background • “Mind the Gap”

Business + Marketing • Family businesses: Successful handover

Modern modalities require boundless imagination and limitless capabilities. Optimum Infinite changes the paradigm of Hyper Dk materials providing immeasurable opportunities to support your speciality lens designs.

Interview

All about you & Event dates

8

All about markets

9

All about products

10 All about research

optimum-infinite.com

• William Lee • Alan Bennett • Jerome Legerton

6

INTERVIEW 12 With Alan Bennett and Dr. William Lee – Meet the new board members of EFCLIN

Hyper Dk

Tailored Modulus

Inherently Wettable

Silke Sage

26 With Jerry Legerton – Extended reality for vision impaired

Eyepress Fachmedien GmbH Saarner Str. 151, 45479 Mülheim a. d. Ruhr

Silke Sage

NOW AVAILABLE AT YOUR APP STORE

INDEX TO ADVERTISERS Title: Contamac, www.contamac.com

HISTORY 20 Kevin Tuohy Hans-Walter Roth

Inside front cover: Bausch + Lomb Inc., www.bausch.com Page 4: Schneider GmbH & Co. KG, www.schneider-om.com Page 7: LAMBDA-X S.A., www.lambda-x.com Page 19: OPTOCRAFT GmbH,

FITTING BACKGROUND 15 Imaging techniques – case study Corinna Kurz & Matthias Lagodny

16 Mind the gap Eef van der Worp

www.optocraft.com Page 25: Larsen Equipment Design Inc., www.larsenequipment.com Page 29: AMETEK Precitech, Inc.,

TECHNOLOGY 30 The importance of poroelasticity in soft contact lenses Alina Kinder

www.precitech.com Page 37: Optimec Systems Ltd., www.optimecsystems.com Page 39: K&Y Diamond Ltd, www.kydiamond.ca Inside back cover: Efclin, www.efclin.com Outside back cover: DAC International, Inc., www.dac-intl.com

NAMES TO NOTE Bennett, Alan

12

Jungwirth, Carola

40

Kinder, Alina

30

Kurz, Corinna

15

Lagodny, Matthias

15

Larsen, Erik

36

Lee, William

12

Legerton, Jerome

26

Roth, Hans-Walter

20

van der Worp, Eef 16, 38 GlobalCONTACT 2-21

05_Content.indd 5

REPORT 34 Menicon anniversary: 70 years Rebekka Nurkanovic

MANUFACTURING 36 What a difference a year makes Erik Larsen

COLUMN 38 Glasses are for drinking Eef van der Worp

BUSINESS + MARKETING 40 Successful handover in family businesses Carola Jungwirth

SERVICE 44 Yellow Pages 5

30.06.21 11:56

INTERNATIONAL NEWS

All about you Nicoletta Losi re-elected for a mandate of two years at the Euromcontact board

for Johnson & Johnson Vision, was unanimously elected for a third mandate

The board of Euromcontact met on 15th June 2021 to discuss the priorities

Nicoletta Losi was first elected in May 2017 and again in June 2019 by her

for the organization from June 2021 onwards and elect its bureau.

peers at the board. Nicoletta Losi has been a board member of Euromcontact

Nicoletta Losi, Professional Education & Development Director in EMEA

since 2009 and was previously president of ASSOTTICA, the Italian

of two years.

association of contact lens manufacturers. Nicoletta has extensive experience in professional affairs education and in KOL strategy and development.

The board of Euromcontact also unanimously supported the re-election of Marion Beeler, Secretary General of EFCLIN, as treasurer and of Simon Rodwell, Secretary General of ACLM, as secretary.

Discussing the priorities from June 2021 onwards, the board agreed to continue the efforts to support the business in the transition from the Medical Devices Directive to the Medical Devices Regulation and to work on distribution channels to support the contact lens consumer journey.

Euromcontact also supports the European agenda towards more sustainability and will continue to engage with contact lens wearers and eye care Nicoletta Losi. Source: Euromcontact

professionals to increase education on waste collection.

Time on the internet during COVID-19 A new study by Lenstore has analyzed the top countries around the

During the past year, computer and mobile screen usage drastically

world that are the most addicted to their screens.

increased on a global scale. A staggering 76% of the population between

In terms of screen time, Filipinos are the most avid phone users with an

16 and 24 are spending more time on their phones, while 45% have increased

average of ten hours of screen time per day since the outbreak of COVID-19,

the amount of time they spend on their laptops. And it’s not just phones

a 17-minute increase from January 2020. South Africa and Brazil are next

and laptops that are the digital culprits: 34% of the population is spending

in line with an average of 9.39 and 9.34 hours of screen time respectively.

more time watching TV, while 22% have increased their tablet usage.

Residents in Japan, on the other hand, are the least addicted to their phones

According to behavioural optometrist, Bhavin Shah, staring at screens

with an average of just 4.30 hours of screen time each day, followed by the

can have a big impact on transient blurry vision, an increased need for

Netherlands who look at their screens for 4.45 hours. Germany, Denmark

wearing glasses, the discomfort of the eyes, and performance at work.

and France all have an average screen time of just over five hours.

It can also have a detrimental effect on our neck and shoulders.

WEBINARS, CONFERENCES & TRADE FAIRS 2021

N

(due to the corona crisis, please check via the websites whether the event takes place)

6

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

Webinar: Contact lenses and allergy – fixing that itch (BCLA members only) www.bcla.org.uk

July 14

online event

ICSC 2021 www.icscmeeting.com

July 23-24

Fort Lauderdale, FL (USA)

ECLSO Symposium www.eclso.eu

Sep 4

online event

IOFT 2021 International Optical Fair Tokyo www.ioft.jp/en-gb.html

Oct 18-20

Tokyo (JPN)

American Academy of Optometry https://academymeeting.org/

Nov 3-6

Boston, MA (USA)

ECLSO Symposium www.eclso.eu

Nov 26-28

Sibiu (Rumania)









GlobalCONTACT 2-21

30.06.21 17:34

Look

!AZ.ind

INTERNATIONAL NEWS

New members at BostonSight’s board of directors

Southeastern University College of Optometry, where he was a

BostonSight has announced the election of Dr. Howard Purcell

principal in the development of the department of cornea and

and Mr. Ron Remy to the board of directors.

contact lenses. Dr. Purcell has also served as the senior vice president,

Dr. Purcell is the current president and CEO of the New England

customer development for Essilor of America and senior director

College of Optometry (NECO). He began his optometric career in

of professional affairs for Johnson & Johnson Vision Care. He is a

a group optometric practice. In 1991, he joined the faculty of Nova

diplomate in the Cornea and Contact Lens Section of the American Academy of Optometry and a graduate of NECO. Mr. Remy is the chief executive officer at Mobile Heartbeat, a software company that improves clinical collaboration by connecting patients’ care teams through a single, unified platform. Mr. Remy has more than 20 years of technology management and leadership experience.

He has served as president and CEO of Auspice Corporation, and chief operating officer of Modiv Media and BioMed 20/20 Technologies. He began his career as a systems engineer for Sun Microsystems. He holds a BS in electrical engineering from Brown University and an MBA from Harvard Business School.

Dr. Howard Purcell and Ron Remy. Source: BostonSight

WCO calls for a standard of care for myopia management

by correcting myopia, while also providing evidence-based

Furthering its commitment to address the global epidemic of

that slow the progression of myopia, for improved quality of life

interventions (e.g., contact lenses, spectacles, pharmaceuticals)

childhood myopia, the World Council of Optometry (WCO)

and better eye health today and into the future.

board of directors unanimously approved a resolution advising

It also advises optometrists to incorporate within their practice the

optometrists to incorporate a standard of care for myopia

standard of care for myopia management, which shifts from simply

management within their practices.

correcting vision to managing the condition, and includes public

The resolution defines the evidence-based standard of care as

education and early, frequent discussions with parents that explain:

comprising of three main components:

• What myopia is.

• Mitigation – optometrists educating and counseling parents

• Lifestyle factors that may impact myopia.

and children, during early and regular eye exams, on lifestyle,

• The increased risks to long-term ocular health that myopia brings.

dietary, and other factors to prevent or delay the onset of myopia.

• The available approaches that can be used to manage myopia

• Measurement – optometrists evaluating the status of a patient

and slow its progression.

during regular comprehensive vision and eye health exams, such

The standard of care resolution can be found in its entirety on

as measuring refractive error and axial length whenever possible.

the World Council of Optometry’s website, here:

• Management – optometrists addressing patients’ needs of today

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10.06.21 17:34 12:49 30.06.21

INTERNATIONAL NEWS

All about markets Loss of working hours

Mido 2021 | Digital Edition

In 2020,

These are the numbers of the digital edition of Mido 2021:

8.8%

Almost 50,000 interactions on the business platform, 438 display pages, more

of global working hours were lost relative to the fourth quarter of

than 5,700 registered users, 50% international attendance

2019, equivalent to 255 million full-time jobs. Working-hour losses in 2020 were approximately four times greater than during the global financial crisis in 2009.

Mido

International Labour Organization (ILO)

G20 GPD growth



Year-on-year GDP growth of the G20 area rebounded to

3.4% in the first quarter of 2021, following a contraction of (minus) 0.7% in the

CL compliance level in students 266 university students with an average age of 22 years completed an online questionnaire in Spain. ­ The findings:

COVID-19 at an earlier stage than other countries, recorded the highest

39.1%

annual growth (18.3%), while the UK recorded the largest annual fall

complied with the replacement schedule, 63.6 % report

(minus 6.1%).

more hours of wear that recommended, 64.9 % have not

previous quarter. Among G20 economies, China, which was affected by

been informed about potential risks of CL wear, OECD

42.1 % expose their CL to water frequently.

DOI 10.1016/j.clae.2021.01.006

Beijing displaces New York to ­become the ­billionaire capital Cities with the highest number of billionaires in 2020

8

08_All About Markets.indd 8

GlobalCONTACT 2-21

29.06.21 16:49

INDUSTRY NEWS

All about products At K&Y Diamond Ltd, it’s all about finding the best solutions for our valued customers.

Whether it’s manufacturing a special diamond tool used to make scleral lenses (as shown) or helping to solve surface finish issues, out team of dedicated technicians and engineers are always willing to go the extra mile.

It’s one reason why we’ve grown into one of the world’s largest manufacturers of single-crystal diamond tools used to make RGP lenses, IOL’S and optical molds.

Our diamonds are in both large and small labs in over 60 countries. It’s earned us a reputation for delivering a superior product at a fair price.

Our consistent growth allows us to invest in both state-of-the art manufacturing systems and the latest metrology; some of which is found nowhere else. If you’re not using us for your tooling needs, why not? Let us put our +40 years of experience to work for you! kydiamond@kydiamond.ca, www.kydiamond.ca

Comprehensive IOL testing in R&D WaveMaster® IOL 2 is TRIOPTICS universal measuring system for the quality control of all common refractive intraocular lenses such as monofocal, toric, spherical and aspherical lenses. Based on a Shack-Hartmann sensor the system runs fully automatically and user independently. It determines refractive power, lens aberrations with comprehensive Zernike analysis, toric axis deviation and marker orientation, MTF, EFL and PSF. Measurements are possible in air as well as in the heated in-situ model eye that was designed in accordance with ISO 11979. With a measurement accuracy that is three times more exact than required in ISO, the WaveMaster IOL 2 is the perfect choice for each R&D lab. info@trioptics.com, www.trioptics.com

Contact lens metrology – NIMOEVO & CLE-MENTOR’s API: a success story illustrated by the NIMO/FocalPoints integration.

Medical Device Regulation (MDR) has become a major point of concern for all contact lenses manufacturers. Today, a metrology tool cannot only be reliable and performant, it also requires a high level of data safety and traceability.

Thanks to its database and its powerful API (Application Programming Interface), NIMO has been efficiently interfaced with the ERP system of several Labs. Among the new functionalities of CLE-MENTOR, discover the NIMO/ FocalPoints integration now in operation in various Specialty Labs. See our customer testimonials here: https://www.lambda-x.com/en/nimo-focalpoints sales-ophthalmics@lambda-x.com, www.lambda-x.com

GlobalCONTACT 2-21

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INTERNATIONAL NEWS

All about research

Studies on diagnostic contact lenses, a new sensor system, and tear film Information technology increasingly finds its way into health research. Two studies show how smart contact lenses are intended to help diagnose and treat diabetes.

The pre-lens drying time of two types of daily disposable contact lenses was the focus of research by Sebastian Marx, Julia Eckstein and Wolfgang Sickenberger.

Photonic contact lens for diabetic diagnosis

concentration in the conjunctival blood vessels by analyzing the near infrared light.

They put their LED contact lenses on rabbit eyes with diabetic retinopathy disease and irradiated light repeatedly for a month. As a result, they confirmed that there was significant reduction of angiogenesis (production of new blood vessels) in the retina and verified the clinical feasibility of the smart LED contact lens for the diabetic retinopathy therapy.

