X-Cel Contacts Product And Fitting Guide

Transcription

X-Cel Contacts Product And Fitting Guide
TM
We Fit Your Pr actice.
Our commitment to you.
X-Cel® Contacts is a leading manufacturer of custom soft and specialty gas permeable contact lenses. In this resource
and fitting guide, you will find detailed information on our complete product offerings. We are committed to
providing you with high quality made to order contact lenses not available in other manufacturer’s product lines.
X-Cel’s order fulfillment time, whether standard or extended parameters, are from 1 to 3 business days.
We believe the patient in your chair is our patient too. We take the same care in consultation and manufacturing that
you do in patient evaluation and fitting. Ultimately, everything we do reflects on you in the eyes of your patients.
Their good vision and satisfaction is your goal. Your complete satisfaction is our goal. Combine all this and you have
an organization committed to the very best, in all we do.
1
www.xcelcontacts.com
Table Of Contents
Products By Brand
2
Products By Condition
3-4
Consultation Services
79
Warranties
80
Materials
81-82
Diagnostic Sets for Custom Soft
83
Diagnostic sets for Specialty GP
84-86
Products By Brand
X-Cel Specialty GP
X-Cel Custom Soft
Flexlens® Arc for Irregular Corneas
5-7
Flexlens® Tri-curve Keratoconus
8-10
Flexlens® Post Refractive (PRS)
11-13
Flexlens® Piggyback
14-17
Flexlens® Large Diameter
18
Flexlens® Aphakic
19
Flexlens® Toric
20-22
Flexlens® Sphere
23
Westhin™ Toric
24-25
Horizon™ Bi-Con Bifocal
26-28
Horizon™ Bi-Con Toric
29-31
Horizon™ Progressive
32-34
Horizon™ Progressive Toric
35-37
Atlantis™ Scleral
38-39
Reverse Geometry
40-41
Apex™ Keratoconus
42-44
Pinnacle™
45-47
Pinnacle™ Large Diameter
48-49
Pinnacle IC
48-49
Titan™ Large Diameter
50-52
Solution™ Bifocal
53-55
CV-4™ Multifocal
56-58
ProPlus™ Multifocal
59-60
Essential Solution™
61-64
Visions™ Toric
65-69
Visions™ Ultrathin
70-72
Starlens™
73-75
X-Cel Thin™
76-78
Horizon™ & Westhin™ denotes a Westcon™ Design
2775 Premiere Parkway, Suite 600 • Duluth, GA 30097 • 800-241-9312 • Fax 800.822.9235
2
Products by Condition
Irregular Cornea
1
- Atlantis Scleral
38-39
- Flexlens ARC
5-7
- Titan Large Diameter
50-52
- Pinnacle Large Diameter
48-49
- Pinnacle IC
48-49
- Flexlens Tri-Curve Keratoconus
8-10
- Reverse Geometry
40-41
9
Keratoconus
- Flexlens ARC
5-7
8-10
- Atlantis Scleral
38-39
- Apex Keratoconus
42-44
28
15
Post Surgical
11-13
- Flexlens Post Refractive (PRS)
11-13
8-10
- Flexlens Piggyback
14-17
- Flexlens Large Diameter
18
- Adult and Pediatric Aphakic
19
- Atlantis Scleral
38-39
- Titan Large Diameter
50-52
- Pinnacle Large Diameter
48-49
- Pinnacle IC
3
48-49
38
Products by Condition
Aphakic
3
- Adult and Pediatric Aphakic
19
Presbyopia
- Horizon Bi-con Bifocal
26-28
- Horizon Bi-con Toric
29-31
- Horizon Progressive
32-34
- Horizon Progressive Toric
35-37
- Solution Bifocal
53-55
- CV-4 Multifocal
56-58
- ProPlus Multifocal
59-60
- Essential Solution
61-64
Astigmatism
- Flexlens Toric
20-22
- Visions Toric
65-69
- Horizon Toric
20-22
- Westhin Toric
24-25
58
Single Vision
- Flexlens Sphere
23
- Visions Ultrathin
70-72
- Starlens
73-75
- Pinnacle
45-47
- X-Cel Thin
76-78
45-47
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FLEXLEN S ® A RC
A Custom Soft Lens Design for Irregular Corneas
The Flexlens ARC (Atypical Refractive Correction) is a custom soft lens design that fits like a regular toric contact
lens. The lens is indicated for the visual correction of various ocular conditions including keratoconus, pellucid
marginal degeneration, corneal transplants, post refractive surgery and/or any irregular cornea conditions.
Lens Design
The Flexlens ARC design utilizes a standard back surface fitting curve with an enhanced center thickness to stabilize
the correction over an aberrated cornea. If residual astigmatism is detected through the over-refraction a toric design is
needed. Cylinder powers ranging from -0.75 up to a -10.00 are available with prism ballast to reduce lens rotation. There
is a laser mark (V) at 6 o’clock to mark the location of the prism ballast. A range of base curves and center thicknesses
can be manipulated to successfully fit a wide patient base. With no need to worry about peripheral curves or any other
parameter that may complicate the fit, the Flexlens ARC is easy to fit, thus reducing chair time.
Below are cases where the Flexlens ARC should be considered:
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PMD
RK
RK
TRAUMA
POST PK
CENTRAL NIPPLE
CONE
CONE
LARGE SAGGING
CONE
PRK
PKP
LASIK
FLEXLEN S ® A RC
Parameter Availability - Available in single, 3, 6 & 12 packs.
MATERIAL
BASE CURVE
FITTING CURVE
DIAMETER
POWER
CYLINDER
AXIS
PRISM
THICKNESS
WARRANTY
Flexlens® ARC
Definitive Silicone Hydrogel 74%
6.0 to 8.7mm in 0.1mm steps
8.6 Standard Back Surface Fitting Curve
+20.00 to -20.00D
-0.75 to -10.00D in 0.25D steps
1º to 180º in 1 degree steps
1.50 standard with 2.00 available
.30mm or .50mm
Initial lens: Unlimited exchanges and cancellation within 90 days
Annual supplies: Non-warranted and non-refundable
Front View
PERIPHERAL
CURVE
Sectional View
FRONT
OPTIC ZONE
TORIC
OPTIC ZONE
FRONT
OPTIC ZONE
TORIC
OPTIC ZONE
FITTING
CURVE
PRISM
PERIPHERAL
CURVE
FITTING
CURVE
PRISM
Basic Fitting Information
For best visual acuity outcome, and reduced chair time, use of a fitting set is required.
If the Flat K is equal to or flatter than 49.00D (6.89), start with 8.1 Base Curve.
If the Flat K is steeper than 49.12 (6.87), start with 7.5 Base Curve.
For cylinder powers at -2.00 or lower, START WITH THE .30 THICKNESS
Over a -2.00 cylinder START WITH THE .50 THICKNESS
Insert lens and evaluate fit/position as you would a normal soft lens. High molecular fluorescein is provided if needed.
As your Flexlens ARC fitting experience broadens, your base curve philosophy may vary.
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FLEXLENS ® A RC
Fitting Steps
1. Starting with the position evaluation of the lens, look for a well centered alignment with no more than 2mm of
movement.
