Dailies Total 1 Multifocal Fitting Guide: A Simple 2-Step Approach for Success

Presbyopia, the age-related loss of near vision, is a common condition that affects a significant portion of the adult population. Multifocal contact lenses offer a convenient and effective solution to correct presbyopia, allowing patients to enjoy clear vision at all distances. Alcon’s portfolio of multifocal contact lenses, including the popular DAILIES TOTAL1 Multifocal, is designed to meet the diverse needs of presbyopic patients and simplify the fitting process for eye care professionals.

This guide focuses on the straightforward 2-step fitting process for Alcon multifocal contact lenses, particularly DAILIES TOTAL1 Multifocal, engineered to enhance fitting success and patient satisfaction.

The Alcon Multifocal Advantage: 3:2:1

Alcon’s multifocal contact lens portfolio stands out with a “3:2:1 advantage,” designed to benefit both practitioners and patients:

• 3 Multifocal Contact Lenses: A comprehensive range to address various presbyopic needs and lifestyles.
• 2 Replacement Schedules: Daily and monthly options to promote lens replacement compliance, crucial for eye health.
• 1 Innovative Optical Design: Precision Profile™ Design, combined with a streamlined fitting process, ensures ease of fitting and visual performance.

2-Step Fitting Guide for DAILIES TOTAL1 Multifocal

Alcon has developed a user-friendly, two-step initial fitting process for their multifocal lenses, designed to maximize first fit success and streamline chair time.

STEP 1: Initial Lens Fit

This initial step focuses on determining the appropriate lens power and ADD for the patient.

1. Start with Spectacle Rx: Begin with the patient’s most current spectacle prescription. For refitting with a different Alcon multifocal lens material, also use the spectacle Rx as a starting point.

2. Determine Initial Contact Lens Power: Use the vertex-corrected spherical equivalent of the distance Rx that is most plus. Critically, add +0.25D to each eye to the calculated power.

3. Select Contact Lens ADD: Determine the lowest acceptable spectacle ADD for the patient. Then, use the provided chart to select the corresponding contact lens ADD (LO, MED, or HI).

   Spectacle ADD	Contact Lens ADD (Both Eyes)
   Up to +1.25	LO
   +1.50 to +2.00	MED
   +2.25 to +2.50	HI

4. Real-World Adaptation: Allow the patient 5–10 minutes outside the exam room to adapt to the lenses in a real-world environment before assessing their visual performance. This adaptation period is crucial for multifocal lens success.

STEP 2: Distance Over-Refraction

This step refines the distance vision correction using a simple over-refraction technique.

1. Monocular Distance Over-Refraction: With both eyes open, perform a distance over-refraction on each eye separately using hand-held lenses. Add plus power in 0.25D steps until the patient reports a slight blur or decline in distance vision.
2. Binocular Verification: Verify the results binocularly. Have the patient look at both distance and near objects through the hand-held lenses to ensure comfortable and clear vision at all ranges.
3. Apply Lens Changes (If Needed): If necessary, apply new lenses based on the over-refraction findings, keeping the ADD power the same as initially selected.
4. Dispense Trial Lenses: If vision is deemed functional and satisfactory, dispense trial lenses for a 5–7 day real-world evaluation period. Schedule a follow-up appointment to assess long-term comfort and vision performance.

High Fitting Success Rates

Alcon’s refined fitting process, coupled with the Precision Profile™ Design, leads to remarkable fitting success rates. Studies show that:

• 80% Fit Success with 1 Lens per Eye: The majority of patients achieve successful fits with the initial lens selection in each eye.
• 96% Fit Success with ≤ 2 Lenses per Eye: An overwhelming majority of patients achieve success with minimal lens adjustments.
• High ECP Satisfaction: More than 9 out of 10 Eye Care Professionals agree that DAILIES TOTAL1 Multifocal contact lenses are easy and efficient to fit, thanks to this streamlined process.

Consistent Power Profile with Precision Profile™ Design

The Precision Profile™ Design in Alcon multifocal lenses ensures a smooth power progression across the optic zone for all ADD powers. This design minimizes aberrations and contributes to the high fitting success. The lens design strategically adds minus power in the periphery, which may often result in a plus power over-refraction at distance, a normal and expected finding in this fitting process.

Conclusion

The Alcon DAILIES TOTAL1 Multifocal fitting guide offers a simple and efficient 2-step process for achieving high fitting success in presbyopic patients. By following these guidelines, eye care professionals can confidently fit patients with multifocal contact lenses, providing them with excellent vision and comfort. This streamlined approach not only benefits patients but also enhances practice efficiency. Remember to follow up with patients after the trial period to ensure continued satisfaction and address any potential issues.

References:

1. Alcon Multifocal Contact Lenses: Fitting Guidelines. 2019.
2. Merchea M, Evans D, Kannarr S, et al. Assessing a modified fitting approach for improved multifocal contact lens fitting success. Presented at the Annual Meeting of the American Optometric Association, June 20-24, 2018, Denver, CO.
3. Bauman E, Lemp J, Kern J. Material effect on multifocal contact lens fitting of lenses of the same optical design with the same fitting guide. Presented at the British Contact Lens Association Clinical Conference & Exhibition, June 9-11, 2017, Liverpool, UK.
4. Merchea M, Akerman DH, Mathew J, Mack C. Patient and ECP satisfaction in the United States with a novel water gradient daily disposable multifocal contact lens. Poster presented at the Annual Meeting of the American Optometric Association, June 21-26, 2017, Washington, DC.
5. Alcon data on file, 2008.