Beschrijving

Image surface without Relax

Image surface with Relax

Geometry

Spherical front and back optic zones
Aspheric flattening
Toric variant Relax-T available, designs like Toris

Technical Data

Parameter	from	to	steps
Total diameter	12.00 mm	15.00... 17.00 mm	0.01 mm
Base curve	7.00 mm	12.00 mm	0.01 mm
Sphere	-00.25 dpt	-40.00 dpt	0.01 dpt
Defocus Addition	+ 0.50 dpt	+ 9.00 dpt	0.01 dpt (Default +1.50 dpt)
Distance optic zone diameter ZOC	2.50 mm	6.00 mm	0.01 mm (Default 4.50 mm)
Flattening	(-) flowing	(+) pronounced	(-–) monocurve

Extra informatie

Application	Myopia Management
Indication	Regular cornea
Correction type	Astigmatism, Myopia
Lens Type	Soft
Designed by	SwissLens

Fitting advice

Use fitting advice for BC and Diameter like for corresponding unifocal design Orbis, Toris or OrbiFlex below

HDC: start with default value (Add +1.50 dpt / ZOC 4.50 mm) or use additional measurements

Optimising HDC:

Central optical zone for distance vision (Zoc) by measuring Pupil size in room lighting

small Pupil (< 5.00 mm): Zoc = 4.00 mm
medium Pupil (5.50 to 6.50 mm): Zoc = 4.50 mm
large Pupil (> 6.50 mm): Zoc = 5.00 mm

Peripheral Hyperopic Addition

2 possibilities to measure:

Near Lag of Accommodation – measured with MEM Retinoscopy
- Position yourself 33-40 cm away from the patient (2.50 -3.00 D accommodative demand). Have them either look at your nose or a near fixation card attached to your retinoscope. Use ±1.00, ±1.50 and ±2.00 flippers and start with looking at the reflex without a correcting lens, sweeping quickly along the horizontal and vertical, checking right then left eyes and then repeating. Try the +1.00 flippers first, and if you still see ‘with’ movement, quickly change to +1.50. If the reflex reverses, you get your answer at +1.25. Once you have got neutralisation or reversal, your last lens is your answer. See how this measurement works on youtube:
Near Lag of Fixation – measured with Thorington or Schober Cross
- Use the Thorington Method or Schober test (or other similar) to measure the needed Addition to bring the cross into the center of the circle.
  Patient hold the test in 33-40 cm in front of the eyes in normal gaze position. Use a red/green or polarisation filter, depending on the test. Ask the patient to look at the cross and circle and let them explain where they are. Try with the binoculars flipper plus power so long until the cross is in the middle of the circle.
  If the disparity indicates an exophoria, then this is not useful and probably the Relax lens will not work as expected.

Fitting advice and guide for soft contact lenses

Diameter and Base curve choice for the first contact lens

Measurement of the corneal diameter (HVID + 0.6 mm)* and K-readings
Determine the contact lens diameter ØT (use table below)
Determine the Base curve r0 = rcfl + BCf (use table below, rcfl = flattest central K)

Orbis (ØCornea + 2.10 mm / BCf = 0.60 mm)

Toris Bal – Torelis Bal – Borelis (ØCornea + 2.30 mm / BCf = 0.70 mm)

Toris Int/Ext – Torelis Int/Ext (ØCornea + 2.50 mm / BCf = 0.80 mm)

Example: Parameter for Toris Ballast:

Cornea parameters: ØCornea = 11.70 mm / Kreading = 7.80 / 7.70 mm

ØT = 11.70 mm + 2.30 mm = 14.00 mm
r0 = 7.80 mm + 0.70 mm = 8.50 mm

for 0.40 mm delta K, reduce 0.10 mm on r0

Definitive 74: 0.10 mm steeper

* Information: 80% of the corneal curves are statistically between 11,3 and 12,1 mm.

Progress of the adaptation

Insert trial lens for a duration of between 30 minutes and 2 hours. Over refraction (you can use the autorefractometer for getting an idea of cyl/axis).
Biomicroscopy (× 10 to 15) white light: observe the lens with patient looking straight ahead and during eye movement.
Mobility by eyelid movement (Push up test).
Sag of the lens should be from 1 to 2 mm downwards.
Appearance of the front optic zone: tear film, hydration, lubrication, deposit.
Keratometry on the contact lens: (deformation of the mires).
Check for corneal and conjunctival staining with fluorescein after lens removal.
Order the definitive lens on the basis of the SN.