2. Centrally the lens should display slight central touch with no air bubbles or folds.
3. Let lens settle for 10 minutes before performing rotation, edge and acuity evaluation.
4. Check for lens rotation. Any rotation over 10 degrees requires next steeper base curve.
5. Evaluate the edge in complete 360 degree circle by checking all four gazes (Up, Down, Right, Left)
6. Perform sphere-cylinder over-refraction and compare to best achievable acuity of patient. (should be at least
equal)
7. All evaluation information should be given to an X-Cel consultant for final lens order.
Troubleshooting
Problem
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1st Change
2nd Change
Too little or no movement
Flatten BC 0.3mm
Decrease diameter 0.5mm
Excessive movement
Steepen BC 0.3mm
Increase diameter 0.5mm
Central air bubble
Flatten BC 0.3mm
Lens fold
Steepen BC 0.3mm
Excessive touch
Steepen BC 0.3mm
Unstable over-refraction
Flatten BC 0.3mm
Unstable lens rotation
Steepen BC 0.3mm
BCVA not achieved with
0.30 thick lens
Go to 0.50 thick lens
Increase prism to 2.00
FLEXLEN S® T RI-C U RVE
For Moderate to Advanced Keratoconus
The Tri-Curve Keratoconus Lens is indicated for daily wear use for the correction of refractive ametropia and
specialized use such as atypical ametropia.
Indications
Examples include, but are not limited to: irregular astigmatism created by keratoconus, trauma, or
post/penetrating keratoplasty. The lens is for patients with moderate to advanced keratoconus and
is ideal for those:
• Who cannot adapt to a rigid lens material
• With monocular keratoconus who wish to wear a soft lens in the fellow eye
• Who experience decentered optics with a rigid lens material
Other patients who may benefit from the increased central thickness and rigidity of the Tri-Curve Keratoconus
Lens for vision correction include those with:
• Pellucid marginal degeneration
• Refractive surgery
The Flexlens Tri-Curve Keratoconus lens can correct up to 6.00 diopters of irregular astigmatism, but may need
a .65 center thickness to do so.
Below are cases where the Tri-Curve Keratoconus should be considered:
PMD
RK
RK
TRAUMA
POST PK
CENTRAL NIPPLE
CONE
CONE
LARGE SAGGING
CONE
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FLEXLENS® T RI- C U RVE
Lens Design
The Flexlens Tri-Curve Keratoconus Lens is based on a tri-curve posterior design. The optical success of the design is based
on the standard center thickness that ranges from .45 to .65mm which is often thicker than the keratoconus cornea itself.
The design incorporates a flat secondary curve of 1.2mm to 1.8mm flatter, depending on the base curve. A scleral curve
with a radius of 2.2mm to 2.8mm flatter, depending on the base curve, is added peripherally to align with the scleral curve
of the eye. For those patients who exhibit high degrees of irregular astigmatism, they may be better served with the
Flexlens ARC design.
BASE CURVE
DIAMETER
POWERS
CENTER THICKNESS
WARRANTY
+30.00 to –30.00D in 0.25D steps
.45 to .65mm
Sectional View
Flexlens® Tri-Curve
Front View
A diagnostic set is recommended foremost in successfully fitting this lens design.
*If fitting a patient in the Definitive 74%, adjust the Base Curve 0.3mm steeper or the Diameter 0.3mm larger.
BASE CURVE
Select a diagnostic lens using the averaged keratometer value.
EXAMPLE:
“K’s”
52.00D @ 180 / 57.00D @ 090
Mean “K”
(52.00D + 57.00D) /2 = 54.50D
Diagnostic Lens 6.2mm Base Curve is Average K
Lens Evaluation
When evaluating the fit of the Tri-Curve Keratoconus Lens, the lens should exhibit:
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• Lens centration with 1.0 to 1.5mm of limbal draping
• Lens movement of 0.25 to 0.50mm in primary position with normal blink, maintaining stable vision
• Visual acuity within two lines of best corrected vision
FLEXLEN S® T RI-C U RVE
Push Up Test
If the lens decenters up, down, left, or right, the base curve is most likely too flat and the next steeper base curve should be
evaluated. If the lens centers well, a simple “push-up” test will verify if the base curve is appropriate for the patient. Place
your index finger on the patient’s lower lid margin and manually push the lower lid and evaluate the lens movement. If the
decentered lens slowly drops into a centered position, the lens to cornea relationship is appropriate. If the lens remains in a
superior decentered position, or if edge stand off is noted as the lens reaches the lower limbus, the base curve
relationship is too flat. In this situation, the next steeper base curve/diameter should be evaluated. A steep fitting lens will
exhibit resistance to the manual manipulation of the lens with the lower lid. In this situation, the next flatter base curve can
be evaluated.
Lens Power
If the visual acuity is less than expected, an additional over-refraction should be performed. The most accurate
results will be obtained after the lens is worn for three to seven days of daily wear, with the lens being worn at least four
hours on examination day.
Troubleshooting
Patient Symptoms
Objective Findings
Possible Cause
Plan
Unacceptable vision on eye chart
Incorrect refraction or over-refraction
Order new lens based on new
refraction or over-refraction
Base curve too flat
Steepen base curve by 0.3mm
Diameter too small
Increase diameter by 0.5mm
Base curve too flat
Flat Fit = patient will exhibit “clear,
blur, clear” when blinking
Base curve too steep
Steep Fit = patient will exhibit “blur,
clear, blur” when blinking
Flatten base curve by 0.3mm
Cylinder over-refraction 2.00 diopters
and under; Center thickness too thin
Increase center thickness to .65mm
Cylinder over-refraction over 2.00
diopters
Change to Flexlens ARC design,
Atlantis Scleral, Flexlens Piggyback
design or utilize spectacles over the
lenses
Lens is too steep
Lens is too large
Decrease diameter by 0.5mm
Lens is too thick; material does not
provide enough oxygen
Increase water content of lens
material, or decrease center thickness
Lens not centered
Poor visual acuity on
delivery or first follow-up
Fluctuating vision
Sphero-cylindrical
over-refraction provides
good vision
Scleral indentation
Vision decreases
during the day
Corneal edema
Initial discomfort
Excessive movement
Discomfort at day’s end
Scleral indentation
Lens dislodges during wear
Superior to inferior edge lift
Lens is too steep
Improper fit
Evaluate fit
Incompatibility with solutions
Change patient’s care system
Base curve too flat
Diameter too small
Diameter too large
Lens dehydrating on eye
Decrease water content of lens
Diameter too large
Base curve too flat
Diameter too large
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FLEXLE N S ® PRS
Soft Contact Lens Following Corneal Refractive Surgery
The Flexlens Post Refractive Lens is indicated for daily wear use for the correction of refractive ametropia and specialized
use such as atypical ametropia following corneal refractive surgery.
Lens Design
The Post Refractive Lens function allows the central optical portion of the lens to be flatter than the mid-periphery. The
optical zone has a thickness of approximately .28mm at –1.00D, which provides stable optics over the central cornea. The
peripheral lens carrier is as thin as, or thinner than, any standard soft lens to ensure maximum oxygen permeability to the
peripheral cornea, limbus and conjunctiva.
Parameter Availability - Available in single, 3, 6 and 12 packs.
