Solving Individual Needs
James Kershaw, OD, of North Olmstead, Ohio, relies upon Hoya PALs to tailor solutions to individual presbyopic needs. "If you pay attention to what a lens does and what a patient's expectations are, you can have a lot of success," he said.

Kershaw reaches for the HoyaluxSummit CD as his workhorse lens that solves a wide range of problems. In addition, he relies on the Hoyalux GP for presbyopes with a lot of near demand like computer use, and the Summit ECP for patients with more need at distance and intermediate. He personally wears the Hoyalux iD and enjoys its performance.

"There is no one perfect progressive lens," he explained, "so it's nice to have an arsenal to address people who say they've experienced a lot of distortion or haven't been able to adapt to bifocals." Kershaw, who serves a suburban patient base in his 31-year-old practice, keys his presentation to each patient. "If someone appreciates technology, I'll talk about the integration of the front and back surface optics," he said." But generally, people relate when I explain that a new lens design has less peripheral distortion."

Jim Kershaw, OD, measuring a patient for progressive lenses.

Kershaw relies on his local lab for technical help, and he said that Hoya's coordination oflens coatings and materials helps to deliver a quality product that commands a premium price. "My patients understand that a premium product commands a premium price," he said.

Other latest-generation lenses incorporate unique features and technologies. For example, the Kodak Unique progressive from Signet Armorlite uses proprietary production technology that automatically customizes the lens design for the patient's frame selection. This ensures the best overall visual performance for any 'B' measurement, large or very small, from 18mm to a 13mm fitting height, according to Signet Armorlite. In addition, Signet has developed a system that synchronizes the front and back surfaces of the lens for "smooth visual performance."

Visual corrections are applied to the back surface of the lens with a process called Digital Resolution Technology, and visual performance is then verified through wavefront technology. No difficult dispensing techniques or special equipment is required, according to Signet Armorlite. With the patient's monocular pupillary distance, fitting height measurements and frame selection the Kodak Unique lens design will be customized for maximum visual performance. Signet Armorlite offers Kodak Unique in 27 lens materials, including 15 photochromic choices, six polarized, and six clear lens options.

Paul Di Fiore

"I'm in practice for 21 years, and having seen the degree and range of difficulty with satisfying early presbyopes with progressive lenses, I am just in disbelief with the success I've had with the [Signet Armorlite] Kodak Unique lens," said Paul Di Fiore, OD, of Optique Boutique in Mt. Laurel and Lawrenceville, N.J.

Di Fiore attributes his success to the synchronization feature in the Kodak Unique and to the fact that the lab generates the finished lens with readings of the exact shape of the chosen frame, in addition to regular Rx and measurements. Di Fiore's office faxes a tracing of each lens to the lab.

"There's a tremendous wow factor when a patient tries on their new Unique lenses," said Fiore

Di Fiore insists that ECPs themselves have to take on the task of explaining to patients how well the Kodak Unique lens works. "I explain that this lens goes to the next generation of technology," he said. This helps in patient acceptance of a premium price: Lenses can run $350, up from $275 for other PALs. Di Fiore includes in that price Kodak's anti-static, hydrophobic, AR coating, which he says is excellent. "I also include a complete satisfaction guarantee in that price." In a half year of fitting the lens, he has done only one redo. He also offers the Kodak lens in polycarbonate, high-index plastic and photochromic materials.

PAL Choices Multiply
Shamir Insight employs proprietary Eye-Point Technology to simulate the human eye at various angles of vision. That information is combined with Rx data from the patient and frame choice in generating a personalized PAL through its trademarked Freeform Technology.

Shamir Insight is in the process of upgrading all of its semi-finished PALs to its "Freeform Optics" technology platform, which is used to produce Shamir's Creation PAL. The newest lens to be produced with Freeform Optics is the Shamir Piccolo short-corridor PAL. Two other Shamir PALs--Shamir Office and Shamir Attitude, will soon be available with Freeform Optics as well.

Shamir is also expanding its Autograph line of personalized PALs. Positioned by Shamir as a "lifestyle" lens, the Autograph design is created using a patient's specific prescription, frame measurement, pupil distance and seg height.