Soft Contact Lens Materials

Features	Definitive 74 (SiH)	UniSil 62 (SiH)	Igel 77	CTF 67	GM3 58	Igel 58	GM3 49	ES70 UV
DK Fatt ISO 9913-1	60/44*	50/37*	39/29*	30/22*	25/19*	21/16*	16/12*	35/26*
Material type	Silicone Hydrogel	Silicone Hydrogel	Hydrogel	Hydrogel	Hydrogel	Hydrogel	Hydrogel	Hydrogel
Manufacturer	Contamac	Contamac	Contamac	Contamac	Contamac	Contamac	Contamac	Lunelle
Classification	Filcon V3	Filcon V3	Filcon II3	Filcon II2	Filcon II1	Filcon II1	Filcon II1	Filcon II2
Water content	74%	62%	77%	67%	58%	58%	49%	70%
Refractive index	1.37	1.51	1.37	1.39	1.41	1.40	1.42	1.38
Handling tint	clear / blue	blue	clear	clear	clear / blue	clear	clear / blue	clear
UV	√ (blau)	√	√	√	√	√	√	√
Normal tear film	+++	+++	++	+++	+++	++	++	++
Reduced tear film	+++	+++	+	+	++	+	+++	++
Watery tear film	+++	+++	+++	+++	++	++	++	++
Tear film with lipid	+	++	+	+	+++	++	+++	++
Tear film with protein	+	++	+	+	++	+++	+++	++
Durability	+	++	+	++	++	+++	+++	+++
Initial comfort	+++	+++	+++	+++	++	+	+	+++
Low dehydration	+++	+++	+	+	+++	++	+++	++
Moistening	+++	+++	++	++	+++	+	+++	+++
Dry eye	+++	+++	+++	++	++	+	+++	++
Non-ionic	√	√	√	√	√	√	√	√

* ×10-11 (cm2/sec) [ml 02/(ml × mm Hg)]

** ×10-11 (cm2/sec) [ml 02/(ml × hPa)]

Default material: GM3 58% white

Quality assurance

These materials are in conformity with the standard ISO 10993-1 defining the biocompatibility of materials.

SwissLens manufacturing process warrants this biocompatibility even after the manufacturing process, in particular without adding polish material. This standard is required by the quality assurance system of SwissLens

Lunelle ES70

Name: Relax Myopia | SwissLens
SKU: Relax
Availability: InStock

Lunelle ES70 Material, the optimal solution for eye health and safety since the '80s.

The researchers has led in the ’80 to the development of Essilor’s ES70 contact lens material, the most stable high quality material for soft lenses.
Through intensive research, ES70 has been proven to be one of the safest and healthiest lens materials that has been developed over time. Lenses made from ES70 material can be adapted to all types of visual defects with optimum safety and for a wide range of uses

LUNELLE ensures good oxygenation of the cornea

Material permeability is an important parameter in the fitting of contact lenses. For soft lenses, this permeability depends on the water content of the material.
The ES70 material used for Lunelle lenses has a hydrophily of 70%. It has a permeability (Dk) four times higher than that of HEMA and twice as high as that of a material with 55% hydrophily.
The choice of a non-ionic material gives a good resistance to deposits on the lens and therefore an optimal supply of oxygen throughout the life of the lens.
The material ES70 is composed of non-ionic polymers. It delivers a limited amount of protein substances to the lens surface, which ensures better visual quality.

LUNELLE ENSURES GOOD VISION FOR A LONG TIME

Lunelle considers the metabolism of the cornea. The geometry of the Lunelle lens ensures good mobility, so that a film of tears between the lens and the eye is ensured. This pumping effect contributes to a higher oxygen supply, so that the metabolism remains practically unchanged.

At the same time, the high-water content remains stable and ensures an optimal metabolism.

The combination of the ES7O material and the geometry of the Lunelle lens offers a completely safe fit by respecting the corneal metabolism.