BASE CURVE
DIAMETER
POWER
WARRANTY
11
+30.00 to –30.00D in 0.25D steps
POST LASIK
RK
PRK
LASIK
RK
Flexlens® Post Refractive Lens
FLEXLE N S ® PRS
Front View
Sectional View
AOZ(Variable OZ)
INTERMEDIATE
ZONE
BC (8.7mm)
FLANGE
LENS DIAMETER (15.0mm)
TRANSITION
ZONE
ANTERIOR
OPTIC ZONE
AOZ –- Anterior
Zone
AOZ
Anterior Optic
Optic Zon
BC - –Base
BC
Base Curve
Curve
Central keratometric readings are of little value in fitting the Post Refractive Lens. A diagnostic set is recommended for
most successful fitting of this lens. Select a lens from the diagnostic set with a base curve of 8.7mm and a diameter of
15.0mm. Allow the lens to settle a few minutes before performing the initial evaluation. If the diagnostic lens does not
exhibit obvious edge lift, allow the lens to settle an additional 30 minutes. If the lens does exhibit edge lift or decenters in
any direction, this indicates a flat fitting relationship and the next steeper base curve should be tried.
Push Up Test
If the lens centers well, a simple “push-up” test will verify if the base curve is appropriate for the patient. Place your index
finger on the patient’s lower lid margin and manually push the lower lens edge up to the lower limbus. Release your finger
pressure from the lower lid and evaluate the lens movement. If the decentered lens slowly drops into a centered position,
the lens to cornea relationship is appropriate. If the lens remains in a superior decentered position, or if edge stand off is
noted as the lens reaches the lower limbus, the base curve relationship is too flat. In this situation, the next steeper base
curve/diameter should be evaluated. A steep fitting lens will exhibit resistance to the manual manipulation of the lens with
the lower lid. In this situation, the next flatter base curve can be evaluated.
Lens Fitting Evaluation
When evaluating the fit of the Post Refractive Lens, the lens should exhibit:
• Lens movement of 0.25 to 0.50mm in primary position with normal blink
• Visual acuity within two lines of best corrected vision
Post-Op K’s Range
Base Curve
Diameter
Pre-Op K’s Range
Base Curve
Diameter
37.75 - FLATTER
38.00 - 41.00
9.0
8.7
15.0
15.0
41.75 or FLATTER
42.00 - 45.00
9.0
8.7
15.0
15.0
41.25 - STEEPER
8.4
15.0
45.25 - STEEPER
8.4
15.0
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FLEXLENS ® PRS
Troubleshooting
Patient Symptoms
Objective Findings
Lens not centered
Base curve too flat
Fluctuating vision
Center thickness too thin
Cylinder over-refraction 2.00
diopters and under; center
thickness too thin
Cylinder over-refraction over 2.00
diopters
Change to Flexlens ARC lens
design, Atlantis Scleral, Piggyback
lens design or utilize spectacles
over lenses
Lens is too steep
Lens is too large
Lens is too thick; material does not
provide enough oxygen
Increase water content of lens
material, or decrease center
thickness
Lens is too steep
Lens is too large
Incompatibility with material
Change to lower water
content
Care system not followed or not
adequate
Discuss care system with
patient and change as
necessary
Improper fit
Evaluate fit
Base curve too flat
Diameter too small
Diameter too large
Diameter too large
Sphero-cylindrical
over-refraction
provides good vision
Corneal edema
Deposits
Initial discomfort
Excessive movement
Discomfort at day’s end
Scleral indentation
13
Plan
Order new lens based on new
refraction
Scleral indentation
Vision decreases
during the day
Possible Cause
Incorrect refraction or
over-refraction
FLEXLENS® PIG G YBAC K
For Advanced Keratoconus
The Flexlens Piggyback Lens design is ideal for the patient who requires the optics of a rigid lens but has difficulty with the
initial comfort of that material.
This lens is indicated where centration is difficult to achieve due to an irregular corneal surface.
Patients who would benefit from this design could have:
• Beginning to advanced keratoconus • Pellucid marginal degeneration
• Terrien’s marginal degeneration
• Penetrating Keratoplasty
• Refractive corneal surgery
• Corneal trauma
• Corneal surface disease
Lens Design
The Piggyback Lens incorporates a central circular depression into the anterior surface of the soft lens carrier.
The design recesses the GP lens within the soft lens eliminating upper lid dislodgement and maintaining
centration of the GP optics over the pupil.
Below are cases where the Flexlens Piggyback lens should be considered:
PMD
LASIK
RK
RK
POST PK
CENTRAL NIPPLE
CONE
CONE
LARGE SAGGING
CONE
TRAUMA
PRK
Parameter Availability - Available in single, 3, 6 and 12 packs.
BASE CURVE
DIAMETER
ANTERIOR CUT-OUT DIAMETER 6.5 to 12.5mm in 0.1mm steps
POWER
Plano
WARRANTYInitial lens: Unlimited exchanges and cancellation within 90 days
14
Front View
Sectional View
Flexlens® Piggyback Lens
SOFT LENS BASE CURVE
The Piggyback Lens fitting criteria is identical to any soft lens, with movement and centration the primary
factors. The initial lens selection should be 1.0mm flatter than the patient’s flattest keratometric value (in mm).
There should be lens centration with 1.0 to 1.5mm of limbal draping and lens movement should be minimal,
0.25
to 0.50mm in primary position with normal blink.
EXAMPLE:
“K’s”
Flat “K”
Diagnostic lens
52.00D @ 180 / 57.00D @ 090
52.00D = 6.49mm
7.5mm Base Curve
Recommended lens: 7.5mm Base Curve, 14.5mm Diameter, Plano Power, 10.2mm Anterior Cut-out Diameter
Diagnostic fitting of the soft lens is enhanced by inserting a GP lens that is 1.0mm smaller than
the recessed cut-out diameter. GP Insert Lens: Take the keratometric reading for the insert
lens over the piggyback carrier. For example, if the anterior cut-out is 10.2mm, the largest
GP lens diameter would be 9.2mm. This will mimic the final weight and lid to lens
interaction, allowing for a better evaluation.
NOTE: The soft lens skirt should be inserted first, followed by the GP lens
being inserted on top of the soft lens.
Lens Evaluation
When evaluating the fit of the Piggyback lens, the soft lens should exhibit:
15
Push Up Test
If the soft lens decenters up, down, left or right, the base curve is most likely too flat and the next steeper base curve should
be evaluated. If the soft lens centers well, a simple “push-up” test will verify if the base curve is appropriate for the patient.
Place your index finger on the patient’s lower lid margin and manually push the lower lens edge up to the lower limbus.
Release your finger pressure from the lower lid and evaluate the lens movement. If the decentered lens slowly drops into a
centered position, the lens to cornea relationship is appropriate. If the lens remains in a superior decentered position, or if
edge stand off is noted as the lens reaches the lower limbus, the base curve relationship is too flat. In this situation the next
steeper base curve/diameter should be evaluated. A steep fitting lens will exhibit resistance to the manual manipulation of
the lens with the lower lid. In this situation, the next flatter base curve can be evaluated.