This device is supposed to let diabetic patients monitor their blood-sugar level in real-time and also enable medical treatment for retinopathy which is caused by diabetic complications.

Based on these results, the team also developed a wearable

Geon-Hui Lee, Hanul Moon, Hyemin Kim, and a team of

medical device to analyze glucose concentration in sweat, and

researchers developed a technology that allows diagnosis of

verified that it could be clinically feasible for diabetes diagnosis.

diabetes and treatment of diabetic retinopathy by wearing a

With the company PHI Biomed, they developed a blue-tooth

'smart light-emitting diode (LED) contact lens.'

system that can send data wirelessly, with the goal of allowing

The team invented a photonic contact lens and a wearable medical

patients to check their diabetic diagnostic results on their

device which can diagnose diabetes and treat diabetic retinopathy.

mobile phones.

The research team developed a contact lens with integrated micro LED and photodetector which can measure glucose 10

10_AllAboutResearch.indd 10

Sources: Abstract of the study [1], EurekAlert 2020-02-10 [2] GlobalCONTACT 2-21

30.06.21 17:46

INTERNATIONAL NEWS

Hydrogel contact lens for biomarker sensing

artificial tears in the channels were measured at different levels of hydration, with zero flow measured at complete dehydration and full spontaneous flow observed at full hydration.

A noteworthy observation during these tests was that when the hydrogel was mildly dehydrated, liquid flow in the channels would stop, but when additional rhythmic pressure was applied, the flow would resume. This was a demonstration of support for the hypothesis that eye blinking would also provide the

A collaborative team, which includes a group from the Terasaki

necessary pressure and additional hydration needed to allow

Institute for Biomedical Innovation, has developed a fabrication

for tear flow in the contact lens, and therefore, in the eye.

method to meet the challenges in making a hydrogel contact

Next, the team prototyped sensors to collect, test for and

lens for biomarker sensing. The work was supported by a grant

measure pH levels of artificial tears f lowing through the

from CooperVision. The team began by optimizing the

microchannels. Sodium levels were also tested, and the results

components of the hydrogel to obtain elastic characteristics

showed an acceptable and predicted range of sodium detection

which would allow it to be engineered into various shapes with

for diagnostic purposes.

a smooth surface profile. They next fashioned microchannels

Additional goals would be to fine-tune factors such as humidity,

in the hydrogel with the use of a 3D printed mold. The final

hydrogel hydration and applied pressure in order to enhance

step in the fabrication process was to enclose the hydrogel

all the flow rates and dynamics of the biosensing contact lens.

channels by bonding an additional layer of hydrogel onto the

There are also plans to experiment with smaller channels in

microchannel surface.

thinner hydrogel films before a final contact lens is devised.

Once the prototype was completed, it was tested for its performance in channeling and collecting fluids. Flow rates of

Sources: Abstract of the study [3], EurekAlert 2020-11-23 [4]

Tear film stability of daily disposables The wettability of a contact lens plays an important role in the experience of comfort for its wearer. Sebastian Marx, Julia Eckstein and Wolfgang Sickenberger have evaluated the non-invasive pre-lens drying time of two types of daily disposable contact lenses (DDCLs) after twelve hours of wear in vivo.

As stated in the abstract of the paper the prospective, randomized, single-center, cross-over pilot study evaluated

The researchers found that the mean time to reach 15% ring

31 subjects aged 18–44 years with normal eyes and good tear

distortion was similar for Nelfilcon A and Stenfilcon A DDCLs

film stability who were adapted soft contact lens wearers at the

but varied highly among subjects. The mean speed of break-up

time. The researchers had the subjects wear Nelfilcon A and

at 15 sec post-blink is reported as 0.3±0.38% distortion/sec for

Stenfilcon A DDCLs for twelve hours each on two different

Nelfilcon A and 0.2±0.23% distortion/sec for Stenfilcon A

days. They recorded non-invasive video keratography drying-up

DDCLs.

time (NIK-DUT) videos of each eye twelve hours after lens

Marx, Eckstein and Sickenberger came to the conclusion that

insertion for about 25 seconds. A five minute tear film recovery

multifunctional topography allowed the objective evaluation of

time was allowed between video recordings of the right and

in vivo pre-lens tear film stability using ring mire projection.

left eyes to avoid bias. The team measured the post-blink time

The researchers describe the dynamic method as being simple,

required to reach 15% distortion of the projected rings and the

fast and non-invasive, enabling measurements of NIK-DUT and

speed of break-up at 15 seconds post-blink at each time point.

evaluating wettability over an area that is larger than the optical

They determined the on-eye wettability by ring mire projection

zone of the contact lens surface, for the entire inter-blink interval.

under white light illumination.

Source: Abstract of the study [5]

Referenzen: [1] Lee, GH., Moon, H., Kim, H. et al. Multifunctional materials for implantable and wearable photonic healthcare devices. Nat Rev Mater 5, 149–165 (2020). https://doi.org/10.1038/s41578-019-0167-3 [2] https://www.eurekalert.org/pub_releases/2020-01/puos-nnt011020.php [3] Chen, Yihang et al. Microengineered poly(HEMA) hydrogels for wearable contact lens biosensing. Lab Chip, 2020,20, 4205-4214. DOI: 10.1039/ D0LC00446D [4] https://www.eurekalert.org/pub_releases/2020-11/tifb-clf112020.php [5] Marx S, Eckstein J, Sickenberger W. Objective Analysis of Pre-Lens Tear Film Stability of Daily Disposable Contact Lenses Using Ring Mire Projection. Clin Optom (Auckl). 2020;12:203-211 https://doi.org/10.2147/OPTO.S262353 GlobalCONTACT 2-21

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INTERVIEW

Speed date – Meet the new board members of EFCLIN The European Federation of the Contact Lens and IOL Industries, EFCLIN, has elected two new members to its board of directors in 2021. Alan Bennett, a senior quality leader for the specialty vision products team of Bausch & Lomb, now serves as secretary to EFCLIN. Dr. William Lee, VP of R&D and regulatory affairs at AST Products, Inc. (U.S.A.) and president of ICARES Medicus, Inc. (Taiwan), has taken on the role of treasurer.

GlobalCONTACT has asked both the same seven questions. By Silke Sage

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INTERVIEW

For the second year in a row, EFCLIN members were unable

Lee: I am the VP of R&D and regulatory

to meet in person due to the pandemic. On April 16, 2021 – for

affairs at AST Products, Inc. (U.S.A.)

the first time in its history – they met online for the annual

and the president of Icares Medicus,

general meeting. This date also marked the end of the second

Inc. (Taiwan). As an engineer,

period of service for two board members: Tanja Malkus , B+L

executive and entrepreneur, I have

Boston Materials, who served as secretary on the board, and

over 30 years of experience in surface

Peter Vermeulen Ophtecs-Europe B.V., hitherto treasurer. Both

treatment technology, and product

were honored for their commitment to EFCLIN and their work

design and development for IOLs and

was acknowledged.

IOL injectors. I am the sole inventor of the

It was also announced when the next live meeting will take

LubriMATRIX surface treatment technology

place: The 2022 EFCLIN Annual Congress and Exhibition

that has been applied onto more than five million IOL injectors

will be held from 28th to 30th April 2022 at the Melia Hotel

annually, and was awarded the 2020 Heroes of Chemistry Award

in Sitges/Barcelona, Spain. The organizers will stay with

by the American Chemical Society (ACS). I obtained my Ph.D.

the concept of lectures in the morning, exhibition in the

in chemistry and biotechnology, B.Eng. and M.Eng. in chemical

afternoon.

engineering from the University of Tokyo, Japan. I am fluent in

But first things first: Let's take time to get to know the new

seven languages including English, Japanese, Mandarin and

players. 7 questions, 7 answers to Alan Bennett and Dr.

Malay, and a serial Japanese calligraphy awardee in Japan.

D r W il li a m L e e

William Lee. GlobalCONTACT: What are your goals and plans for your upcoming GlobalCONTACT: Briefly describe yourself: what is your professional

time as a board member?

background and which of your skills are of particular value to EFCLIN?

Bennett: My primary focus is split two ways: The first is to

Bennett: My professional background was originally in the

support the industry in every way I know how in terms of

field of industrial engineering (process improvements, process

the regulatory challenges that have been so prominent in

measurement and operational planning) for the Royal Mail

our industry. There is the EU MDR – a monumental hurdle

in the UK. After 20 years I needed a change and moved to

to cross for companies large or small; there are the new UK

Bausch & Lomb. I have been in the field of medical device

regulations (post-Brexit), and then there are the new

quality for eleven years and have found myself increasingly

challenges from the PFAS chemicals issue (as a result of the

involved at an industry level through

EU Chemicals Strategy).

collaboration with Euromcontact,

The second is to help promote EFCLIN and build sustainable

the ACLM (UK) and now with

growth in active membership, which is why I volunteered to

EFCLIN as a newly appointed

serve as secretary within the board structure. I have learned

board member.

over the past few years that our industry has grown stronger

As we are all starkly aware the

and more effective in how it tackles regulatory and quality

regulatory landscape within

challenges if we all work together – one unified, stronger

E u r op e h a s d r a m at ic a l l y changed since the publication of the EU MDR, and continues to present

voice!

Alan B e n nett

Lee: Firstly, to assist in expanding the network of EFCLIN to the IOL and contact lens communities around the world.

additional challenges – such as the PFAS

Particularly, I think the IOL section of EFCLIN still has a lot

chemicals issue. With my strong background in quality and

of room to expand and improve in order to create more value

experience of working closely with the incredible industry

for our members. Secondly, to match academic research with

associations I intend to leverage this knowledge to the industry’s

industries for more innovative commercialization of technologies

benefit by working in a much more influential way with the

that will bring value and benefits to the end users.

EFCLIN community.

WITH ALL OF THE REGULATORY CHALLENGES THE INDUSTRY HAS HAD TO FOCUS ON THESE IN ORDER TO PROTECT ITSELF LONG TERM. (ALAN BENNETT)

GlobalCONTACT 2-21

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INTERVIEW

WE NEED TO CREATE A COMMON PLACE FOR MEMBERS TO EXCHANGE IDEAS THAT WOULD EVENTUALLY LEAD TO INNOVATIVE CREATIONS. (DR. WILLIAM LEE)

GlobalCONTACT: What excites you about serving as a board member?

Lee: Integration of various technologies in order to create and

Bennett: Working with such a talented and energized group

commercialize the so-called smart contact lenses and smart

of industry professionals – both on the board, and being

IOLs, and eventually bring values and benefits to the end users.

able to work more closely w it h t he various member companies. When you get such a diverse range of talents

GlobalCONTACT: How can EFCLIN continue to increase its number

together in one place you are always going to get a result

of members?

that is something special. Our industry has the benefit of

Bennett: Continue to reach out to companies that are not members

presenting endless learning opportunities, so by working

and help them to understand how working with one voice will

with so many different people those opportunities remain

help the industry, both to endure and to grow. In addition we can

fresh and exciting.

extend our reach through creative use of remote working tools

Lee: As mentioned above, to assist on expanding the IOL section

– something that the COVID pandemic has taught us all.

of EFCLIN.

Lee: While the number is important, I think more importantly, the quality of members has to be achieved. In order to do so,

GlobalCONTACT: What have you achieved so far?

EFCLIN needs to step up its standard and quality so that all

Bennett: So far, having attended my first board meeting, I have

members can have a win-win relationship. We need to create

started contributing to the initial plans for the 2022 EFCLIN

a common place for members to exchange ideas that would

Congress. In the last few weeks I have also acted as moderator

eventually lead to innovative creations. Before achieving such,

for the IOL edge profiles webinar delivered by Dr. Mayank

we need to provide valuable lectures, seminars and an annual

Nanavaty (Consultant Ophthalmologist).

conference in order to attract more members and attendees.

Lee: To get Santen Pharmaceutical to become a corporate member of the EFCLIN this month.

GlobalCONTACT: What do you like to say to the members of EFCLIN? Bennett: These difficult times will pass us by. As an industry we

GlobalCONTACT: What does the industry need most right now?

have amazing products that help our professional clinical colleagues

Bennett: In short – stability! With all of the regulatory

to protect the precious gift of sight. EFCLIN is committed to

challenges that have happened over the past few years, as well

bringing together our industry and to support its growth through

as the ongoing ones, the industry has had to focus on these in

innovation. Thank you to all of our members for supporting our

order to protect itself long term. These challenges create a lot

goals, and I – along with my board colleagues – look forward to

of worry that ultimately detracts from the creative process of

continuing to work with you all long into the future.

bringing new and innovative products to market. We now need

Lee: I am very honored to have been elected as a board member

a stable period wherein we can all implement the required

and I will try my best to bring more values to all of us in the

changes, get our organizations onto a good track and then do

EFCLIN family.

what we all do best – support our professional customers as they support their patients.

14

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GlobalCONTACT: Thank you for the interview.

GlobalCONTACT 2-21

29.06.21 17:12

FITTING BACKGROUND

Imaging techniques Photo presentation: HFAK students present their findings in GlobalCONTACT

Photograph Corinna Kurz, Matthias Lagodny

What can be seen here?

