Myopia is now one of the biggest threats to eye health.1 In the past 20 years, the number of people with myopia has nearly doubled—by 2050, it is projected that more than half the world’s population will have this chronic, progressive disease.2,3,4,5 The outdated perception is that myopia is simply refractive error. However, myopia is associated with increased risks to eye health in adulthood, including:
- Myopic macular degeneration (MMD)6
- Retinal detachment8
- Primary open-angle glaucoma9
It’s been shown in clinical studies that each diopter increase in myopia results in a 67% increased risk of myopic macular degeneration (MMD).11 MMD and retinal detachment can be devastating and have the strongest relationship to myopia and longer axial lengths.11,14 In people with axial length > 26mm, 25% will develop visual impairment by age 75.12
It’s important to note there is no safe level of myopia.13 In fact, over 30% of MMD occurs in people with mild to moderate myopia, measuring at -6.00 diopters or less.14
The following sections detail why Johnson & Johnson ACUVUE® Abiliti™ Overnight Therapeutic Lenses may be an effective, lifestyle-positive option that has demonstrated safety in use for children. Plus, the high rate of fitting success with customized lens-fitting software (FitAbiliti™ software) makes it easier for inexperienced practitioners to fit patients with orthokeratology lenses. Experienced practitioners also benefit with a reduction in chair time and cost associated with the lengthy process of using trial lenses to find an optimal fit.
Table 1: The increased likelihood (odds ratio) of a myopic person > 60 years developing eye disease versus an emmetrope by degree of myopia.15
What are Abiliti™ Overnight Lenses?
Johnson & Johnson Abiliti™ Overnight Lenses are FDA-approved gas permeable orthokeratology (ortho-k) lenses approved for the management of myopia. A non-surgical treatment that temporarily reshapes the cornea through central flattening and mid-peripheral steepening, ortho-k lenses are specially designed to be worn while sleeping to correct refractive error and offer the wearer clear, spectacle-free vision throughout the next day.16
Just as myopia affects all patients uniquely, Abiliti™ Overnight Lenses and Abiliti™ Overnight Lenses for Astigmatism are approved to treat a range of prescriptions including astigmatism up to 1.50 DS. Leveraging the latest technology, FitAbiliti™ software has guided eyecare professionals into consistent and successful first fit rates with a 90% success rate for spherical prescriptions and a 95% first-fit success rate for astigmatic prescriptions up to 1.50 DS.‡ Its precise algorithms also help eyecare practitioners make the critical judgment of whether a toric or spherical lens is needed.§
Mechanism of action of ortho-k lenses
Specifically, ortho-k lenses create special fluid dynamics behind the lens due to the action of the lids that result in a Positive Push Force (compressive) on the central cornea, causing a central flattening and leaving a thin (1-10µm) tear film below.17 Simultaneously, a Negative Pull Force (suction) is created in the mid-peripheral region, resulting in thickening and steepening of the mid-peripheral cornea. The resulting shape change provides an optical correction for the patient.17 Myopia is often corrected within the first week of overnight wear to result in clear vision during the waking hours, but the greatest change has been observed to occur after the first night and typically stabilizes by 7-14 days with roughly three weeks needed for full treatment effect.16
Image 2: A model of forces acting in orthokeratology.17
Abiliti™ Overnight Lens Material
Abiliti™ Overnight lenses are crafted with Menicon Z (Tisilfocon A)—an ultra-permeable copolymer made of siloxanylstyrene and fluoromethacrylate, which enable copious oxygen transmission of Dk 182 x 10-11 (cm2/sec) [mLO2/(mL * mmHg)] (ISO 18369-4).18
Image 2: Depiction of standard curve of ortho-k lens.