Gas Permeable Insert
Once the appropriate soft lens has been designed, the GP lens is removed from the central cut-out with a standard GP
suction device. Keratometry is performed over the central depression of the soft contact lens and a standard GP lens is
designed as if it were being fit onto the cornea. A base curve is selected on “K” or .10mm steeper than the flat “K”. The GP
lens diameter should be selected at least 1.0mm smaller than the anterior cut-out boundaries to facilitate lens movement
and tear exchange.
Ensures centration of the rigid lens over the central cornea maintaining a comfort level
similar to a soft lens, allowing freedom of day to day activities without discomfort.
16
Troubleshooting
Patient Symptoms
Objective Findings
Possible Cause
Plan
Incorrect refraction or over-refraction
Order new GP lens based on new
refraction or over-refraction
Base curve too flat
Steepen base curve by 0.50D and
adjust power
Anterior cut-out too large
Order new soft lens with smaller
anterior cut-out
Lens too small
Increase soft lens diameter by 0.5mm
Lens too loose
Steepen soft lens base curve by 0.3mm
Bubble between posterior surface of
GP and anterior surface of soft lens
Incorrect GP base curve
Flatten GP base curve by 0.50D and
adjust power
GP lens too large for anterior cut-out
Incorrect GP diameter
Reduce GP diameter to fit into cut-out
Build up of foreign matter between
lenses
GP base curve too flat
Steepen GP base curve by 0.50D and
adjust power
Excessive edge lift of GP lens
Reduce edge lift of GP lens
Base curve of soft lens too steep
Flatten base curve of soft lens by
0.3mm
Diameter of soft lens too large
Reduce soft lens diameter by 0.5mm
GP base curve too steep
Flatten GP base curve 0.50D and
adjust power
Water content of soft lens too low
Increase water content of soft lens
material
Dk of GP lens too low
Increase Dk of GP lens material
GP base curve too flat
Steepen GP base curve 0.50D and
adjust power
Soft lens base curve too steep
Flatten soft lens base curve by 0.3mm
Edge of GP lens too thick
Reduce edge profile of GP lens
GP diameter too large
Call Consultation for best material
recommendation
Care system not followed or not
adequate
Discuss care system with patient and
change as necessary
GP lens too large trapping debris in
cut-out
Base curve of soft lens too flat
Steepen soft lens base curve by 0.3mm
Diameter of soft lens too small
Increase soft lens diameter by 0.5mm
GP Lens not centered
Soft lens not centered
Corneal edema
Vision decreases
during the day
GP lens dislodges
Deposits
Excessive movement
Initial discomfort
Too little movement
Base curve of soft lens too steep
Flatten soft lens base curve by 0.3mm
Diameter of soft lens too large
Reduce soft lens diameter by 0.5mm
NOTE: The gas permeable lens should be rinsed with saline or a multi-purpose soft lens solution prior to inserting it into the soft lens.
17
FLEXLENS® L ARG E DIAMETE R
Custom Soft Large Diameter
The Flexlens Large Diameter is ideal for protection of eyes that have undergone keratoprosthesis (K-Pro/Alphacor),
conditions where conventional soft lenses are not large enough in diameter to fit properly (i.e. megalocornea,
pterygia, etc.), and refractive ametropia when large diameter soft lenses are needed to provide adequate centration.
Lens Design
The Flexlens Large Diameter is a spherical soft lens made in a large diameter often used for therapeutic purposes.
Due to the large diameter, the posterior surface of the lens is three curves unlike standard spheres which are two
curves. The anterior side has a lenticular cut to reduce overall lens thickness.
Standard Parameters - Available in single, 3, 6 & 12 packs.
BASE CURVE
DIAMETER
POWER
MATERIALS
WARRANTY
+30.00 to -30.00D in 0.25 steps
Methafilcon A 55%
Horizon Sphere is
available in the same parameters
18
FLEXLENS® APHA KIC
Adult & Pediatric
The Flexlens Aphakic Lens is indicated for daily wear use for the correction of refractive ametropia and specialized
use such as atypical ametropia. The lens is available for those patients who have undergone cataract removal either as
a child or an adult. The range of available lens parameters makes it an ideal lens for any patient who cannot tolerate a
GP lens after surgery.
BASE CURVE DIAMETER
POWER
WARRANTY
+00.00 to +50.00D in 0.25D steps
*If fitting a patient in the Definitive 74%,
adjust the Base Curve 0.3mm steeper or the
Diameter 0.3mm larger.
Horizon Aphakic is
19
FLEXLENS® TORIC
Designed for Success. Guaranteed to Fit.
The Flexlens Toric Lens is indicated for daily wear use for the correction of visual acuity in aphakic and non-aphakic
persons with non-diseased eyes with myopia or hyperopia and possesses refractive astigmatism not exceeding 10.00D.
Lens Design
The Flexlens Toric Lens utilizes a back surface toric design, with 1.50D of prism ballast to stabilize rotation. There is a laser
mark (V) at 6 o’clock to mark the location of the prism ballast. For those patients with high degrees of irregular
astigmatism that cannot achieve optimal visual acuity can try a rigid gas permeable lens, Flexlens ARC or the Piggyback
design.
Standard Parameters
BASE CURVE DIAMETER
POWER
CYLINDER
AXIS
CENTER THICKNESS
13.5 to 15.0mm in 0.1 steps
+10.00 to -10.00D in 0.25D steps
-0.50 to -10.00D in 0.25D steps
1º Increments up to 180º
.16mm at -3.00D
Parameter Availability - Available in single, 3, 6, & 12 packs
Base Curve
Diameter
Power
Cylinder
Axis
WARRANTY
+40.00 to –40.00D in 0.25D steps
–0.50 to –10.00D in 0.25D steps
1º increments up to 180º
Horizon Toric is
20
FLEXLEN S® TORIC
Front View
Sectional View
Flexlens® Toric Lens
The Flexlens Toric Lens is fit using a nomogram method which utilizes the Flat keratometry value.
Flat “K” Reading
45.00D and steeper
43.25D to 44.75D
41.25D to 43.00D
41.00D and flatter
Suggested Base Curve
8.0mm to 8.3mm
8.3mm to 8.6mm
8.6mm to 8.9mm
8.9mm to 9.2mm
Suggested Diameter
14.0
14.0 or 14.5
14.5 or 15.0
15.0
The chosen lens should be placed on the eye and allowed to settle for a minimum of 20 minutes before evaluating the fit for
movement, rotation, and centration. The ideal lens fit should exhibit good centration with approximately 0.25 to 0.50mm
of lens movement in primary position. If upon evaluation, the lens rotates more than 10 degrees and your over-refraction
does not yield good visual results, consider a change in base curve and/or diameter prior to ordering a new lens that
incorporates the cross cylinder as determined by your over-refraction. If lens rotates 10° or less and yields a stable overrefraction then re-order based on new lens that incorporates the cross cylinder as determined by your over-refraction.
21
FLEXLEN S® TORIC
Troubleshooting
Patient Symptoms
Objective Findings
Possible Causes
Plan
Sphere/cylinder off axis
If over-refraction yields good results, reorder new
powers indicated
Diameter too small
Base curve too flat
Steepen base curve by 0.3mm and incorporate over
refraction. Re-order new lens (as long as O/R is
stable and consistent).