When looking at the back surface of the lens with the specular illumination, two sharply defined circles can be seen in the lower nasal area of the right eye in figure 1.

No abnormalities are visible on the posterior surface of the left lens.

1

Imaging technique:

Slitlamp: 40 x magnification, specular illumination (Haag-Streit BQ 900, Koeniz, Schweiz)

Finding:

The hyaloid artery, which was present during embryonic development to supply nutrients to the developing lens, started at this point. It regresses again until birth.

Presumably, the posterior circle was the point of attachment of the canalis hyaloideus – also called the Cloquet's canal, which once encased the arteria hyaloidea within the vitreous body.

This finding could also be mistaken for a cyst on the posterior surface of the eye lens (see image 2, 25x magnification). However, as two circles are clearly visible on picture 1 at 40x magnification (on the lens posterior surface and posterior lens capsule), the above-mentioned finding – also called Mittendorf Dot – is very likely.

Characteristics:

2

This is a physiological anomaly. In rare cases, partial anopsia may occur if the hyaloid artery has not regressed (arteria hyaloidea persistens).

Further procedure:

Treatment is not necessary in this case and a change in abnormality is not expected as the hyaloid artery has completely regressed.

GlobalCONTACT 2-21

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FITTING BACKGROUND

Mind the gap The knowledge gap between understanding ocular surface shape and contact lens shape is narrowing quickly as of late, which is contributing to a better understanding of on-eye soft lens fitting characteristics and the future of the modality. It seems that one little gap needs to be closed: the gap in between the ocular surface and the back surface of the contact lens. By Eef van der Worp

A popular Netflix documentary ‘The Social Dilemma’ sheds a

studies done on scleral shape with the sole purpose of fitting

completely new light on social media and how this can be used

scleral lenses. Based on different methods including optical

in the future – an eye-opening film that perhaps everyone

coherence tomography (OCT), profilometry and Scheimpflug

should see. In our soft lens arena, we are facing an equally

technology, the overall sagittal height (OC-SAG) over a 15 mm

interesting ‘dilemma’ as discussed here previously in

chord in the horizontal meridian is thought to be in the

GlobalCONTACT. In short: eye care practitioners do not ‘fit’

3750-micron range. Some Placido disc topographers are also

soft lenses; at best, they select one. But based on what? That is

capable of fairly accurately estimating the OC-SAG based on

the big question. In line with the mentioned documentary, new

extrapolation from measured corneal data. The chord or

technology could be a game changer for this dilemma.

diameter of 15 mm is chosen and generally accepted as the

WORKBENCH

16

16_Eef.indd 16

‘workbench’ for soft lens fitting, because a typical soft lens is in the 14.2 mm range and allows for about 0.2 or 0.3 mm of

Let’s start at the beginning. What do we know about the ocular

movement on each side.

surface and its shape? Parts of this have been covered in

But what about individual variation within each eye? A number

GlobalCONTACT before, as most of this research stems from

of recent studies looked at the amount of difference within GlobalCONTACT 2-21

30.06.21 17:41

FITTING BACKGROUND

different (semi-)meridians of the normal eye. Consejo et al looked at anterior scleral regional variation between Asian and Caucasian populations using the Eye Surface Profiler (Eaglet Eye). They used 6 mm , 7 mm , 8 mm and 9 mm distances from the centre in 121 eyes. Looking at the 7 mm data (approximately our desired 7.5 mm half-chord, for our purposes), it showed that the maximum difference between the eight meridians (in the 0°, 45°, 90°, 135°, 180°, 225°, 270° and 315° directions) was 240 microns based on the averages of all eyes. So, this suggests

THERE IS A LOWERING OF THE SAGITTAL HEIGHT VALUE WHEN THE LENS IS APPLIED TO THE EYE, POSSIBLY IN THE 180-MICRON RANGE BASED ON THEORETICAL CALCULATIONS.

that 240 microns is the amount of ‘relative flexure’ that a soft lens must go through to fully conform to the anterior ocular surface shape in different meridians/segments.

FLEX ‘To flex’ is a slang term meaning ‘to show off’. Wouldn’t it be

deviation (SD) of ± 74 microns). E.g., this is the amount of

nice if we could measure the amount of OC-SAG variation

relative ‘flex’ in microns of a soft lens on the eye. The minimum

within one eye? Then we could really ‘show off’ and better

difference on an individual eye was 90 microns, but the

predict soft lens f lexure on-eye. A practical question in

maximum difference was up to 390 microns for another eye.

conjunction with this is: can we measure just the horizontal

It appears that some eyes have substantially higher OC-SAG

OC-SAG (as this is by far the easiest to measure) to predict the

values horizontally than vertically, but equally often it is the

overall OC-SAG value?

other way around. This explains the low ‘mean difference’

In considering horizontal versus vertical differences in eye

reported earlier. Comparing H/OC-SAG and V/OC-SAG in

dimensions, we are typically ‘stuck’ in thinking about corneal

absolute terms, the difference is 109 microns (SD ± 79), with a

diameter and visible iris diameter (VID). Our current

range of 0-255 microns. For the H/OC-SAG compared to the

understanding is that the vertical VID is substantially smaller

average overall OC-SAG, this is a 79-micron difference (SD ±

compared to the horizontal one (HVID). Hence, the common

49 micron), with a range of 8-190 microns.

advice is to measure the oblique VID (to be in between, as an

What this seems to imply is that you can measure H/OC-SAG

artificial average). Does this translate to OC-SAG? The difference

with a given instrument, but you have to take into account that

in the Consejo paper between the average horizontal OC-SAG

this number is ‘somewhat’ off: roughly 100 microns on average,

(H/OC-SAG) and the vertical (V/OC-SAG) of all eyes was

but more for some individual eyes, of course. Hence, ideally

60 microns over a 7 mm half-chord. The difference between

you would measure the average OC-SAG in 360 degrees to

the average H/OC-SAG meridian and the average OC-SAG of

calculate the actual average ocular surface shape. Having said

all eyes was only 20 microns. This looks promising, but remember

that, soft lenses are very forgiving and flexible, and the clinical

that these are all average values. If the OC-SAG is sometimes

significance of a 100-micron variation is up for debate. To

smaller and sometimes bigger, then the average would artificially

emphasise that differences between eyes and individuals exist,

generate a low number.

Consejo et al did find differences between Asian eyes and

INDIVIDUAL EYES Markus Ritzmann published a paper in Contact Lens & Anterior Eye a number of years ago looking into the same matter using

Caucasian eyes in that the Asian anterior sclera was found to be flatter than in Caucasians.

TOOLS

OCT imaging (Zeiss Visante). On 39 normal healthy subjects,

What do we know about our ‘tools’ – the lenses that we have

he too looked at eight meridians at a distance of 7.5 mm from

in our arsenal – to fit that ocular surface? First and foremost,

the centre. The difference among eyes was 118 microns. His

the new CLEAR publications on evidence-based contact lens

average values show comfortably low numbers for average

practice by the BCLA group state that: ‘Ideally the lenses’

values similar to the Consejo paper; the difference between H/

sagittal height (CL-SAG) should be matched to corneal sagittal

OC-SAG and V/OC-SAG was only 13 microns, and it was only

height’. Please note that sagittal ‘height’ is used for both the

5 microns between H/OC-SAG and the overall average

ocular surface and for the lens (not ‘depth’). The paper also

OC-SAG.

states that these SAG values for lenses are not widely available.

Going back to the original Ritzmann source data, though, and

A new study recently published in Contact Lens & Anterior

analysing individual eyes rather than mean values as was

Eye by a team at Pacific University explores the CL-SAG of 44

suggested by Consejo, a slightly different picture is painted:

commercially available daily disposable and reusable lenses in

the average eye shows 227 microns of difference (with a standard

spherical and toric variations. As we speak, new lenses are

GlobalCONTACT 2-21

16_Eef.indd 17

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30.06.21 17:41

FITTING BACKGROUND

THE TEMPERATURE INDEED IS A FACTOR TO TAKE INTO ACCOUNT.

microns over its labelled diameter, then this would mean a roughly 75-micron difference to take into account for the change from room to on-eye temperature.

CLOSING THE GAP So, on the contact lens side, the gap in knowledge is closing too. But what happens if a soft lens goes on the eye? There is not enough room in this article to cover that in detail – more on that in future editions of GlobalCONTACT – but the essence is that the lens has to be substantially ‘steeper’ than the ocular surface to create an acceptable lens fit. If the CL-SAG matches the OC-SAG, the lens moves too much, influenced by tear film being analysed by Ben Coldrick at Optimec in the UK with the

and eyelid/blinking and even gravity forces. How much steeper?

is830 instrument. What all lenses analysed, recently and in the

In Graeme Young’s landmark publications on mathematical

past, have in common is that the lenses (per ISO standards)

modelling of soft lens fitting and the inter-relationship between

are measured at room temperature or 20°C. However, if the

diameter, base curve and lens fit – the term ‘edge strain’ was

lens goes on the eye, the temperature actually rises to a mean

coined. The optimal or ideal ‘edge strain’ supposedly is 2.7%,

of 34°C. One would expect that number to be dependent on

according to Young. Simplified, this means that a lens has to

environmental circumstances (e.g., cold or warm weather), but

be steeper than the ocular surface to create the ‘right’ amount

it appears that outside conditions are only responsible for just

of flexure, and thus the right amount of grip, for a good lens

a few degrees of difference in on-eye temperature – hardly

fit to be achieved. In that case, the on-eye lens diameter increases

clinically relevant, it seems.

by 2.7% after flexure.

A HOT TOPIC

optimally fitting lens (i.e., an edge strain 2.7%), the sagittal

temperature does make a huge difference in lens shape. It may

height of the lens decreases by approximately 5% on-eye. Going

be surprising for eye care practitioners to learn that the average

back to the mentioned Pacific database of all spherical lenses

lens ‘shrinks’ on-eye. By how much is the question. A landmark

(average CL-SAG of 3666 microns) and after applying a

paper by Graeme Young et al in 2016 looked at the effect of

temperature shrinkage factor of 2% to that, a further 5% on-eye

temperature on soft lens diameter. To determine the difference,

decrease would be in the 180-micron range.

they calculated the ‘shrink factor’ by taking the on-eye

One other factor that is mentioned regarding soft lens fitting

temperature diameter and dividing that by the room temperature

is that there could be something ‘lost,’ as the lens does not per

diameter. He looked at 24 different lenses: the shrink factor on

se fully align with the ocular surface. In other words, there

average was 0.982 (a 2% difference), varying between 0.997 and

could be a ‘post-lens gap’ between CL-SAG and OC-SAG, after

0.950 (depending on material). This is for diameter – what does

flexure. Recent OCT studies have shown the post-lens gap to

this mean for CL-SAG? Could the shrink factor used for diameter

be extremely low, though; up to a few microns – less than the

be applied to CL-SAG too? A small study by Coldrick and

thickness of a red blood cell, typically – and this factor therefore

Richards presented as a poster at the Global Specialty Lens

appears to be a neglectable one.

versus temperature change. Although this was a small pilot

16_Eef.indd 18

height value when the lens is applied to the eye. With a typical

But making the transition from room temperature to eye

Symposium (GSLS) in 2016 looked at both diameter and CL-SAG

18

In essence, according to Young, there is a lowering of the sagittal

F

F-FACTOR

study, with a large variation of lens materials, thicknesses and

Bringing it back to our terminology in contact lens practice,

powers, the shrink factor for diameter was 0.968, and this was

this edge strain and relative steepness of the lens could therefore

in line with the shrink factor for CL-SAGs (0.966). The range

be transformed into a ‘flex-factor’ describing the amount of

in shrink factor was 0.991 and 0.941 for that potpourri of

flexure of a given lens on the ocular surface. One would want

different lenses.

‘a number’ to add to the OC-SAG to come up with the optimal

This shows that temperature indeed is a factor to take into

lens of first choice. However, this depends on a number of

account. The exact magnitude is to be determined, though.

variables including the exact material of the lens, the thickness

The new lenses currently being analysed are going to be measured

of the lens and external factors such as tear film and eyelid

at 20°C and at 34°C to get a better understanding of this. If we

forces. The term fitting factor therefore could prove to be more

would use – hypothetically – the shrink factor found by Young

practical than flex-factor. But in essence, this factor might not

of 2% (although variance up to 5% seems possible) and use the

be that easy to uncover and may prove to be a pain in the butt

average of all spherical lenses in the Pacific study of 3666

to nail down, as it is dependent on material and many other GlobalCONTACT 2-21

30.06.21 17:41

!AZ.ind

FITTING BACKGROUND

factors. Hence, the F-factor, in a way, almost seems like it would

CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K,

be the best term. But no matter how you look at it, ‘F-factor’

Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice.

seems to be the appropriate term for this final piece of the

Cont Lens Anterior Eye. 2021 Apr;44(2):368-397. doi: 10.1016/j.

puzzle. Mind the gap. It’s the missing piece of the puzzle.

clae.2021.02.008. Epub 2021 Mar 25. PMID: 33775383.