The technology gives Shamir Autograph optical accuracy up to 1/100 diopters, according to Shamir. Shamir currently has two Autograph lenses available to order. The original Autograph design, which is recommended for the everyday wearer, is classified as a general purpose lens with a fitting height of 19mm. The Autograph-Fashion, which has a 16mm fitting height, is made specifically for those who enjoy wearing small, contemporary frames. Additional Autograph lifestyle lenses will be released throughout the year including Occupation and Sport designs. Shamir also plans to release Autograph single-vision lenses, broadening its product line to include patients whose needs are not specific to presbyopia.

Shamir Insight now offers a Freeform certification program to its partnering labs and ECPs interested in boosting their sales of the Shamir Autograph and Shamir Creation progressive lenses. The program consists of a day-long training program where attendees learn the history, terminology, technology and process of Freeform Technology and the Shamir Freeform Family of lenses. Upon completion of the certification process, participants will be listed as a Freeform Certified Lab or ECP on Shamir's Web site, and will receive a Freeform Certified certificate and decal to post in their lab or practice as well as receiving sales aids and many other benefits.

"I'm wearing the new Creation lens from Shamir, and when I put it on I noticed a definite improvement over the Genesis lens from Shamir that I was wearing before," said Giovanni Passamonti, an optician at Mazzuca Eye and Laser Center, Inc., in Salem, N.J. Both he and the owner of the practice wear progressive lenses by Shamir, which he calls state-of-the-art in Freeform Technology. "For me, it's almost like wearing a single-vision lens with very little distortion and good peripheral vision." When he fits patients with the lens, they often remark that they have crisper vision than what they had before. "My patients notice a difference," he said.

Passamonti added that he positions the Shamir Creation at a good price point for his practice: $249.95 a pair. He also said that the lens is very flexible, accommodating a variety of styles of head and eye movements.

In addition to the Creation, Passamonti fits the Shamir Piccolo for short-corridor lenses. Once again, he can dispense with confidence. "The owner of the practice, an ophthalmologist, wears the Piccolo and is very happy with the lens."

Several other PAL suppliers have recently introduced new, digitally-surfaced products in the U.S. market. These lenses are just beginning to come to the attention of ECPs.

Seiko Optical Products of America is expanding its portfolio of progressive addition lenses (PALs) with the release this month of the Seiko Succeed Internal Free-Form, a digitally surfaced progressive that features a 100 percent back-surface design.

Although Seiko had previously introduced a back-surface PAL, the Proceed Internal Progressive, that lens is made in Japan and is only available in the U.S. on a special-order basis from Seiko. The Succeed Internal Free-Form is being distributed through select U.S. wholesale laboratories equipped with digital or direct surfacing technology to process the lens.

Seiko Succeed Internal Free-Form lenses utilize technology invented and patented by Seiko Epson, which pioneered backside PAL designs in the 1990s. The technology places the patient's entire Rx onto the back surface of the lens, leaving the front surface a perfect sphere. This alleviates the "swim and sway" effect caused when the progressive power is on the front surface, and effectively eliminates non-adapts. It also significantly expands the fields of view, since the corrective surface is placed closer to the eye, the company said.

Seiko Internal Free-Form lenses are custom made to each patient's prescription using the latest surfacing equipment. Aspheric compensation is calculated for each sphere, cylinder, axis and prism in each visual field, taking into account eye rotation and the change in vertex distance. This allows for total management of off-center astigmatism and power error, another cause of non-adapts.

Succeed Internal Free-Form lenses are available from authorized Seiko distributors in a variety of materials and coatings, including 1.67, poly and plastic, and Transitions lenses. A polarized version of the lens will be available in standard plastic and 1.67 beginning in May.

Indo Lens U.S. is also introducing digitally-surfaced PALs in the U.S. under the umbrella of "Free-form Solutions." The company offers two "global designs," a multi-purpose PAL designs in 22mm regular corridor with a soft design and a 16mm short corridor, which optimized and specialized for small frames with a fitting height of 16mm or more.

Indo also offers several "action designs" to meet specific visual needs. These include a "PC design" for indoor working environments; a "road design," which has been developed for far and intermediate distances and improves the vision quality of backwards driving or using the rear-view mirror, and an "outdoors design" optimized for outdoor activities. In addition, Indo offers "FreeDesign" PAL designs based on characteristics and parameters provided by the patient. This design will be created by Indo's R&D division upon demand and exclusively marketed by the lab who requested its development.