Diameter too small
Increase diameter 0.5mm and incorporate over
refraction. Re-order new lens (as long as O/R is stable
and consistent).
Diameter too small
Base curve too flat
Lens too steep
Lens is too large
Material does not provide
enough oxygen
Change to a higher water content material
Lens too steep
Lens is too large
Lower water content material.
Care system not followed or
inadequate
Discuss care systems with patient and change as
necessary
Occasional rotation of lens
Diameter too small
Slight edge lift
Base curve too flat
Improper fit
Evaluate fit
Base curve too flat
Diameter too small
Diameter too large
Lens rotates 10 degrees or
less
delivery or first
follow-up
more
Lens does not rotate but is
decentered
Scleral indentation
Corneal edema
Vision decreases during
the day
Lens rotates out of position
at days end
Deposits
Unstable vision
Initial discomfort
Excessive movement
Discomfort at days end
22
FLEXLENS® SPHE RE
For An Exact Fit Every Time
The Flexlens Spherical Lens is indicated for daily wear use for the correction of higher degrees of ametropia. The lens
is available in a large diameter with or without a thick edge and also with 1.50D or 2.00D of prism.
Lens Design
Standard soft lens fitting principles apply to the Flexlens Spherical Lens. Lens selection should be 4.00D flatter than
the patient’s flattest keratometric value. There should be lens centration with 1.0 to 1.5mm of limbal draping and lens
movement should be minimal, 0.25 to 0.50mm in primary position with normal blink.
Standard Parameters
BASE CURVE
DIAMETER
POWER
+10.00 to –10.00D in 0.25D steps
BASE CURVE
DIAMETER
POWER
WARRANTY
+40.00 to –40.00D in 0.25D steps
Horizon Sphere is available in the
same parameters and is available
for tinting. See Below:
23
Original
Eye Color
Aqua
Brown
Green
Blue
WEST HIN™ TORIC
Soft Toric Contact Lens for Daily Wear
The Westhin Toric is indicated for Daily Wear use for the correction of visual acuity in aphakic and non-aphakic
patients with non-diseased eyes with myopia and hyperopia and who process refractive astigmatism not exceeding
10.00 diopters.
Lens Design
The Westhin Toric is a lathe cut back surface toric utilizing the dual thin zone for stabilization. The inferior and
superior peripheral area of the lens is thinner allowing it to position under the upper and lower lids while the slightly
thicker area will position between the lids. There are two “V” axis marks horizontally at 3 & 9 o’clock to determine
axis location.
Standard Parameters - Available in single, 3, 6 & 12 packs
BASE CURVE
DIAMETER
POWER
CYLINDER
AXIS
WARRANTY
+20.00 to -20.00D in 0.25D steps
-0.50 to -10.00D in 0.25D steps
24
WEST HIN™ TORIC
Troubleshooting
Patient Symptoms
Objective Findings
Possible Causes
Plan
Sphere/cylinder off axis
If over-refraction yields good results, reorder new
powers indicated
Diameter too small
Base curve too flat
Steepen base curve by 0.3mm and incorporate over
refraction. Re-order new lens. (as long as O/R is
stable and consistent).
Diameter too small
Increase diameter 0.5mm and incorporate over
refraction. Re-order new lens. (as long as O/R is stable
and consistent).
Diameter too small
Base curve too flat
Lens too steep
Lens is too large
Material does not provide
enough oxygen
Change to a higher water content material
Lens too steep
Lens is too large
Lower water content material.
Care system not followed or
inadequate
Discuss care systems with patient and change as
necessary
Occasional rotation of lens
Diameter too small
Slight edge lift
Base curve too flat
Improper fit
Evaluate fit
Base curve too flat
Diameter too small
Diameter too large
less
delivery or first
follow-up
more
Lens does not rotate but is
decentered
Scleral indentation
Corneal edema
Vision decreases during
the day
Lens rotates out of position
at days end
Deposits
Unstable vision
Initial discomfort
Excessive movement
Discomfort at days end
25
HORIZ ON ™ BI-C ON BI FO C A L
Soft Bifocal Contact Lens for Daily Wear
The Horizon Bicon Bifocal Sphere is indicated for Daily Wear use for the correction of visual acuity with
non-diseased eyes with myopia, hyperopia, and presbyopia and less than -0.75 diopters of refractive astigmatism.
Lens Design
The Bicon Bifocal Sphere is a back surface spherical lens utilizing the double slab off for stabilizing cylinder axis.
The “V” axis orientation marks are located horizontally at 3 & 9 o’clock. The center near zone is variable in size and
power.
BASE CURVE
DIAMETER
SPHERE RANGE
ADD POWER
ADD ZONE
WARRANTY
+20.00 to -20.00D in 0.25 steps
Up to +4.00 ADD in 0.25 steps
1.8, 2.0, 2.5, 3.0, 3.5, 4.0
26
HORIZ ON ™ BI-C ON BI FO C A L
Basic Fitting Information:
Step 1
From the keratometry reading select the initial base curve from the chart
Select a Lens from
the Diagnostic Set
Flattest Keratometry measurement
38.00 to 41.00
41.25 to 45.00
45.25 to 48.00
Suggested base curve
8.9 or flatter
8.6 to 8.9
8.3 or steeper
From the horizontal visible iris diameter choose the initial diameter from the chart
HVID measurement
Suggested diameter
Less than 11.0mm
14.0mm or smaller
11.0mm to 12.0mm
14.5mm
Greater than 12.0mm
15.0mm or larger
Select a trial lens for the dominant eye with a 2.5mm near zone and a 3.0mm near zone for the nondominant eye.
Step 2
Insert lens
Once the trial lens is inserted and allowed to settle evaluate the fit for movement, and centration. The ideal
lens fit should exhibit good centration with approximately 0.25 to 0.50mm of lens movement in primary
position.
Step 3
If the lens decenters up, down, left, or right, the base curve is most likely too flat and the next steeper base
curve should be tried and evaluated.
Push Up Test
If the lens centers well, a simple push-up test will verify if the base curve is appropriate for the patient.
To perform a push-up test, place your index finger on the patients lower lid margin and manually push the
lower lens edge upward to the lower limbus. Release your finger pressure from the lower lid and evaluate
the lens movement.
If the decentered lens slowly drops into a center position, the lens to cornea relationship is appropriate.
The base curve relationship may be too flat if the lens remains in a superior decentered position, or if the
edge standoff is noted as the lens reaches the lower limbus. If this occurs, the next steeper curve/diameter
should be evaluated.
A steep fitting lens will exhibit resistance to the manual manipulation of the push-up test. In this situation,
the next flatter base curve should be tried and evaluated.
Step 4
Final Evaluation
27
Once the ideal fit is achieved perform a sphero-cylinder over refraction to determine best distance acuity.
Once best distance correction is determined over-refract for best near vision preferably using hand held
lenses. If the over refraction does not result in acceptable visual acuity in either distance or near consider
a change in base curve and or diameter and repeat the over refraction procedure. For the Bi-Con toric
or sphere lenses, if the patient is reporting ghosting or 3D vision in distance order the initial lenses with
smaller near zones. If ghosting or 3D vision is observed in the near vision order the initial lens with larger
near zones. Please note that the Horizon Progressive toric or sphere near zones are a fixed size and cannot
be altered. If your patient has smaller than average pupil sizes it is advisable to fit the Bi-Con with the small
near zones.