• Young G. Mathematical model for evaluating soft contact lens fit.

Optom Vis Sci. 2014; 91:e167–76.

See the Pacific website via the URL and

• Young G. The inter-relationship of soft contact lens base curve

QR code for full access (and future updates

radius, diameter and fit. ECLSO meeting, Izmir (Turkey). Oct 2015.

and additions).

• Young G, Potts M, Sulley A.The Effect of Temperature on Soft Contact Lens Diameter. Eye Contact Lens. 2016; 42(5):298-302

Sources: • Consejo A, Wu R, Abass A. Anterior Scleral Regional Variation between Asian and Caucasian Populations. J Clin Med. 2020 Oct 25;9(11):3419.

• Ritzmann M, Caroline PJ, Börret R, Korszen E. An analysis of anterior scleral shape and its role in the design and fitting of scleral contact lenses. Cont Lens Anterior Eye. 2018 Apr;41(2):205-213 • Van der Worp Eef, Matthew Lampa, Beth Kinoshita, Mari J. Fujimoto, Benjamin J. Coldrick, Patrick Caroline. Variation in sag values in daily disposable, reusable and toric soft contact lenses. Cont Lens Anterior Eye. Jan 2021. DOI: https://doi.org/10.1016/j.clae.2020.11.006 • Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen

Eef van der Worp, BOptom, PhD, FAAO, FIACLE, FBCLA, FSLS is an educator and researcher. He received his optometry degree from the Hogeschool van Utrecht in the Netherlands (NL) and has served as a head of the contact lens department at the school for over eight years. He received his PhD from the University of Maastricht (NL) in 2008.

He is a fellow of the AAO, IACLE, BCLA and the SLS. He is currently adjunct Professor at the University of Montreal University College of Optometry (CA) and adjunct assistant Professor at Pacific University College of Optometry (Oregon, USA). He lectures extensively worldwide and is a guest lecturer at a number of Universities in the US and Europe.

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18.02.21 17:41 12:47 30.06.21

HISTORY

Kevin Tuohy (l.) during lens fitting

The success of Kevin Tuohy History of the first corneal lenses The history of contact lenses begins in the late Middle Ages when the first attempts were made to compensate for malformations of the eye using water-filled glass bowls. The breakthrough

Fig. 1: Blown glass scleral lens,1924.

came towards the end of the 19th century when the German ophthalmologist Adolf Eugen Fick, the French ophthalmologist Eugène Kalt and the German doctoral student August Müller developed the first scleral shells made of mineral glass that could be worn on the eye. Around 1888 they experimented independently with small shells that rested on the cornea and parts of the sclera.

A decisive contribution to today’s contact lenses was made in the first half of the 20th century by the American optician Kevin Tuohy. By Hans-Walter Roth 20

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HISTORY

The first scleral shells made of glass at the end of the 19th century served

Fig. 2: First report on the new lens with picture of Kevin Tuohy, 1948.

exclusively to compensate for malformations of the cornea, evening out irregularities of the anterior surface of the eye by applying gentle pressure to the cornea. These anomalies were the consequences of a variety of symptoms such as corneal staphyloma, the historical term for keratoconus or cicatricial astigmatism as a result of malformation, inflammation or injury. In such cases, it was not possible to achieve satisfactory compensation with spectacle lenses. Early attempts at contact optics often failed because the glass available was difficult to mold and the original two-curve design still required a lens diameter of over 20 mm which, due to its poor gas permeability, significantly impaired corneal metabolism (Fig. 1). Frequent lens breakage also made the lenses difficult to wear for a long time.

THE BREAKTHROUGH: PLASTIC LENSES The breakthrough in contact optics only came with the successful

Fig. 3: Press report about the invisible vision aid from 1948.

synthesis of a transparent plastic: polymethyl methacrylate.

Its easy formability when heated, the ease with which it could be reworked and lastly its high breaking strength made it the plastic of choice in contact optics for many years. However, the disadvantage remained that large scleral lenses could still only be worn for a limited amount of time each day. Impairment of the corneal metabolism due to lack of oxygen permeability of the material and restricted tear convection under the scleral lens made it impossible to wear such lenses for longer periods. In the long run, smaller lens diameters had to be achieved. This would become possible thanks to the

Fig. 4: DIn 1949, the headline read "The Corneal Lens".

American optician Kevin Tuohy (1919-1968) (Fig. 2) who was the first to patent a much smaller corneal lens in 1948.

He called it corneal lens (Fig. 3), a term that was confusing at the time. The reason for this was that some inventors before him also referred to their lenses as corneal lenses. Although these lenses also covered the cornea, with their wide rim they were seated on the sclera; thus they were better termed scleral shells or scleral lenses.

AS CHANCE WOULD HAVE IT Like many great inventions, the discovery of the corneal lens was ultimately due to an accident. While measuring the diameter of a scleral lens on the lathe, its haptic part

Fig. 5: Early large-diameter corneal lenses from Solex.

– i.e. the part located on the sclera – accidentally split off; all that remained was its central part, i.e. its optical zone. The lens was GlobalCONTACT 2-21

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HISTORY

Fig. 6: List of fitting parameters for the first corneal lenses.

Like ma ny grea t inventio ns, the corneal lens wa s ultimate ly discove red by chance .

Fig. 7: Lens values available and tolerance range of the first Solex corneal lenses .

going to be discarded but somehow Tuohy came up with the idea

standardization was to make it easy for as many opticians as

of trying out this fragment which only covered the cornea on

possible to fit them, as well as to be able to manufacture them

himself, or as other reports say on his wife. Contrary to

in large quantities. In order to achieve an optimal fit, the inner

expectations, this middle part of the scleral lens positioned itself

radii had to be curved in such a way that ultimately the lens

spontaneously directly in front of the cornea. The foreign body

could only move up and down in front of the cornea through

feeling also seemed to be acceptable. The development of a corneal

a capillary gap filled with tear fluid when the eye blinked or

lens which could be worn for longer periods of time had begun.

was closed. Initially, the inner curvature of the lens was

In 1948 Kevin Tuohy was granted the first patent in the USA

calculated based on the central radii of curvature of the front

for a contact lens made of PMMA, now known as a corneal or

surface of the cornea, from which pre-defined parameters for

mini-lens (Fig. 5). As noted in the patent specification, his lens

the fitting sets could then be derived (Fig. 6).

still had a diameter of 11.0 mm and a central thickness of 0.3 mm (Fig. 4). At the time, Tuohy was working for Solex, who

22

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MODERN MEASUREMENT DATA COMES INTO PLAY

immediately skillfully brought this new kind of "corneal

It was soon realized that the lens fit was only optimal when

mini-lens" to the attention of the public.

multispherical inner curves were used. Now the use of Gullstrand's

However, before they could go to market, it was still necessary

ophthalmometer for determining the central radii of curvature

to introduce standardization of the lens parameters, in contrast

of the cornea and their use for selecting the base curve of the

to the scleral lenses previously produced from thermoplastic

corneal lens took on a particular importance. Indeed, this

impressions of the eye or on a lathe. The purpose of this

measurement data is still the basis of all contact lens fitting today.

GlobalCONTACT 2-21

30.06.21 17:45

HISTORY

Fig. 8: Graphic representation of the lens design for myopia.

Fig. 9: Distance vision test charts from the Solex contact lens studio.

Fig. 10: Test chart for children.

Fig. 11: Test chart for near vision, card game.

Once it had been proven that contact lenses with the diameter

equipment from his workshop on

of the cornea could be worn comfortably on the eye, Tuohy

display but also some of his drawings

continued with his experiments. He recognized that the design

(Fig. 8), graphs and the first fitting

of the edge of the lens was largely responsible for the fit on the

sets of his corneal lenses. Even the

eye, the loss rate and ultimately for the wearing comfort.

test charts from his studio at Solex

While the back surface of the corneal lens – also known as the

are still to be seen (Figs. 9, 10 & 11).

inner or base curve – was primarily responsible for the seat of the lens on the eye, an optical zone had to be incorporated into

THE RIGHT MARKETING

its front surface. Its values were based on the respective refraction

Tuohy knew better than anyone else how to advertise his "Tiny

values of the eye. The first corneal lenses were still over 10 mm

Lenses" as he called his contact lenses in the media. (Fig. 12).

in diameter with rounded edges. After measuring the central

With catchy advertising slogans, he knew how to get people’s

radius of curvature as a basic value, the optimal lens design

attention. "The new window for your eyes" was the headline of

had to be determined by trial and error. The Solex product

the New York Times in 1949, going on to explain that his lenses

range (Fig. 7) contains the lens parameters available for the

were "held on the eye by tears alone". “The new mini-lenses do

first fitting set of Tuohy’s corneal lenses.

not irritate the eye,” wrote the London Observer in 1951. To

Some of the equipment from Tuohy's workplace is still on

demonstrate the quality of PMMA as a lens material, the article

display. It can be seen in the Contact Lens Museum at Forest

mentions that it was the same plastic material as used for the

Grove, Oregon, USA on the Atlantic coast. Not only is there

cockpits of US Air Force bombers.

GlobalCONTACT 2-21

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30.06.21 17:45

HISTORY

Fig. 12: "Tiny Lenses" made of plastic material from aircraft panes.

Fig. 13: Advertisement for Tuohy's invisible vision aid, 1952.

Fig. 14: Eye casts for molding contact lenses .

Almost all the media at the time

comfort of contact lenses through their own developments. Both

reported on his invention and its wearers, and he

before and after him, opticians, optometrists and ophthalmologists

constantly encouraged prominent artists, actors and athletes

were constantly searching for new, better-tolerated plastics and

to wear the lenses. At the time, however, not all lens wearers

lens designs, in order to extend daily wearing times and reduce

were as enthusiastic about the "invisible lens for everyone"

foreign body irritation. For example, Heinrich Wöhlk, a scientist

(Fig. 13). Corneal lenses were still often accompanied by a

from Kiel in Germany who developed a contact lens made of

strong foreign body feeling in the eye, and it often took several

Plexiglas in 1946, should undoubtedly be considered one of the

weeks to get used to them. There was no advice on lens cleaning

pioneers of the corneal lens. He certainly made a mistake in not

or care, and artificial tear drops for rewetting the lenses had

applying to patent his lens in 1947, ahead of Kevin Tuohy. As a

not yet been introduced.

result, Tuohy took precedence and the credit for having developed

Even one US president is reputed to have worn the lenses, and

the scleral lens into the corneal lens, thus making it suitable for

Marilyn Monroe is also said to have been one of his customers.

almost everyone with ametropia to wear.

While the eye casts in a museum in Ulm, Germany, made for the production of contact lenses (Fig. 14) could possibly be ascribed to her, this cannot be proven beyond doubt because the relevant prescription data is missing. All that is known for

Dr. Hans-Walter Roth Institut für Wissenschaftliche Kontaktoptik Ulm, Germany.

E-mail: institut.roth.ulm@t-online.de

certain is that the casts came from Tuohy's workshop.

Kevin Tuohy was not the only person who worked on the development of hard contact lenses in the post World War II years, countless others contributed to improving the wearing 24

20_Tuohy.indd 24

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30.06.21 17:45

PR-Advert

Larsen Equipment In 2004, Keith Parker and I opened Advanced Vision Technologies (AVT). At that time, the economy was going through a very bad recession and as a result, it was impossible for a new business starting up to get a loan. We immediately reached out to Erik and Pam at Larsen Equipment to get refurbished equipment to use in our Laboratory. As AVT’s business grew, we invested in many different pieces of new equipment from Larsen Equipment and this helped us grow into one of the Premiere Labs in the United States. Our success is due in part to Erik and his Team with their state-of-the-art equipment and maintenance of their products. AVT is forever grateful for Larsen Equipment’s support of AVT. It is great to know AVT is working with Industry leaders with the Larsen Equipment and their Team!

Janine Bungo, Vice President

PRESIDENT: KEITH PARKER

QUALITY MANAGER: RANDY MINGOY I have known Erik Larsen since 1992. Since then I have used

I have had the pleasure of working Erik since the beginning of

just about every piece of equipment his company has built. My

Larsen Equipment. The first piece of equipment, a 6 spindle

experience with Erik and the Larsen team has been one of great

horizontal arm polisher revolutionized our production of GP

appreciation as they have always helped me in my needs of

contact lenses. Through the years, I watched his business grow

fully understanding equipment used to manufacture quality

as he and his team listened to our Industry needs and developed

contact lenses. Erik has also been able to engineer any part

now numerous products not only simplifying many tasks of

needed for me even it was a custom part.

manufacturing but improving the consistency of quality in

Erik (Larsen equipment) has been and still is a pioneer in the

our finished products. Innovation has been an ongoing

contact lens and optical industry, and I am thankful to him

experience of our Company only made possible through the

for his support over the years.

innovation of necessary equipment developed and made Randy Mingoy

available by the Larsen team.