Lunelle ES70 allows contact lenses to be used all lifelong.

The material is fully compatible with the cornea with special properties in the water bond, so that a stable geometry is achieved and therefore a low sensitivity to changes in pH, temperature and tonicity.

Lunelle lenses have good mobility and remain comfortable throughout the wearing period.

Lunelle Lenses - for a precise fit of all visual defects

The ES70 Material

The ES70 material used for Lunelle contact lenses is composed of PMMA, which makes it robust and transparent, and PVP, which ensures a stable water content. The production of ES70 material will continuous after the take over by SwissLens. The same laboratorie will produce the row material and blank as before and exclusively availalbe for the Lunelle Products from SwissLens. The material involves the use of the most advanced techniques to obtain the stable material. The development of Essilor's polymerisation technology has proven to provide a very consistent material quality.

PRODUCTION SwissLens uses a high-tech lathing technique to achieve optimum reproducibility. Lunelle contact lenses are systematically inspected at all stages to ensure that the parameters remain the same in the dehydrated state
QUALITY GUARANTEE
The material and the contact lenses are produced in accordance with the strict rules laid down by Quality Assurance. This is an independent quality assurance service at Essilor, which ensures consistent product quality.

SPECIFICATION

Percentage of hydrophily 70 %
DK: 35
Transmission in the visible area (%) 98,6

Increase DK permeability according to the method FATT at 35° C
10·11.cm'(02).cm/cm2.s.mmHg

Publication on Relax

Poster IMC 2017: Changes in relative peripheral refraction, HOAs and optical quality using a soft centre distance multifocal contact lens with different additions and optical zones

Relax STUDY 2019 – Abstract as Published

The influence of high addition soft multifocal contact lenses on visual performance

Poster IMC 2019: Giancarlo Montani; EFFECTS OF CENTER-DISTANCE MULTIFOCAL SOFT CONTACT LENSES WITH DIFFERENT OPTICAL ZONES AND ADDITIONS ON HOAs, ACCOMMODATION AND NEAR PHORIA IN MYOPIC YOUNG ADULTS.

Poster IMC 2019: S. Kropacz-Sobkowiak; THE INFLUENCE OF MEDIUM AND HIGH ADDITION SOFT MULTIFOCAL
CONTACT LENSES ON ACCOMMODATION AND PHORIA AT NEAR

Pascal Blaser, Ian Sexton; Power profiles of Peripheral Additions using topographers with Soft Contact Lenses in Myopia Control

Enhancing the optical zone of custom made myopia prevention contact lenses

Several domestic and international health institutions such as The World Health Organisation (WHO)[1], the Brien Holden Institute[2] and the British Association of Optometrists (AOP)[3] have published recommendations for the use of myopia control contact lenses. Even though research into peripheral refraction in connection with myopia control is still ongoing [4], multiple studies have clearly indicated that multifocal contact lenses, as well as orthokeratology contact lenses, have a positive effect on the slowing of myopia progression. Walline[5] reviewed the peer-reviewed literature of studies which used the currently available standard lens geometries and found that the progression of myopia can be reduced by up to 50%.

Aller’s research [6] however, shows a success rate of over 70% in myopia reduction. A closer look into Aller’s work shows that it is important to not only test the binocular vision when fitting multifocal or orthokeratology contact lenses, but to take this into account in order to improve this success rate and this is borne out in other studies too[7-10].
Aller’s research[6] however, shows a success rate of over 70% in myopia reduction. These studies raise the questions: Why do not all children and adolescents respond positively to these products? How can we improve the products so that myopia prevention has a positive effect on everybody?

Figure 1: Meta-Analysis of data collated in Lisa-Maria Mathys Bachelor‘s thesis 2016 ‘Effektive Kontrolle der Myopieprogression: Erstellung einer Metaanalyse und deren Ableitung auf Handlungsmöglichkeiten für Optometristen‘

Is this the key to more effective myopia control?

Binocular vision investigations which influence the success rate would include measuring the AC/A ratio, accommodative lag and any heterophoria together with an assessment of its compensation.