HORIZ ON ™ BI-C ON BIFO C A L
Troubleshooting
Patient Symptoms
Plan
Excessive Movement
No Movement
Poor Centration
Excessive rotation, more
than 20 degrees
Unsatisfactory visual
acuity for distance
acuity for near
Order new lenses based on sphero-cylindrical
over-refraction, providing over-refraction results in
good end point vision. Westcon will calculate new
lens powers from your over-refraction
Increase zone diameter .5mm
Adjust add power
Ghosting at distant vision
Decrease zone diameter .5mm in both eyes
Ghosting at near vision
Increase zone diameter .5mm in both eyes
Fluctuating vision or overrefraction fails to give
acceptable visual acuity
Lack of intermediate vision
Fit problem, normally corrected with a change in base
curve or diameter
Decrease add power on the dominate eye
28
HORIZ ON ™ BI-C ON BIFO CAL TORIC
Soft Bifocal Contact Lens for Presbyopic Patients
The Horizon Bi-con Bifocal Toric is indicated for Daily Wear use for the correction of visual acuity with
non-diseased eyes with myopia, hyperopia, and presbyopia having refractive astigmatism not exceeding 10.00
diopters.
Lens Design
The Horizon Bi-con Bifocal Toric is a back surface toric utilizing the double slab off for stabilizing cylinder axis.
The “V” axis orientation marks are located horizontally at 3 & 9 o’clock. The center near zone is variable in size and
power.
BASE CURVE
DIAMETER
SPHERE RANGE
CYLINDER RANGE
BIFOCAL ADD POWER
AXIS
WARRANTY
29
+20.00 to -20.00D in 0.25 steps
-0.50 to -10.00D in 0.25 steps
+0.50 to +4.00D in 0.25 steps
Step 1
Select a Lens from
the Diagnostic Set
38.00 to 41.00
8.9 or flatter
41.25 to 45.00
8.6 to 8.9
45.25 to 48.00
8.3 or steeper
Flatter than 38.00 or steeper than 49.00 Call for consultation
HVID measurement
Suggested diameter
Less than 11.0mm
14.0mm or smaller
11.0mm to 12.0mm
14.5mm
15.0mm or larger
Greater than 12.0mm
Select a trial lens for the dominant eye with a 2.5mm near zone and a 3.0mm near zone for the
non-dominant eye.
Step 2
Insert lens
position.
Step 3
Push Up Test
the lens movement.
Step 4
Final Evaluation
Once the ideal fit is achived perform a sphero-cylinder over refraction to determine best distance acuity.
near zones.
30
Troubleshooting
Patient Symptoms
Excessive Movement
Plan
No Movement
Poor Centration
than 20 degrees
acuity for distance
acuity for near
31
Adjust add power
Ghosting at distant vision
Decrease zone diameter .5mm in both eyes
Ghosting at near vision
Fluctuating vision or
over-refraction fails to give
curve or diameter
Lack of intermediate vision
Decrease add power on the dominate eye
HORIZ ON ™ PRO G R E S SIVE
Soft Contact Lens for Presbyopic Patients
The Horizon Progressive Sphere is indicated for Daily Wear use for the correction of visual acuity with non-diseased
eyes with myopia, hyperopia, and presbyopia and less than -0.75 diopters of refractive astigmatism.
Lens Design
The Horizon Progressive Sphere is a spherical bi-curve back surface. These lenses are center near and the zones
are 3.0 for the non-dominant eye and 2.5 for the dominant eye. The near zone power is aspherical providing for
intermediate vision while the distance zone surrounding the near zone is spherical.
BASE CURVE
DIAMETER
POWER
ADD ZONE
ADD POWER
WARRANTY
+20.00 to -20.00D in 0.25D steps
Dominant or Non-dominant
Up to to +3.50 in 0.25 steps
32
HORIZ ON ™ PRO G RE S SIVE
Step 1
Select a Lens from
the Diagnostic Set
38.00 to 41.00
41.25 to 45.00
45.25 to 48.00
8.9 or flatter
8.6 to 8.9
8.3 or steeper
HVID measurement
Suggested diameter
14.0mm or smaller
Less than 11.0mm
14.5mm
11.0mm to 12.0mm
15.0mm or larger
Greater than 12.0mm
non-dominant eye.
Step 2
Insert lens
position.
Step 3
Push Up Test
the lens movement.
Step 4
Final Evaluation
33
near zones.
HORIZ ON ™ PRO G R E S SIVE
Troubleshooting
Patient Symptoms
Plan
Excessive Movement
No Movement
Poor Centration
than 20 degrees
acuity for distance
acuity for near
Order new lenses after determination of adjusted near
power using hand-held lenses
Fluctuating vision or overrefraction fails to give
curve or diameter
34
HORIZ ON™ PRO G RESSIVE TORIC
Soft Contact Lens Option for Your Astigmatic Presbyopes
The Horizon Progressive Toric is indicated for Daily Wear use for the correction of visual acuity with non-diseased
eyes with myopia, hyperopia, and presbyopia having astigmatism not exceeding 5.00 diopters.
Lens Design
The Horizon Progressive Toric is a back surface toric utilizing the double slab off for stabilization. There are two
“V” axis marks horizontally at 3 & 9 o’clock to determine axis location. These lenses are center near and the zones
are 3.0 for the non-dominant eye and 2.5 for the dominant eye. The near zone power is aspherical providing for
intermediate vision while the distance zone surrounding the near zone is spherical. Three material options are
available along with a wide parameter range.
BASE CURVE
DIAMETER
POWER
CYLINDER RANGE
AXIS
ADD POWER
WARRANTY
35
+20.00 to -20.00D in 0.25D steps
-0.75 to -5.00D in 0.25D steps
Up to +3.50 ADD 0.25D steps
HORIZ ON ™ PRO G RESSIVE TORIC
Step 1
Select a Lens from
the Diagnostic Set
38.00 to 41.00
41.25 to 45.00
45.25 to 48.00
8.9 or flatter
8.6 to 8.9
8.3 or steeper
HVID measurement
Suggested diameter
Less than 11.0mm
14.0mm or smaller
11.0mm to 12.0mm
14.5mm
15.0mm or larger
Greater than 12.0mm
non-dominant eye.
Step 2
Insert lens
position.
Step 3
Push Up Test
the lens movement.
Step 4
Final Evaluation
near zones.
36
HORIZ ON ™ PRO G RESSIVE TORIC
Troubleshooting
Patient Symptoms
Plan
Excessive Movement
No Movement
Poor Centration
than 20 degrees
acuity for distance
acuity for near
Order new lenses after determination of adjusted near
power using hand-held lenses
Fluctuating vision or
over-refraction fails to give
37
curve or diameter
AT L ANT IS™ SC L E R A L
It’s a 1-2-3 Fit Strategy
Atlantis is a scleral lens design that performs well on any patient with an irregular cornea, including keratoconus,
pellucid marginal degeneration, corneal transplants, post refractive surgery, post corneal rings, and ocular surface
disease. Scleral lenses have also been utilized on regular corneas, dry eye patients, and athletes.