Quality Manager

Larsen Equipment is a family owned business hosting a team

Advanced Vision Technologies

of willing Staff all having the attitude of serving their

DIRECTOR OF OPERATIONS: JORDAN GOBEL

Customer’s needs. As a Customer, we are made to feel like we have a friend in the business helping us develop a more

There can be a lot of moving parts when it comes to managing

efficient process allowing our Company to deliver better

operations, so it is key to have reliable precision equipment

products for our Customers.

that assists in overall efficiency. Larsen Equipment delivers just

Our success of AVT simply could not have been possible without

that! I have been utilizing Larsen manufacturing equipment

the help, assistance and dedication of Larsen Equipment. I

for over 15+ years and have yet to run in to an issue they could

will be forever grateful for my opportunity to work with Erik

not resolve. I am a satisfied owner of bladder polishers, edge

and his very capable Staff.

roller’s and auto-blockers etc. Each one of these units greatly

Keith Parker

assist in the reduction of rejects and manufacturing waste.

President

Their ability to customize and retrofit specific tools certainly sets them apart from the competition. Larsen stands behind their equipment with a knowledgeable staff that provides exceptional service. Simply put, we are a better laboratory because of our relationship with the folks at Larsen.

Jordan Gobel Director of Operations/Consultant Advanced Vision Technologies GlobalCONTACT 2-21

PR_Larsen.indd 25

969 S. Kipling Parkway, Lakewood, CO 80226 Phone: 303-384-1111 888-393-5374 Fax: 303-384-1124 www.AVTLENS.com 25

29.06.21 13:57

INTERVIEW

eMacula extended reality for the visually impaired – Interview with Dr. Jerome Legerton, Innovega What would happen if you lost most of your sight, if things you are used to recognising were suddenly no longer visible? Finding your way around in everyday life would become increasingly difficult. This is not only a problem obvious in the pandemic, where visually impaired people are dependent on help anyway.

It affects many people in various stages of visual impairment. A new device, glasses in combination with contact lenses, can improve recognition and vision to a certain extent. But beyond that, it pushes open a new door: Welcome to the world of virtual, augmented or mixed reality.

Jerry Legerton presents a previous version of a contact lens as a prototype for modern optics in Budapest in 2012.

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Photo: Silke Sage

By Silke Sage

30.06.21 18:17

INTERVIEW

GlobalCONTACT: Who are emacula's target groups?

anytime-anywhere information, direction and instruction. The

Legerton: The eMacula system is categorized as extended

contact lens enabled system brings the advantages and benefits

reality eyewear. Extended reality (XR) includes virtual reality

of wide field of view, high resolution, full color gamut, low latency,

(VR), augmented reality (AR), and mixed reality (MR). Each

greater brightness, and potential to be less power hungry.

system provides visual content to the user in different ways.

The eMacula system enabled by the iOptik contact lens may

GlobalCONTACT: How can I imagine the view through the glasses?

be used for all three forms of XR. VR employs an occluded

Legerton: AR and MR employ a transparent display technology

display in glasses or a headset. The real world is blocked by the

in glasses that allows the user to see the display content and

display. Even so, the content or media on the display can be

the real world at the same time. AR presents the image in the

very high resolution, bright, and in a full color gamut.

transparent display without being registered to the real world.

The first target group for the eMacula VR system will be the

The image simply is viewed simultaneously like an insect on a

visually impaired. The advantage and benefit of the eMacula

windshield is seen simultaneously with the real world when

system over other VR systems for the visually impaired is the

driving. MR employs greater technology to register the image

wide field of view in combination with lightweight and stylish

with the real world to allow it to be manipulated in size, position

eyeglass form factor. The software that takes the image from an

and action with the real world. MR presents far greater challenges

onboard camera or from a mobile phone or PC enhances the

with the need for additional sensors, electronics, processing

image for the visually impaired. The first enhancement is to enlarge

and power consumption. MR is regarded as one of the most

the image in proportion to the best corrected visual acuity. The

difficult technology challenges of this decade. We see the added

user can control the image enlargement, brightness, contrast and

challenge of making the MR display eyewear useful while

color rendering. The wider the field of view of the system, the

making it usable with regard to weight, comfort and appearance.

greater the ability to enlarge the image and still see enough of the

This understanding supports the prediction that VR and AR

image. Small field of view systems cause a loss of context when

systems will be adopted well before full MR systems.

the image is enlarged. In other words, the user sees less of what they want to view even though the image is large enough to resolve.

GlobalCONTACT: On what technology is augmented reality achieved?

Legerton: AR is achieved by way of image processing to

GlobalCONTACT: How does the use of the devices work?

micro-displays that are placed in a near eye location. There are

Legerton: Innovega designed two systems for the visually

three primary technologies: Waveguide, off axis projection

impaired that we call ambulatory and non-ambulatory. The

which is sometimes called holographic, or beam combining

ambulatory system or mobile system can be worn in all settings

by use of occluded micro-displays and some form of optical

and is expected to be used by the visually impaired for driving

combiner. The goal in each case is to put an image in front of

in the same manner as bioptic telescopes. The ambulatory

the line of sight of each eye in a pair of glasses or a headset.

eMacula system delivers variable magnification, brightness, contrast and scene manipulation while the bioptic telescope is

GlobalCONTACT: The lens power is generated via the contact lens.

fixed for each of these.

Up to what prescription does the glasses/CL-system work? Are there

The non-ambulatory system is designed for stationary activities

limits, if so what are they?

like reading, desk work, and vocational tasks. The field of view

Legerton: The Innovega iOptik contact lens is similar to any

can be larger than the ambulatory system and thereby allow

disposable soft lens and the power limit is governed in the same

for greater magnification while maintaining more image context.

manner as any molded soft lens.

These same systems may be used by fully sighted individuals.

There is value in the ambulatory system for anytime-anywhere

GlobalCONTACT: How many smart glasses do you currently produce

information. The system may be used for spectator activities

and who are your customers?

to eliminate the need to use binoculars while also allowing

Legerton: This question actually addresses our business model.

simultaneous media feed to enhance the enjoyment of the

Innovega is executing a licensing model wherein we are licensing

spectator event. Sports training or performance enhancement

our technology to contact lens partners and to display eyewear

is anticipated with the ambulatory system as well. Sensors and

and application partners. We do not plan to produce or sell

information content systems are already in use for cycling.

finished products.

These data may be presented in the eyewear instead of on a display on the handle-bars. The cyclist can see the information

GlobalCONTACT: When will the product be available, and where?

without looking away from the path.

Legerton: The first application is for the visually impaired. We

Occupational enhancement, also called enterprise, is already a

are seeking FDA market clearance for the iOptik contact lens

significant target for XR headsets and eyewear. The eMacula

and then will follow with CE marking. The first markets will

systems may be employed in many industries to allow for

be North America, the United Kingdom and Europe.

GlobalCONTACT 2-21

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30.06.21 18:17

INTERVIEW

GlobalCONTACT: Where is production taking place?

We are pleased to see that other XR developers are thinking

Legerton: We see value in the contact lenses being produced

about refractive correction. We anticipate that XR will be

close to or in the market where they are distributed. Ideal

another reason for wearing contact lenses since the placement

licensees will be located close to the eye care practitioners who

of spectacle lenses behind an already heavy or bulky headset

will be fitting the iOptik lenses in the same region.

or display eyewear seems to exacerbate the comfort and appearance challenges that already exist. The Fresnel solution

GlobalCONTACT: What are the biggest challenges in production?

helps to keep the weight down. Visual noise must be avoided

Legerton: Our lens is in the category that we call component

in all systems and we believe fully sighted consumers will

containing. The lens has an encapsulated two-state gas permeable

demand excellent clarity.

light polarizing filter. We developed methods of transferring the filter to the lens substrate during molding. This method of

GlobalCONTACT: How much does the unit weigh?

manufacturing is more complex than single stage molding

Legerton: Our eyewear weight goal is to be less than 60 grams.

used for disposable soft lenses. We have ongoing process

There will be a constant push to achieve 45 grams and then

engineering to drive the cost out of the manufacturing.

30 grams. The reality that today’s conventional eyewear is very light must be respected.

GlobalCONTACT: Currently there is a product from Germany that uses a Fresnel lens integrated monocular into the spectacle lens.

GlobalCONTACT: Who will distribute the glasses and contact lenses?

The lens power can be integrated directly (no matter what power)

Legerton: We are in discussions with a global distributor of

into the spectacle lenses. Why do you think the solution with a

products for the visually impaired. They will distribute the

contact lens is better?

eyewear and the regional contact lens manufacturer will distribute

Legerton: We clearly believe in what we call eye-borne optics.

the contact lenses to the eye care providers who fit them. North

The lens power required to directly view a near eye display

America and Europe have different channel economics and

ranges from +60.00 to +85.00 diopters depending on the vertex

systems. The low vision specialist in the US is most often an

distance of the display from the eye. The majority of users also

independent practitioner or an employed practitioner in an

need vision correction and the majority of those needing vision

institutional setting. The same individual will fit the iOptik

correction have some astigmatism and need for a cylindrical

contact lens and dispense the eMacula eyewear. It is ideal to have

lens component. It just makes sense to us to put the refractive

the two parts of the system delivered under the same roof.

correction along with the micro-lens for viewing the display

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26_Innovega.indd 28

in a contact lens or intra-ocular lens.

GlobalCONTACT: Will the glasses be roadworthy?

We also believe in providing users with binocular vision and

Legerton: The eyewear must be robust. The industrial design

fulfilling the global mission of eye care professionals to provide

of the eyewear is a major development component in the same

clear comfortable two-eyed vision at all distances. All of our

manner as the design of a mobile phone. Impact tolerance and

reference designs and methods of fitting are directed to binocular

heat dissipation are design requirements along with weight

vision and usual and customary correction of refractive error.

and power use reduction.

GlobalCONTACT 2-21

30.06.21 18:17

!AZ.ind

INTERVIEW

GlobalCONTACT: How can the product be arranged with data

significant minification of components. We believe consumers

protection? Are there any hurdles here?

will see fully functional telecommunication eyewear at some

Legerton: The software developers for each application follow

point. Before that time, we see value in tethered eyewear in an

the state of the art that is applied to other electronic devices.

effort to keep power and data sources off the eyewear to achieve

Efforts are made to employ connectivity that is contemporary

the weight reduction and improved styling.

with all electronic devices.

GlobalCONTACT: Thank you for this Interview!

GlobalCONTACT: Does the device have to be equipped with its own (electronic) simcard or does it only use the connection to the smartphone. Which implies: It must be carried at all times? Also during sports?

Legerton: We have reference designs for tethered eyewear and eyewear that has wireless connectivity. Keep in mind that a fundamental goal for the eyewear is to be lightweight and stylish. This usually means that it is best to put everything possible somewhere other than in the eyewear or work to significantly reduce what is called SWaP, size, weight and power.

There is a rapidly growing group of folks who believe in the post mobile phone era. The 5G providers are all eager to move the telecommunications console to eyewear and away from

Dr. Jerome A. Legerton: OD, MS, MBA, FAAO, Director of Innovega Practiced for 26 years prior to launching a successful career in contact lens development and commercialization; 57 issued U.S. patents, co-inventor of Paragon CRT contact lenses, the market leader for overnight corneal reshaping. Co-founder and former CTO and EVP of SynergEyes, Inc., the world leader in hybrid contact lenses, before joining Innovega to lead contact lens design and clinical and regulatory activities.

mobile phones. The achievement of this vision will require

Advertisement

!AZ.indd 5 26_Innovega.indd 29

20.03.20 18:17 17:54 30.06.21

TECHNOLOGY

The importance of poroelasticity in soft contact lenses Evidence of the pore space of a silicone hydrogel contact lens as transport path for pore diffusion and molecular diffusion – Part 1.

Scleral lenses, hybrid lenses or Ortho-K: To ensure safe use of these types of contact lenses, the main focus is on the oxygen permeability of the plastic material of the lens. The metabolism of the cornea and the limbus should suffer as little irritation as possible. The aim of this article is to explain how this transport mechanism occurs and why it is so important. By Alina Kinder In an age of retro looks and vintage design, even conventional

degeneration/dystrophy using contact lenses made of modern

systems are being updated offering newer approaches to

materials not only stabilizes the vision but the lenses are also

solutions. Scleral lenses have made a comeback in contact lens

physiologically safer for wearing all day long.

optics. Using these lenses where only the edge is seated on the

Other contact lenses, such as the orthokeratology contact lenses

sclera, and which thus can be adapted to more complex corneal

(Ortho-K), have also gained in significance since the introduction

geometries , the discomfort to the physiology of the already

of modern materials and have been able to reposition themselves

stressed cornea through contact lens wear is kept as low as

in contact lens optics since the advent of higher oxygen

possible thanks to new materials and higher oxygen

permeable materials. Furthermore, the importance of corneal

permeability. [2]

swelling is not insignificant, especially with Ortho-K lenses.