A high accommodative convergence movement occurring with the accommodative effort (a high AC/A ratio) or a decompensating ‘phoria deserves special attention. A Malaysian study showed that children with a significant near esophoria are more likely to develop myopia[11] and this can be tested with the Schober Test, or a fixation disparity test, at the habitual reading distance. The aligning sphere can be used to indicate which near addition would be optimal for myopia control. Furthermore, an accommodative lag has also been shown to trigger myopia progression and seems to be more prevalent in myopes than in emmetropes[10]. In accommodative lag, the image shell would not be formed on the retina but would be relatively hypermetropic (i.e. behind the retina) and this has been shown to be a stimulus for a progression of the myopia[12]. By having a relatively hyperopic power in the periphery of the contact lens, the effect of the accommodative lag can be overcome. Further aspects which influence the progression of myopia include aberrations caused by both the pupil itself and the size of the optical zone of the contact lens in relation to the pupil diameter [13]. They describe how the pupil diameter also influences which lens design might be more beneficial and this is taken into account in our individualised lens designing.

What does SwissLens offer?

SwissLens provides an online calculation tool available at www.swisslens.ch/toolbox where you can enter additional measurements in order to obtain the ideal parameters needed for a customised near zone, maximizing the opportunity to achieve the best possible hyperopic defocus control result.
The Relax soft contact lens has been on the market for 9 years with proven effectiveness[14] and the feedback from our customers has been extremely positive. This product is available in spherical as well as toric options, with an almost limitless choice of diameters and base curves to ensure a perfect fit. Depending on the quality of the tear film, we offer different materials, including Definitive74 Silicon, and you can choose between 3 or 6-month replacement schedules. Since 2015, our Relax contact lens has also been available in RGP materials and at the moment we are also developing an orthokeratology version. The combination of our online tool, additional test recommendations and our Relax products will allow a more precise myopia management.
Ongoing studies will also lead to a better understanding of the relationship between binocular vision, the pupil size, the prescription variations and the mechanisms of the longitudinal growth of the eye.

References:

[1] Bastian Cagnolati, Periphere Refraktion und Myopieentwicklung – Update, die Kontaktlinse, 7-8/2016

[2] Walline JJ 2016, Myopia Control: A Review.

[3] Thomas A. Aller, et al., Myopia Control with Bifocal Contact Lenses: A Randomized Clinical Trial

[4] Whatham, A., Influence of accommodation on off-axis refractive errors in myopic eyes

[5] Goss DA, Grosvenor T. Rates of childhood myopia progression with bifocals as a function of nearpoint phoria: consistency of three studies. Optom Vis Sci 1990;67:637Y40.

[6] Fulk GW, Cyert LA, Parker DE. A randomized trial of the effect of single-vision vs. bifocal lenses on myopia progression in children with esophoria. Optom Vis Sci 2000;77:395Y401.

[7] Gwiazda JE, Hyman L, Norton TT, Hussein ME, Marsh-Tootle W, Manny R, Wang Y, Everett D. Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children. Invest Ophthalmol Vis Sci 2004; 45:2143Y51.

[8] Chung, K.M. and E. Chong, Near esophoria is associated with high myopia. Clin Exp Optom, 2000. 83(2): p. 71-75.

[9] Charman, W.N., et al., Peripheral refraction in orthokeratology patients. Optom Vis Sci, 2006. 83(9): p. 641-8.

[10] Gifford, K. Myopia Profile – Measuring near lag of accommodation. 2015

[11] Gwiazda, J., et al., A dynamic relationship between myopia and blur-driven accommodation in school-aged children. Vision Res, 1995. 35(9): p. 1299-304.

[12] W.N. Charman, Aberrations and myopia, 2005

[13] Michaud Langis; https://www.clspectrum.com/issues/2016/march-2016/defining-a-strategy-for-myopia-control

[14] A. van der Heide, DATA ANALYSIS OF THE EFFECTIVENESS OF THE RELAX CONTACT LENS FOR REDUCING MYOPIA PROGRESSION 2019

Relax Myopia

The Relax contact lens is developed and CE approved for the indication of myopia management in children between 8 and 18 years of age with the indication of progressive myopia.

The unique Relax Design is available in Soft toric Relax-T, as well in a RGP design RelaxFlex and a special OrthoK design for Children wit progressive Myopia, NightFlex Relax