Lens Design
The Atlantis proprietary lens design was developed to provide a problem solving solution along with a simplified
fitting system with the 1-2-3 fit strategy. The unique peripheral curve calculation will allow central clearance while
providing good distribution of pressure in the landing area, adequate edge lift and overall superior comfort.
Below are cases where the Atlantis Scleral should be considered:
PMD
RK
RK
TRAUMA
POST PK
CENTRAL NIPPLE
CONE
CONE
LARGE SAGGING
CONE
PRK
PKP
LASIK
38
AT L AN T IS SC L E R A L
Standard Parameters
BASE CURVE
DIAMETER
POWER
MATERIAL
COLOR
WARRANTY
6.50 to 9.00mm, 7.03 to 9.00mm, 7.18 to 9.00mm
15.0, 16.0 and 16.5
+20.00 to -20.00D in 0.25D steps
Boston XO and Boston XO2
Ice Blue, Clear
Two exchanges per eye or cancellation within 90 days
The Atlantis lens is best fit utilizing a diagnostic set and the 1-2-3 Fit Guide. The fitting philosophy is based on the
premise of customizing the lens fit by manipulating 3 zones to control the sagittal height relationship of the lens
to the anterior ocular surface. The design offers 3 proprietary zones which each has a specific function and are
independent of each other. The diagnostic set will offer laser markings to easily identify the 3 proprietary zones to
ensure an easier evaluation process for the practitioner.
A comprehensive fit guide or fitting tutorial, is available for download at www.xcelcontacts.com, or call your local
branch.
Each set contains:
24 GP Atlantis Lenses
1 Fitting Guide
4 Patient Insertion/Removal Guides
2 Single Use Saline
2 Small DMV’s
2 Large DMV’s
3 Lap Towels
1 Pen Light with Cobalt Blue Filter
3 Fluorescein Strips
39
REVERSE G EOMETRY
Optimal Stabilization
The Reverse Geometry lens design can be used for patients with any irregular cornea including Lasik, RK, PRK and
PKP to aid in comfort and over all fit.
Lens Design
The Reverse Geometry lens has a central optical zone with a flatter radius of curvature as compared to the adjacent
intermediate curve to allow better centration for irregular corneas.
*If being used for corneal reshaping the following material options are available:
Boston XO & XO2: Red or Yellow
Equalens: Red or Yellow
Paragon HDS: Violet
Paragon HDS 100: Yellow
Below are cases where the Reverse Geometry should be considered:
RK
LASIK
PRK
PKP
Standard Parameters
BASE CURVE
DIAMETER
POWER
WARRANTY
6.00 to 12.00mm
8.0 to 12.6mm
+50.00 to -50.00D in 0.25D steps
40
REVERSE G EOMETRY
Troubleshooting
Patient Symptoms
Plan
Steepen base curve by .50D
Excessive Movement
Steepen Reverse Curve and Peripheral curves by
1.00mm each
Flatten base curve by .3mm
Restricted Movement
Decentration in any
Direction
Bearing in Intermediate
Flatten Reverse Curve and Peripheral curves
Increase Diameter by .3mm
Decrease OZ by .3mm
Flatten Reverse Curve and Peripheral curve by
1.00mm each
Flatten Base Curve by .50D
Centrally
Flatten Reverse Curve by .75mm
Bubbles
Peripherally
41
Steepen Peripheral Curves by 1.00mm with a .2 width
APEX™ K ER ATO C ON U S
Fitting Forgiveness
Apex is indicated for the early, moderate and advanced keratoconus patient. With a thin lens profile, this lens allows
quick and easy adaptation to lens wear.
Lens Design
The Apex™ Keratoconus Lens is an aspheric thin lens design. This proprietary design is based upon the belief that
those patients who are successful with GP lenses must be fitted with a lens that minimizes apical interaction, avoids
impingement of the peripheral cornea, specifically in the flatter superior quadrant, and places the optical zone over
the pupil. In order to meet this challenge, the posterior surface has a spherical optical zone radius small enough to
allow tear exchange yet large enough to provide good vision without excessive flare. In addition, the posterior lens
surface has enough eccentricity to adequately align with the flattening seen in the peripheral keratoconic cornea.
Below are cases where the Apex Keratoconus should be considered:
CENTRAL NIPPLE
CONE
CONE
LARGE SAGGING
CONE
Standard Parameters
BASE CURVE
DIAMETER
POWER
PERIPHERY
WARRANTY
4.96 to 8.44mm
7.9 to 10.5mm
+30.00 to -30.00D
Steep, Medium, Flat
42
APEX™ K ER ATO C ON US
The following are proven guidelines to aid in the fitting of keratoconus with X-Cel’s Apex proprietary lens design.
This design has a number of inherent “fitting forgiveness factors” to aid lens performance.
OBJECTIVES:
• Maintain centration of the spherical posterior optical zone over the visual axis to maximize vision and minimize
flare.
• Minimize interaction of the lens and the typically more elevated corneal apex.
• Establish a “grip” or fulcrum points along the horizontal meridian to maintain centration of the lens.
• Avoid impingement in the peripheral and mid-peripheral cornea, especially in the superior quadrant.
Impingement can result in limited wear time, poor comfort, inferior lens decentration, and poor tear film
replenishment during the blink that can result in epithelial breakdown.
• Consider the use of a topical anesthetic for patients who are not currently wearing GP lenses. By blocking the
reflex tear mechanism, and the use of wratten filter, a more accurate fluorescein pattern may be determined.
Apex is indicated for the early, moderate and advanced keratoconus patient. With a thin lens profile, this lens
allows quick and easy adaptation to lens wear.
Step 1
Select Base Curve
Step 2
Evaluate Diameter
Step 3
Determine Periphery
Step 4
• Insert the “mean” diagnostic lens (45.00D -4.00 9.3) on the eyes(s) regardless of keratometry.
• Apply proper amount of fluorescein and observe with a cobalt light.
• If a constant “black” appearance is observed over the corneal apex, steepen the base curve until a
“lightening” is observed during the blink.
• If the corneal apex is vaulted or a bubble is observed trapped beneath the lens, flatten the base curve.
• If lens is decentered, increase lens diameter.
• If proper centration is achieved and inferior edge stand off is observed, decrease lens diameter.
• If poor tear exchange over the apex is observed during the blink, consider reducing the diameter.
• Three edge lift values available are steep, medium, and flat. (all lenses in the diagnostic set are medium)
• If insufficient edge lift is observed, consider the next flatter edge lift value.
• If excessive edge lift is observed, utilize the next steeper edge lift value.
• Over-refract the most appropriate diagnostic lens to determine lens power to be ordered.
Determine Power
43
APEX™ K ER ATO C ON US
Troubleshooting
Patient Symptoms
Possible Causes
Steepen Base Curve by 1.00 D
Lens Riding High
Lens Riding Low
Plan
Reduce Diameter by .3 mm
Movement with Blink
Flatten Base Curve by 1.00D
No Movement
Decrease Diameter by .3mm
Steepen Base Curve by 1.00 D
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Decrease Edge Lift (Flat to Medium, Medium to Steep)
New Lens
Surface Non Wetting
Older Lens
Clean Lens
Change Material
Clean Lens
Order New Lens
Too Much Edge Lift
Reduce Edge Lift (Flat to Medium, Medium to Steep)
Increase Diameter by .3 mm
Increase Edge Lift (Steep to Medium, Medium to Flat)
Not Enough Edge Lift
44
PIN NAC L E ™
Aspheric Comfort Design
For the myopic or hyperopic patient who shows moderate to high amounts of with the rule corneal and refractive
astigmatism.