[1]

In addition, lens systems such as hybrid lenses and also piggyback lenses catering for more complex corneal geometries

OXYGEN PERMEABILITY AS A KEY FACTOR

have made a comeback in contact lens optics. Here, too, the

To ensure safe use of the above-mentioned systems, the main

benefit of lenses made of newer materials is to ensure a better

focus is on the oxygen permeability of the plastic material

oxygen supply to the cornea.

Current studies show that

of the contact lenses. The lens material must perfectly satisfy

treating keratoconiosis, keratoplasty and some forms of corneal

the optical requirements in addition to the requirements

30

30_KinderPoroelastizitaet.indd 30

[3]

GlobalCONTACT 2-21

30.06.21 17:04

TECHNOLOGY

regarding the comfort of the contact lens wearer, without irritating the metabolism of the cornea and the limbus; or with only minimal irritation. For this reason, oxygen permeability is already taken into account during the production of the plastic material.

An inadequate supply of oxygen to the cornea can lead to

• too high acidity of the cornea resulting in lactate build up in the stroma.

• osmotic water influx into the cornea resulting in edema formation.

• structural changes of the cornea, such as loosening of the cell bond in the epithelium with an associated increase in the rate of loss of epithelial cells.

Fig. 1: Schematic visualization of oxygen permeability. Lotrafilcon B, left with -3.00 dpt and right with -10.00 dpt [8]

Thus one of the main aims when fitting contact lenses is to preserve the anatomical and functional integrity together with

Nowadays, modern equipment can track the potential oxygen

the rigidity of the cornea, in order to minimize the physiological

transmissibility over the entire surface of a soft contact lens in

changes mentioned above. [4,5]

relation to the dioptric effect of the lens. This theoretical

Contact lens optics use the permeability or transmissibility of

approach, aimed at visualizing the oxygen permeability of the

the contact lens material as a suitable parameter for describing

contact lens, is realized purely theoretically via the ratio of the

or predicting whether the plastic material has a high or low

permeability to the corresponding thickness of the lens with

impact on the physiology of the cornea.

a dioptric effect. For this, the transmissibility, i.e. the Dk/t value of the individual points of the lens, is allocated a color

SOFT MATTER

code designed to indicate the permeability (Fig. 1).

In science, soft matter is used to describe a state where a

The color codes correspond to the internationally valid

distinction cannot easily be made between liquid and solid. Soft

minimum Dk/t values. As early as 1984, Holden and Mertz

matter can also be described as amorphous. Polymer melts and

identified a critical limit value of 84 Dk/t for extended wear,

solutions as well as elastomers (rubber), for example, are classified

in order to keep corneal swelling overnight as low as possible.

as soft matter, and the same is also true for soft contact lens

In 2009, Harvitt and Bonnano's study recommended higher

materials. [6]

limits, such as a minimum value of 35 Dk/t for daytime wear

In the literature, the transmissibility of solutes in soft matter is

and a minimum of 125 Dk/t for extended wear (EW), with a

described by permeability. In chemistry, with regard to soft

minimum of 140 Dk/t for EW. [9,10]

matter, permeability also refers to the aggregate state of the

With hard contact lenses, which are clearly in a solid state,

material.

the analogy with the Dk/t value clearly cannot be maintained.

Permeability alone cannot adequately define the solute

In such cases, comparison of the oxygen permeability of

transmissibility of a soft matter material. [7]

the respective materials is given purely by the Dk value.

Such amorphous polymers are produced by polymerization

Here contact lens optics attributes the reason for good

processes based on polyaddition or polycondensation. The

oxygen transmission through hard contact lenses to the

particular polymerization process used in turn determines the

high amounts of silicone and f luorine as oxygen carriers.

properties of the plastic.

Accordingly, a comparison of soft and hard contact lenses

DK/T AND DK VALUES

with regard to material permeability is only possible based on the Dk value.

Permeability describes the transmissibility of dissolved particles

A study by Hideji Ichijima and H. Dwight Cavanagh compared

in the material. The oxygen permeability of a contact lens

the permeability of a hard contact lens with a value of 90 Dk/t

material is referred to by manufacturers as the Dk value

*10-9 ml(O2) * cm/ml * hPa*s with a soft silicone hydrogel

(permeability), where D is the diffusion constant of the material

contact lens with a value of 125 Dk/t *10-9 ml(O2) * cm/ml *

and k the solubility constant of the material.

hPa*s and found that the hard contact lens delivered more

For a better analogy, in contact lens optics the property of

oxygen in total to the cornea than the highly oxygen-permeable

oxygen transmission in soft contact lenses is given by the Dk/t

silicone hydrogel contact lens. [11] This result was not due to the

value. For this purpose, the geometric thickness of the center

respective permeability of the contact lens materials, but rather

of the contact lens to be compared with a power of -3.00 dpt is

to the different diameter sizes of the lenses, and thus to the

set as the reference distance.

different areas of the cornea covered.

GlobalCONTACT 2-21

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TECHNOLOGY

Fig. 2: Model of the interpenetrating network (IPN) of a silicone hydrogel contact lens. The aqueous phase runs through the channels (blue arrow). The channel system is embedded in a silicone hydrogel material (white arrow).

The size of the lens diameter of a hard contact lens may be 20%

suggest any other means for transporting solutes. It is

to 30% smaller than the diameter of the cornea. The exposed

interesting to note that the product description does not

area of the cornea thus enables oxygen to reach the cornea via

make any distinction between the different aggregate states

the physiological way, through the tear film by diffusion, driven

"solid" and "soft". The Dk/t value is rarely mentioned for

by the partial pressure difference of the oxygen.

hard contact lenses, because it is difficult to imagine that

HYDROGEL VS. SILICONE HYDROGEL

oxygen can diffuse through the solid contact lens material within a reasonable wearing time. In this regard, the industry

The product descriptions of contact lens optics emphasize the

does not seem to make use of the transmissibility method,

benefits of the individual elements such as silicone and fluorine

whereby the Dk value is only divided by the center thickness

as oxygen carriers. The selling point of the good oxygen

of the contact lens, for hard contact lenses.

permeability of modern contact lens materials lies in the high silicone content and the lattice structure of the plastic polymer.

SOLUTE TRANSPORT PATH

On the one hand, silicone acts as an oxygen carrier and, on the

The transport path of solutes through the material can also be

other hand, the regular lattice structure of the silicone hydrogel

illustrated using another model.

material acts as a water reservoir and thus as an oxygen carrier,

The first possible model is that of capillaries – cavities

as in conventional soft lenses.

running through the contact lens. Oxygen dissolves in the

In conventional contact lenses made of hydrogel material, the

tear film, enters the material through the surface openings

clear polymer lattice structure serves as a good water reservoir.

(pores) and f lows through the lens pore system to the rear

Thus the water stored in the so-called cavities (lattice interspaces)

surface of the lens, thus reaching the epithelium of the

However, based on experience

cornea. This is another way of describing the physiological

with hydrogel contact lenses, it is well known that the oxygen

path and is similar to the process of pore diffusion. Pore

permeability performance of such hydrogel lenses does not

diffusion or diffusion of gas into liquid lends itself to, and

satisfy the demands of the cornea; thus this stored water alone

can realistically describe, the process of oxygen diffusion

is not sufficient as an oxygen carrier.

through the contact lens material.

Due to the internal structure of the silicone hydrogel

Oxygen flow through the silicone is not the simplest of diffusion

material, the cross-linking, the interpenetrating network

processes. The hypothesis of pore diffusion cannot be applied

(IPN) of the two constituents silicone and hydrogel, the

to all materials, only to materials that exhibit porous

ion exchange (according to the manufacturer's information)

characteristics.

takes place in the water channels (Fig. 2). At the macroscopic

In an interpenetrating polymer network (IPN) consisting of a

level, the crystalline lattice structure of the silicone hydrogel

combination of two polymers in the form of a network, the

polymer is said to be responsible for the diffusion of the

relevant polymerization process creates a suitable cavity that

oxygen.

can be used as a pore space for pore diffusion. [13]

The cross-linking of the two components is said to be

IPN technology is a combination of silicone with a hydrogel

responsible for the improved oxygen permeability of the

material and results in a plastic mixture which is cloudy

material. This, at least, is consistent with the current view

due to dispersion and thus opaque. The solution to the

of oxygen transmission through polymeric contact lens

transparency problem lies in the network structure that

materials. Current studies of contact lens materials do not

connects the two phases separately. There is a broad range

can serve as an oxygen carrier.

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[12]

GlobalCONTACT 2-21

30.06.21 17:05

TECHNOLOGY

CURRENT STUDIES CONCERNING CONTACT LENS MATERIALS DO NOT SUGGEST ANY OTHER POSSIBLE WAYS OF SOLUTE TRANSPORT.

of applications of IPN technology, including biomedical

would be significantly reduced. Diffusion through the pores

applications, coatings and adhesives. Some of these IPN-

serves as a transport path for the dissolved particles.

crosslinked plastics exhibit a two-phase structure in the

To avoid scarring after keratoplasty or other penetrating eye

range of several 100 angstroms. This corresponds to a

surgery, a bandage lens is subsequently placed

magnitude of several 10 nm, meaning that the void space

on the cornea to protect it. [18] Here, too, the

available is also in the range of soft matter pore spaces. In

healing process is protected and encouraged

contact lens optics, pores – and thus openings of 1 - 10 nm

by pore diffusion.

(10 - 100 Å) – are known.

[15,16]

According to the International Union of Pure and Applied

This is part 1 of this article. Read part 2 in the

Chemistry (IUPAC), the pores of polymer hydrogel materials,

upcoming issue of GlobalCONTACT and in

which are openings on the outer surfaces of soft matter, are in

our app.

the range of mesopores.

Pore diameter

Nomenclature (IUPAC)

Examples

< 2 nm

Micropores

Activated carbon

2 - 50 nm

Mesopores

Polymer hydrogels

> 50 nm

Macropores

Plants

Tab. 1: Pore size according to IUPAC. [17]

References are available on request from the editorial office or are listed in the GlobalCONTACT app.

More information on using the GlobalCONTACT app on page 46.

Film dressings used in the treatment of severe skin burns are an example of the use of IPN technology for biomedical materials. Made of polymeric material, the transparent dressings transport fluid away from the damaged tissue while facilitating the ingression of oxygen to preserve the tissue cells which are still alive and enabling new tissue to form. Diffusion in the dressings is of great importance in this process, allowing a healing environment (i.e. maintaining the moisture balance) to develop at the damaged tissue site. In addition, transparent dressings allow the treating physicians to optimally follow the healing process. [13, 14] The process of pore diffusion is the process that contributes to better healing due to these transparent film dressings. It is only thanks to this film covering that the moist wound environment can be created appropriately and help the tissue to form new cells. If the processes of oxygen transport and fluid removal were to take longer, then the healing process would be

Alina Kinder (EurOptom, Master of Science (Klin. Optometr y)) is a lecturer at the Professional School for Optometr y in Cologne (HFAK). She also works as an examiner on the examiner board of ECOO diploma and optometrist (ZVA/ HWK).

considerably slowed down and thus the benefit of such dressings GlobalCONTACT 2-21

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30.06.21 17:05

REPORT

Happy Birthday!

70 years Menicon Kyoichi Tanaka was only 19 years old when he set out to develop the first Japanese contact lens in 1951. Equipped with determination, modest tools and using his own eyes for the first prototype test, he managed to produce a functioning contact lens after six years of work. This laid the foundation for the company that would later be called Menicon. In the years since then, Menicon has grown into an international group that is celebrating its 70th anniversary in 2021. By Rebekka Nurkanovic Menicon today offers a broad product portfolio that enables

product range. By constantly improving its technologies and

contact lens specialists to successfully correct almost any

quality assurance systems, Menicon has been able to achieve

refractive error with contact lenses: Flat pack daily disposable

many goals.

lenses, silicone hydrogel monthly disposable lenses, custom

Today, all Menicon products are manufactured in the company's

soft lenses, high-quality form-fitting contact lenses with

own production facilities in Japan, Singapore, The Netherlands,

innovative designs and materials, keratoconus lenses, Ortho-K

Great Britain and France.

lenses, plus care products and accessories. The range is rounded off by Menicon's Easyfit fitting program.

FROM ONE-MAN BUSINESS TO MAJOR CORPORATION

Decades of experience in research and development and high

Founder Kyoichi Tanaka was working in an optician's store

quality standards have gone into this innovative and high-quality

when he first heard about contact lenses from the wife of a US Army officer. He had never seen a contact lens but his interest was piqued and he decided to develop a contact lens himself.

He set to work in 1951, researching and testing, and in 1957 he succeeded for the first time in producing a working contact lens. He then founded Nippon Contact Lens Co. Ltd, the predecessor of Menicon.

Over time, Menicon succeeded in inventing methods to bond and polymerize materials, design innovative products, develop new manufacturing methods and build its own production facilities with fully automated production processes. Thus, the company developed Japan's first oxygen-permeable form-stable contact lens.

