Alcon is looking to make a splash in the soft contacts arena with their new Dailies Total 1 (DT1) Water Gradient Contact Lenses. I had a chance to speak with Dr. Carla Mack, Alcon’s Director of Professional and Clinical Support, about how material science is changing the playing field for contact lens technology and to try out the new lenses on my own eyes. Dr. Mack brings a comprehensive background to her work with clinical, academic, research, and commercial experience including her former role as a Global Director at Bausch & Lomb.
Michael Batista, Medgadget: What are the unmet needs that Alcon set out to address with this new line of contact lenses?
Dr. Carla Mack: Patients have been wearing soft contacts for a little over 40 years (commercialized in 1971). In spite of all that work that’s been put into soft lens technology, we’re currently seeing one sixth of patients quit the use of soft contacts each year. Investigation into the root cause of patient loss revealed that nearly two thirds of patients avoid telling their doctors about their concerns. Patients with issues who aren’t speaking up most likely mentioned some of these issues to their providers and failed to see results or switched products but found that their issues continued. In these scenarios if the doctor isn’t asking about continued concerns, the patients aren’t telling.
Understanding that patients were not voicing their issues motivated us to give providers simple questionnaires that asked patients to rate comfort of their lens on a scale of 1-10 right after putting their contacts in, in the middle of the day, and right before taking the lenses out. This basic questionnaire provided an important starting point for patients to bring up their concerns.
As we collected more information from patients, we identified that their main pain points include dryness (62%), end of day comfort (69%), and irritation (66%).
Medgadget: How does a water gradient lens design compare to standard soft contact lenses?
Dr. Mack: The standard design for soft contacts is to use a single polymer throughout the lens. In contrast, Alcon’s water gradient lenses are constructed with a silicone hydrogel core that becomes a hydrophilic polymer network as you move away from the core towards the front and back of the lens. With this design the lens is able to retain water to various degrees: 33% at the core, 80% in the hydrophilic network, and almost 100% right at the front and back of the lens. The DT1s are the first and only contact lenses using this design.
Medgadget: Does the water gradient lens design confer other benefits?
Dr. Mack: Breathability and lubricity are also improved by the water gradient design. The cornea normally gets oxygen from the aqueous humor, tears, and air. Therefore, oxygen from the air in front of the eye and tears needs to be able to pass through the contact lens to achieve both comfort and white healthy eyes. With the water gradient design, permeability of the contact lens to oxygen, the breathability, is improved up to six times compared to standard soft contact lenses. Improving the lubricity of a contact lens refers to reducing friction between the eyelid surface and the lens. Due to the increased water content of the DT1s, the lubricity of these lenses surpasses all other options on the market today.
Medgadget: What feedback have you received on the DT1s?
Dr. Mack: Consumer studies have shown that 9 out of 10 patients are satisfied with the lenses. Looking at patients considering switching lenses, 13:1 chose to switch to the DT1s from their current products. Probably our proudest statistic is that 9 out of 10 patients claimed the DT1s were so comfortable they did not feel like they were wearing any lens at all!
Medgadget: What’s next for the DT1s and water gradient lenses?
Dr. Mack: At this point we’ve completed FDA clinical studies and are getting feedback from professionals and consumers. We’d like to expand our line of water gradient lenses to offer toric (used for patients with astigmatism) and multifocal options.
Medgadget: Do you have any recommendations or words of wisdom before I try the product myself?
Dr. Mack: Due to the high water content, the DT1 lenses have a moist, slippery feel. Dry fingers make taking the lenses in and out a little easier.
My ocular history, spanning the gamut of vision aides from glasses to gas permeable lenses to soft lenses, made this review of special interest to me. Having tried different types of soft contacts in the last five years, I was excited to hear about a brand bringing something new to the table in soft contact technology.
Due to an astigmatism, I require a toric lens in one eye. Since Alcon’s DT1s are currently not available as toric lenses, I wore one standard lens and one water gradient lens throughout the trial, both prescribed for single day use. Using two different lens designs simultaneously did not impair quality of sight. As expected, the combination of a standard lens with a DT1 lens achieved the same improvement in vision as my previous lenses.
Fitting: To begin the Alcon DT1 trial, I was fitted by an optometrist who provided insight into the practice’s experience with the new lenses. In general, much of the feedback from the optometrist echoed what Dr. Mack highlighted regarding the improved comfort of the new product. Most, if not all, of the optometrist’s patients felt the DT1s were a significant improvement over their current lenses and many had already made the switch to the new product. I learned that those patients who had not yet made the transition were either concerned about the cost of the new product or were patients who had a hard time physically getting the slippery lens in and out of their eyes.
First Impression: Indeed the first thing I noticed in handling the DT1s was how moist the lens felt to the touch. While noticeably hydrophilic, placing the lens into the eye is no more difficult than other lenses. However, Dr. Mack’s advice about keeping one’s fingers dry proved to be important when trying to gain traction on the lens surface during removal of the lens from the eye. Despite this challenge, I found the learning curve of using the new lenses to be reasonable considering the benefits of the product.
Comfort: Similar to Alcon’s questionnaire, I compared the comfort of standard and water gradient lenses in the morning, around noon, and at night. The comfort level of the DT1s consistently ranked higher than the standard lens throughout the day. The DT1s improvement in comfort and moisture is most poignant immediately after putting on both lenses. Throughout the day, while the difference in comfort did not make wearing two different lens designs prohibitive, the relatively lower moisture of the standard lens was noticeable. As a result, I more frequently applied a rewetting solution to the standard lens but not the water gradient lens. The difference in comfort did not make wearing two different lenses unreasonable, simply noticeable. Upon removal of the lenses at the end of the day, friction between the lens and eye was higher for the standard lens compared to the DT1.
Overall: I would recommend and encourage anyone experiencing persistent irritation and comfort issues with their current soft contacts to try out Alcon’s DT1s. The DT1s represented a noticeable, significant improvement in comfort throughout the entire day. The increased moisture content of the lens is apparent even when the lens is worn for close to 20 hours, though patients should make sure to adhere to the regimen of using the product as a daily lens. The eye actually feels drier without the DT1 lens due to how well it retains ocular moisture. Overall, a product that delivers what it promises.
- Significant improvement in comfort
- Eyes feel moist and healthy throughout the day
- Outclasses my collective experiences with other contact lens products
- Higher cost (approximately $95.00 for a pack of 90 lenses)
- Placement, and more likely removal, can be tricky
- Not yet available in specialty options such as toric or multifocal
Disclosure: Author received a free trial of Alcon’s Dailies Total 1 Water Gradient Contact Lenses for review of the product.