In 1995, Menicon established a new research and development center. From the very beginning, all processes at Menicon have been carried out internally: From material development to product designs, manufacturing, distribution and sales.

Kyochi Tanaka and the wife of a U.S. military officer, 1951.

After many decades of experience, the company began to apply the findings to other fields: veterinary ophthalmology,

Kyochi Tanaka’s notebook.

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M.T. Contact Lens – the first commercial corneal contact lens in Japan.

GlobalCONTACT 2-21

30.06.21 17:48

REPORT

Kyoichi Tanaka, Founder of Menicon environmental biotechnology and life science. One example

Dr. Hidenari Tanaka, President & CEO of Menicon

CAUSE FOR CELEBRATION

for veterinary ophthalmology is the Meni-One X, an intraocular

On the occasion of its 70th anniversary, Menicon announced

lens for dogs, which was released in 2020. With the increasing

that it has renewed its vision of Miru. "Miru" means to see, but

prevalence of myopia worldwide, Menicon has also designed

it is also about having fun and enjoyment through the five

the Bloom Myopia Control Management System, a full-service

senses, as well as being empathetic. With this new vision of

myopia control concept.

Miru, Menicon aims to make everyday life richer and filled

Dr. Hidenari Tanaka was appointed president in 2000,

with laughter through all the senses, not just the sense of sight,

succeeding his father. At the time, the Japanese economy was

the company says.

deteriorating and the market was flooded with daily disposable

Menicon also stated that it plans to continue their commitment

contact lenses from global companies. Menicon decided to

to sustainable development by providing safe vision products,

offer a monthly flat rate lens replacement service called MELS

developing environmentally friendly products and implementing

Plan that has now become one of the company’s pillars with

sustainable measures in its factories.

1,3 million plan members in Japan.

“We are so proud to be celebrating this milestone 70 th

From a small company with only two products in the beginning,

anniversary. Menicon manufactures specially controlled

Menicon has developed into a globally active company with a

medical devices, so our top priority has always been the safety

high profile within the industry. For example, Menicon has

of our customers' eyes,” said Hidenari Tanaka. “Challenge,

been listed on the Tokyo Stock Exchange and the Nagoya Stock

safety, end-user first philosophy and high-quality products

Exchange since June 2015. The capital available from the IPO

remain the cornerstone of Menicon’s continued growth and

was invested in the construction of a new manufacturing facility

success. These principles are why we are able to celebrate such

for daily disposable lenses.

a significant anniversary.”

Menicon now operates in more than 80 countries and has 16

The company’s achievements will be celebrated through special

business offices in Japan and 13 overseas. The high-quality

promotions from April 2021 to March 2022. Further information

Menicon products are manufactured in a total of eleven production

and a video of Menicon’s 70-year history can be found on the

facilities. The company generates approximately $770 million

company’s website: www.menicon.com n

(2019/FY 63) and employs around 3,500 people worldwide.

BY CONSTANTLY IMPROVING ITS TECHNOLOGIES AND QUALITY ASSURANCE SYSTEMS, MENICON HAS BEEN ABLE TO ACHIEVE MANY GOALS. Menicon R&D Center, Kasugai, Aichi, Japan GlobalCONTACT 2-21

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30.06.21 17:48

COMMENT

What a difference a year makes Looking back at an unprecedented time This article is different from my usual topics of tips, tooling, and technique. I will look at what was going on in Larsen Equipment Design (LED) and in our industry in May of 2020 as compared with May of 2021. ­ I will look at three areas of the industry: Our partner labs, LED business, and LED suppliers. By Erik Larsen Starting in early 2020, we were beginning to hear from our partner

in a similar fashion. We as machine tool manufactures however,

labs about their business situations. Orders were starting to slow,

operate on a weeks-long delivery schedule. In May of 2020, we

and the future was not clear. We at LED saw a similar trend. We

had a backlog of work of about four weeks. While this situation

saw no indication that our suppliers were having problems with

was uncomfortable, we all had work to do. As we entered June,

filling orders to us. By May of 2020, business was very different

our backlog was two weeks, but we had orders to fill. As it turned

along with every other aspect of daily life. Most of the labs saw an

out, June was the lowest month of work in-house for us.

extreme down-turn in business as did our suppliers and us. Many

We did have an unexpected increase in business from a few

of the labs and our suppliers put their workforce on furlough. This

labs that had lost local suppliers due to the general downturn.

situation would prove to be a concern later in the year as orders

These labs needed custom items (tooling, replacement parts,

started increasing requiring the workforce to return.

etc.). Another source of orders were the medium size and

ORDER BACKLOG

36

36_ErikLarsen.indd 36

multinational companies who were progressing with their plans as were set prior to the pandemic. Mergers and acquisitions

Custom labs try to deliver lenses in a few days. So, they do not

continued. Typically, we see orders soon after these transactions

have an extended backlog of work on hand. Our suppliers operate

are completed. Plus, we get to develop relationships with the GlobalCONTACT 2-21

30.06.21 17:14

!AZ.ind

COMMENT

new engineers and staff. The over-all benefit of this additional

suppliers. These range from raw materials to purchased

business may have just enabled us to keep everyone at LED

components. For raw materials, we use plastics, metals and wood.

actively employed.

We have seen single digit percent price increases for plastic and

Another source of work was research and development, both

metals, but up to 500% for wood used in shipping crates. Of

internal and for customers. Some customers decided to go

course, these costs are a very small part of our over-all costs.

ahead with projects as they saw the pandemic providing a

Purchased components – electronics, motors, bearings – have

window of opportunity.

seen price increases in the single digit percent and availability

According to our government’s criteria, LED is an essential

has remained at a few weeks. We do have a few suppliers who do

business, so we were able to stay open.

post-processing of our in-house manufactured components. With

SOCIAL DISTANCING

our region being an aero-space manufacturing centre, it was hit hard by the pandemic and other problems. Our post processing

It occurred to me that our partner labs, we at LED, and most

suppliers are heavily tied to the aero-space industry. They

of our suppliers share a working arrangement where each

furloughed a large part of their workforce. In the last few months,

person had a cubical or workstation that is at least 6’ (2 m)

we have seen the usual turn-around time of a week grow to 3-4

apart. This arrangement, along with no retail customers, allowed

weeks due to a lack of trained workers. We have been able to

us to fit in with the distancing requirements.

absorb the delay in our 10-12-week lead time, but we are managing

May of 2021 has shown an almost complete reversal (both plus

the situation more closely to maintain the delivery schedule.

and minus) as compared to May of 2020. Most labs have seen a return of orders, but for various reasons, many needed to hire

To say that we at LED have been fortunate is an understatement.

new people who require training. This situation puts an additional

We are also happy to see the optical industry and our suppliers

burden on lab managers. We saw a gradual upswing in orders

returning to pre-pandemic business volumes. I am optimistic

after a level summer of 2020 and business has steadily grown to

that our industry and associated businesses will come away

a current backlog of orders of 10-12 weeks. We have been able

stronger. n

to weather the pandemic with our team intact but with administration staff working from home, which they still are.

SUPPLIERS What effect has the pandemic had on materials and components?

I have not heard from any labs about a shortage in lens material

Erik Larsen graduated from the University of Washington with a Mechanical Engineering degree in 1981 and started Larsen Equipment Design later that year. Erik Larsen has industry awards from CLMA and EFCLIN.

or consumables. Similarly, local utilities seem to have been able to maintain their services. However, costs may have fluctuated.

At LED, we source material and components from a few dozen Advertisement

!AZ.indd 1 36_ErikLarsen.indd 37

08.06.21 17:15 09:13 30.06.21

COLUMN

Glasses are for drinking Let’s face it – we can be a bit myopic in our contact lens industry, especially when we relate contact lenses to other vision correction methods. But myopia management is not a contact lens device-driven field. It is about myopia development at a young age and how it relates to myopic retinopathy later in life. There may be ways to slow that down – the progression of myopia that is, as we cannot stop or prevent myopia from happening. By Eef van der Worp

DIMS A favourite phrase used previously at the Dutch contact lens

very careful, as this relates only to a very short period of time

association meeting (NCC) is: “glasses are for drinking” (e.g.,

during which the eye grows. The bulk of the treatment typically

not for vision correction). A tongue-in-cheek phrase, of course,

has to happen before the age of twelve. Hence, a -6D myope

deliberatly emphasising the ‘myopic viewpoint’ which you can

will not become a -3D myope, unfortunately, with treatment.

expect from a meeting solely devoted to contact lenses. On the

In fact, we can probably get about 1D of reduction in reality

other hand, it sometimes rubs a bit the wrong way for some

on average, as work by Brennan and Bullimore shows. Not that

(including for me), for instance with presbyopia, that it is so

this is negligible: at the same time, the same investigators claim

easy (and profitable) to sell a pair of multifocal glasses when

that ‘every dioptre counts’ in myopia management later in life.

contact lenses may be the preferred option by the client or

The 3-year data on the DIMS lenses is just out, and it shows

patients or even the option that would provide the best optical

surprising similarities to contact lenses: there seems to be a

solution for their needs.

tapering of the effect after the early results. They report over

Back to myopia then: a new spectacle lens has entered the

three years the spherical equivalent refraction and the axial

market that has been developed especially for myopia

length changes in the test group of 65 subjects to be −0.52±0.69D

management. It consists of a lens with a clear centre and

and 0.31±0.26mm compared to a control group. So, the DIMS

multiple droplet-like peripheral +3.5D segments. The

glasses were effective in reducing myopia progression to a degree

lenses use DIMS (Defocus Incorporated Multiple Segments)

– in line with what we see with orthokeratology and soft multifocal

technology developed by the Hong Kong Poly technic

lenses. Other glasses from other manufacturers will follow

University and HOYA.

shortly. At ARVO 2021 results of a test by Essilor will be presented.

The good thing about these glasses compared to other interventions is that they are completely pupil independent.

38

34_Column.indd 38

circumstances (not just in a trial setting), then we have to be

THE BEST?

Do they work? The 2-year data looked very promising, quoting

What is the best intervention method? The answer most probably

reduction rates of 60%. We have to realise that this is in Asian

is that there is not one, at least not a generic one. All things

eyes. We simply don’t know how that relates to other ethnicities.

considered, orthokeratology, soft multifocal lenses and DIMS

Now, we also know from the contact lens field in myopia

glasses perform in the same range if you apply them to a single

management that this is no fair way of putting things. Even íf

patient. Only very high-dose atropine may have a better track

the lens is capable of providing that 60% reduction under all

record, although this has substantial side effects. Atropine GlobalCONTACT 2-21

24.06.21 13:17

!AZ.ind

COLUMN

References • Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res. 2020 Nov 27:100923. doi: 10.1016/j.preteyeres.2020.100923. Epub ahead of print.

• Lam CS, Tang WC, Lee PH, Zhang HY, Qi H, Hasegawa K, To CH. Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3-year follow-up study. Br J Ophthalmol. 2021 Mar 17:bjophthalmol-2020-317664. doi: 10.1136/bjophthalmol-2020-317664. Epub ahead of print.

DIMS: Photo: Eef van der Worp remains a perfectly good option, though, for some, as do glasses.

The only thing that may be clear is that other intervention methods, apart from the ones mentioned here, are substantially less effective. This includes 0.01% atropine, regular hard lenses and standard bifocal glasses.

The lesson here? Let’s not be myopic about the intervention methods for myopia. The best intervention method out of the ones mentioned here is the one that best suits the particular patient in the chair at that moment. Let’s raise our glasses to that. Cheers!

Eef van der Worp, BOptom, PhD, FAAO, FIACLE, FBCLA, FSLS is an educator and researcher. He received his optometry degree from the Hogeschool van Utrecht in the Netherlands (NL) and has served as a head of the contact lens department at the school for over eight years. He received his PhD from the University of Maastricht (NL) in 2008.

He is a fellow of the AAO, IACLE, BCLA and the SLS. He is currently adjunct Professor at the University of Montreal University College of Optometry (CA) and adjunct assistant Professor at Pacific University College of Optometry (Oregon, USA). He lectures extensively worldwide and is a guest lecturer at a number of Universities in the US and Europe.

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!AZ.indd 5 34_Column.indd 39

11.06.19 13:17 10:55 24.06.21

BUSINESS + MARKETING

The five most common stumbling blocks for a successful handover in family businesses Why cross-generational continuity in the family business is not a given Family businesses have once again proven their worth in the corona crisis. With their entrepreneurship and sustainable business practices, they were able to respond more flexibly to the crisis than many large corporations. However, the pandemic also shows that structural changes are needed in family businesses. But regardless of how they position themselves in the future, the regulation of business succession remains a bottleneck for the secure continuation of every family business. The reasons for this are complex. By Carola Jungwirth

40

40_Jungwirth.indd 40

GlobalCONTACT 2-21

30.06.21 17:49

BUSINESS + MARKETING

IF THE SENIOR GENERATION RELINQUISHES INFLUENCE IN THE COMPANY AGAINST ITS WILL BUT CONTINUES TO RETAIN POWER IN THE COMPANY, IT UNDERMINES THE AUTHORITY OF THE SUCCESSOR GENERATION.

Family businesses traditionally form the backbone of the economy, e.g. 89% of companies in Germany are family-run.

TRAP #1: FAMILY CONCERNS VS. BUSINESS CONCERNS

In the USA, family businesses contribute around 54% of private

The greatest challenge for family businesses is the interplay

sector GDP and are responsible for employing 59% of private

between family and business concerns. Unlike a business, a

sector workforce. The Institut für Mittelstand (a German

family is not designed for success, but for love and harmony.

institute for small and medium-sized businesses) assumes that

Both systems – if family and business are considered as two

half of all family businesses aim for internal succession. However,

systems here – pursue different interests. Family businesses

statistics show that only seven out of ten family businesses

are particularly affected by these conflicting interests. The

succeed in transferring to the second generation. Only two of

reason for this can already be seen in the name: in a family

the ten family businesses still exist in the third generation.

business there is always family and business. These two systems

And finally, only one family business in the fourth generation

are blended when they interact. Ideally, both sets of interests

is still managed by the founding family at the operational or

should be taken into account when making business decisions

ownership level.

in a family business. However, this is not always possible.

What exactly makes the cross-generational continuation of

Operationally, it becomes difficult when greater importance is

family businesses more difficult? Even though every family

attached to family peace than to professional aspects in

business is unique and every succession is individual, typical

important business decisions. Here is a case study:

pitfalls that complicate the succession process emerge especially

An entrepreneurial couple has two children and would like to

during the generational transition. The five most common are

start the family-internal generation change in the company.

presented in this article.

Both children have signaled their general willingness to take

GlobalCONTACT 2-21

40_Jungwirth.indd 41

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30.06.21 17:49

BUSINESS + MARKETING

With each generation, the number of shareholders in a family business grows, and sometimes so does the number of intra-family conflicts. on the succession. One of the children is objectively more

managing directors would speak to each other in this tone,

suitable for succession because of their education. If the two

even more so in front of third parties.

children were external applicants, the couple would have an

Keeping roles separate is a daily challenge that only arises in

easy time choosing – they would let the objective criteria speak

family businesses. At Sunday coffee, the two protagonists still

for themselves. As parents, however, they want to treat their

sit together as father and daughter. But as soon as they enter

offspring equally, and so they decide to appoint a joint leadership

the company, their roles change. They have to put on a different

team of both siblings as the new management.

„hat” in order to be able to meet as joint managing directors

From a family perspective, it is understandable that parents

at eye level. This constant change of roles is difficult in many

want to treat their children equally. Equal treatment contributes

family businesses. It quickly comes across as artificial and

to peace within the family. From a corporate perspective, this

wooden when trying to maintain a certain form and

approach can cause problems. In the example case, the dual

professionalism in the company with the person you meet on

leadership, which was chosen for family reasons, could

Sundays in the family circle.

jeopardize the company's ability to act. If the two managing

Why does this role dilemma pose a threat to the success of

directors cannot agree, a stalemate situation may arise. This

corporate succession? When two generations of a company

can also happen in the case of a non-sibling dual leadership.

converse in a “parent-child” relationship, the authority of the

In the latter case, however, it is less likely that emotional

successor generation is limited in its outward appearance. This

arguments will lead to the stalemate.

applies above all to the perception of employees, who have a

TRAP #2: LACK OF ROLE SEPARATION BETWEEN FAMILY AND COMPANY

40_Jungwirth.indd 42

TRAP #3: MISSING THE RIGHT MOMENT FOR THE TRANSFER

A real-life example is also useful for this stumbling block:

In some cases, senior entrepreneurs are still active in the

Advisory board meeting in the medium-sized family business.

company at the ripe old age of 75, whether operationally or at

In addition to the three external advisory board members, the

shareholder level.

company founder and his successor daughter are present. Both

For them, succession is primarily a process of letting go

are active in the company as managing directors. Future

personally. That takes time. They probably spent most of their

investments are to be discussed. In the middle of the discussion,

working lives in the company, so that it became their main

the company founder takes off his spectacles, looks at the lenses

purpose in life. Many long-time entrepreneurs remain in the

and pushes the spectacles over to his daughter sitting next to

company because they don't have a “plan B” for what their lives

him with the remark: “Could you clean them?”

might look like without the family business.

WHAT HAPPENED?

42

sixth sense for “true authority” in the company.

This constellation can have a negative impact on the success of the company successor. If the previous management leaves

The founder of the company did not communicate with his

the company only at an advanced age, the family successor

co-manager as the senior boss. Instead, it was the father who

may also already have passed the age of 50. For the next

spoke to his daughter. It's hard to imagine that two unrelated

generation of executives, the long wait to take over the company GlobalCONTACT 2-21

30.06.21 17:49

BUSINESS + MARKETING

means a loss of energy and authority, and it blocks new

continue to exert influence within the company. This can be

entrepreneurial impulses. There is no objectively right time for

done, for example, by reserving retransfer rights.

company succession. According to the so-called rating criteria

If the senior generation relinquishes influence against its will

of the banks, the succession should be clarified by the 55th

but continues to retain some power in the company, it

year of life of the company owners, i.e. there should be an

undermines the authority of the successor generation. This

appropriate plan. The handover process can easily take up to

weakens the new management because there are no clear

five years. This should be taken into account when planning

decision-making structures.

the timeframe. If the succession cannot be arranged within the family, an external solution is an alternative. This is also a

HOW CAN THESE PITFALLS BE OVERCOME?

personal matter for the senior generation, which takes time

A company succession is only successful if the family business

and needs to be well planned. Succession planning under time

is led safely into the future while preserving family peace. The

pressure increases the risk of not achieving the best solution

complexity of succession issues and the interplay between

for those involved and the company.

family and business aspects can best be resolved with

TRAP #4: FINANCIAL STUMBLING BLOCKS

professional support. After all, corporate succession is an individual and personal process that must be tailored to the needs of those involved if it is to succeed.

Regardless of whether the company succession is to be handled

Two concrete measures are a good start to maneuver the flagship

internally or externally – the financial aspects of a succession

“family business” through the choppy sea of business succession:

can be a stumbling block for all variants. If the company is to be sold to an external successor, the purchase price expectations

Keeping the reins in your hands through timely planning

of the buyer and seller often diverge. It tends to be the owner/

A succession process is lengthy and extensive. In addition to

seller who makes succession planning more difficult with

numerous legal, tax and financial issues, there are personal

unrealistic price expectations. Emotional aspects also play a

issues to be addressed. To manage the complexity of this process,

role in this. As a rule, the owner is not just selling a company,

three to five years should be scheduled for the implementation

but his life's work, in which he has invested energy, time and

of the succession and an individual succession strategy should

money for decades. Many entrepreneurs find it difficult to

be created with professional help.

reduce their life's work to sober numbers. Unfortunately, life's work is not an assessment criterion when determining the value

Avoid disputes through counseling

of a company.

During the succession process, conflicts may arise between

In the case of internal succession, the main factor to consider

family members. The more conflicts arise, the more important

is the tax burden involved in the transfer. If the company shares

it is for the success of the succession to get disputes out of the

are to be transferred to the next generation free of charge, gift

way in good time, if necessary with outside support. Even legal

or inheritance tax will be incurred. If no reserves have been

or tax issues can pose a risk to a successful generational change.

set aside for this purpose, the company may get into difficulties

In addition, there may be conflicts within the family, the

due to a lack of liquidity. After all, the tax office does not wait

resolution of which is indispensable for securing family peace

long to be paid for the transaction and, in case of doubt, the

AND the future of the company.

next generation is not in a position to pay the tax amounts

In any case, the realization remains: those who are aware of

from its private capital.

the typical pitfalls in succession at an early stage take their

TRAP #5: TAX OPTIMIZATION AS A TRAP FOR BUSINESS SUCCESSION The success of an internal succession can also be jeopardized if the company shares are transferred to the next generation solely for tax-saving reasons. Tax advisors often suggest transferring the company shares to the children at an early stage in order to take advantage of gift tax allowances. However, if tax reasons are the sole reason for a generational change, the central question remains unanswered as to whether the current management is at all ready to take a step back in the company and relinquish power. If this is not the case, the senior

force away and are also able to counter them proactively.

Carola Jungwirth Succession consultant Carola Jungwirth advises family businesses and accompanies entrepreneurial families during their internal ­succession. As a lawyer and coach, she has extensive expertise in her work. Carola Jungwir th herself comes from an entrepreneurial family, worked for almost ten years as a legal advisor in a large construction group, and then managed her own family business as a managing partner in the 3rd generation. Since 2015, she has been working exclusively as a succession consultant. www.jungwirth-nachfolgeberatung.de

management may keep (legal) loopholes open in order to GlobalCONTACT 2-21

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30.06.21 17:49

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TRIOPTICS GmbH Strandbaddamm 6 22880 Wedel Germany Phone: +49 4103 18006 0

V-Optics SAS 2, rue du travail 67400 Illkirch-Graffenstaden France Phone: +33 (0) 3 67 10 28 60

www.trioptics.com sales@trioptics.com

Instruments

23.06.2020 12:37:08

info@v-optics.fr www.v-optics.fr

Instruments 45

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MASTHEAD

THE DIGITAL GLOBALCONTACT

The App on your tablet, smartphone or computer.

GLOBAL CONTACT The Website and the Magazine: The complete communication system for the contact lens industry. The magazine, 2,500 copies, is distributed to contact lens laboratories, wholesalers and other organizations active in the contact lens and IOL industry.

The website www.global-cl.com is free for all industry related professionals PUBLISHERS ADDRESS Eyepress Fachmedien GmbH Saarner Str. 151, D-45479 Mülheim a. d. Ruhr Tel.: +49-208-306683-00 Fax: +49-208-306683-99 Website: www.global-cl.com E-mail: info@global-cl.com CEO Petros Sioutis E-mail: p.sioutis@eyepress.de PUBLISHER Silke Sage, Efstathios Efthimiadis, Petros Sioutis EDITOR-IN-CHIEF Dipl.-Ing (FH) Silke Sage E-mail: silke@global-cl.com EDITOR Britta Laupichler E-mail: britta@mafo-optics.com TRANSLATIONS John Saniter, Bopfingen, Germany EDITORIAL BOARD Wim Aalbers, Erik Larsen, Eef van der Worp PRODUCTION & LAYOUT Efstathios Efthimiadis DISTRIBUTION PressUp GmbH, Postbox 70 13 11, D-22013 Hamburg Tel.: +49-40-386666-308, Fax: +49-40-386666-299 MEDIA CONSULTANT Constanze Classen Tel.: +49-208-306683-20 Fax: +49-208-306683-99 E-mail: constanze@global-cl.com ADVERTISING AGENT GREAT CHINA Beijing FOCUS Optics Culture Commnication Co. Ltd. Room 319, Building 2, Nr. 1, Northbank 1292, Nr. 15 Jianguo Eastroad, Beijing 100024 (Chaoyang), P.R. China Mrs. Jian Wang Tel.: +86-10-8537-6529 Email: jennywang_focus@126.com Skype: jennywang611 ADVERTISEMENT RATES Price list No. 10, valid from January 01, 2021 Publication Schedule 3 issues 2021: March, July, November

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GlobalCONTACT App is now available GlobalCONTACT 2-21

30.06.21 12:19

48th

EFCLIN

EUROPEAN FEDERATION OF THE

CONTACT LENS AND IOL INDUSTRIES

CONGRESS EXHIBITION

28TH – 30TH APRIL 2022 BARCELONA/SITGES, SPAIN

A WORLD OF OPPORTUNITIES 2022

Spanish culture combined with ancient and modern science has found Sitges/Barcelona to be the perfect location for business and leisure time as well.

The 48th EFCLIN Congress & Exhibition takes place there from 28th – 30th April 2022.

For an engaging lecture program, manufacturer’s forum and the best trade exhibition in the business, it can’t be beaten. It’s where the Contact Lens & IOL Industry from Europe, the Far East, North America and beyond come together… will you be there?

SAVE THE DATE

www.efclin.com/congress or e-mail us on info@efclin.com

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MORE INFORMATION WEB www.efclin.com MAIL info@efclin.com PHONE +41 41 372 10 10 FACEBOOK search: EFCLIN TWITTER @EFCLIN#efclincongress ADDRESS EFCLIN | Winkelbüel 2 | CH-6043 Adligenswil | Switzerland

27.04.21 14:22 07.06.21 12:27

CALIBRATION SHOULD BE

INTUITIVE NOT LIKE GAZING INTO A

CRYSTAL BALL

Software for Sphericity Control Precision Switch for Thickness Control Height Measurement Gauge for Accurate Tool Height

6390 Rose Lane, Carpinteria, CA 93013 USA Phone +1 805 684 8307 Fax +1 805 566 2196 dac-intl.com Chris Pantle +1 805 745 1610 cpantle@dac-intl.com Curtis Brown +1 805 745 1628 kbrown@dac-intl.com

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