Lens Design
The Pinnacle lens design is a continuous aspheric concave geometry design with adjustable edge lifts to aid in fit and
comfort.
Standard Parameters
BASE CURVE
DIAMETER*
POWER
PERIPHERY
WARRANTY
6.00 to 9.90mm
7.5 to 9.9mm
+60.00 to -60.00D
Steep, Medium, Flat
Unlimited exchanges and cancellation within 90 days
*Base curve radius restricts diameter range available.
45
PINNAC L E ™
Step 1
Select Base Curve
Step 2
CORNEAL
BASE CURVE
Plano to 1.00D
On Flat K
1.12D to 1.50D
0.25D steeper than Flat K
1.62D to 2.00D
2.12D to 2.50D
2.62D or more
Discuss with Consultant
BASE CURVE
DIAMETER
Small
Recommended
Large
7.10 to 7.38mm
8.7 mm
9.0 mm
9.3 mm
7.42 to 8.08mm
9.0 mm
9.3 mm
9.6 mm
8.13 to 8.49mm
9.3 mm
9.6 mm
9.9 mm
Choose Diameter
Step 3
Determine Periphery
Determine the lens power to be ordered. First, vertex the distance power of the spectacle prescription to
the corneal plane, if necessary.
Next adjust for tear layer effects depending on the base curve selected. When fitting steeper than K,
compensate for the tear layer effect with minus power. When fitting flatter than K, compensate for the tear
layer effect with plus power.
This nomogram is based on using the recommended diameter.
*Smaller diameter – fit 0.25D steeper
* Large diameter – fit 0.25D flatter
46
PIN NAC L E ™
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Steepen Base Curve by .50 D
Lens Riding High
Lens Riding Low
Movement with Blink
Steepen Base Curve by .50D
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Too Much Edge Lift
47
PINNACLE™ L ARG E DIAMETE R
PINNAC L E ™ IC
Solutions for Irregular Corneas
Pinnacle Large Diameter or Pinnacle IC can be used for any irregular cornea patient, including lasik, corneal
transplants and injuries to aid in comfort and overall fit.
Lens Design
The Pinnacle Large Diameter and Pinnacle IC lens designs are continuous aspheric concave geometry designs with
adjustable edge lifts and a large diameter to aid in stability and comfort for irregular corneas.
Standard Parameters - Pinnacle Large Diameter
BASE CURVE
DIAMETER*
POWER
PERIPHERY
WARRANTY
6.00 to 9.90mm
10.0 to 11.2mm
+60.00 to -60.00D
Steep, Medium, Flat
Standard Parameters - Pinnacle IC
BASE CURVE
DIAMETER*
POWER
PERIPHERY
WARRANTY
6.00 to 9.90mm
11.3 to 12.6mm
+60.00 to -60.00D
Steep, Medium, Flat
*Base curve radius restricts diameter range available on both Large Diameter and IC.
Below are cases where either Pinnacle design should be considered:
PRK
PKP
LASIK
RK
RK
TRAUMA
LARGE SAGGING
CONE
48
PIN NACLE™ L ARG E DIA METE R
PINNAC L E ™ IC
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Too Much Edge Lift
49
T ITAN ™ L ARG E DIAMETE R
For the Management of Irregular Corneal Conditions
Good candidates for this gas permeable lens design include:
- Irregular corneas, associated with:
• Centration Problems – spherical, oblique, and ATR corneas
• Post Surgical – RK, Lasik, PKP, Intacs, and Ecstasia
• Corneal Dystrophies – KC & PMD
• Corneal Trauma – Scars due to injury
- Patients with regular astigmatism:
• Especially those that experience variable vision with soft and soft toric lenses
Lens Design
The Titan is a large diameter gas permeable lens with an aspheric posterior surface. This posterior surface allows
the large diameter lens to avoid becoming too tight in the peripheral and mid-peripheral area of the cornea. More
than one aspheric value of eccentricity is available with this design.
Below are cases where the Titan should be considered:
PRK
PKP
LASIK
PMD
RK
RK
LARGE SAGGING
CONE
50
T ITAN™ L ARG E DIAMETE R
Parameter Availability
BASE CURVE
DIAMETER POWERS
EDGE LIFT
MATERIAL
WARRANTY
6.75 to 9.93mm
+60.00 to -60.00D
Steep, Medium, Flat
Recommended in Optimum Extra
Step 1
Select Base Curve
Step 2
Evaluate Fluorescein
Start with a diagnostic lens that is approximately one diopter flatter than the flattest K, regardless of the
amount of corneal astigmatism.
Adjust the Base Curve through Fluorescein evaluation. The goal is to equally distribute the mass of the lens
avoiding areas of vault and/or bearing of the corneal surface. Use of a wratten filter is suggested.
Step 3
It is suggested that the steeper edge lifts be “earned”.
Evaluate Diameter
These larger lens diameters ride adjacent to the limbus which tends to be significantly flatter than the
central and paracentral areas of the anterior cornea.
and Periphery
Step 4
Final Evaluation
The medium and flatter edge lift values are most common.
The final lens should display good centration, minimal corneal surface interaction, and some movement in
all gazes.
Not enough edge lift = order Flat PC
Too much edge lift = order Steep PC
When the most appropriate base curve is determined, refract over the lens to determine the final power.
51
T ITAN ™ L ARG E DIAMETE R
Troubleshooting
Patient Symptoms
Possible Causes
Lens Riding High
Lens Riding Low
Plan
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Clean Lens
New Lens
Surface Non Wetting
Older Lens
Change Material
Clean Lens
Order New Lens
Too Much Edge Lift
52
SOLUT ION ™ BIFO C A L
A Solution for an Age Old Problem
For the presbyopic patient whose distance refractive error is between a -10.00 to +6.00, combined with a near power
addition of between +1.00 to +3.00. Most beneficial to patients having with the rule astigmatism of 0.50 to 3.00
diopters.
Lens Design
The Solution Bifocal is a unique translating gas permeable lens design with one-piece construction providing
monocentric optics.
Utilizing the principles of alternating vision, the Solution Bifocal provides patients with natural vision. Similar to
the patients own visual system, both eyes function at distance and near at the same time by alternating the line of
sight between the distance optics in the top portion of the lens and near optics in the lower part. The image jump
patients experience when they change their view from the distance to near optics of other bifocal lenses is virtually
eliminated with this monocentric design. Additionally, the prism ballast positions the near segment inferiorly,
stabilizing the vision.
BASE CURVE
DIAMETER POWER
ADD POWER
PRISM BALLAST
PRISM AXIS
SEGMENT POSITION
TRUNCATION
MATERIAL
WARRANTY
7.14 to 8.44mm
8.5 to 10.0mm
+6.00 to -10.00D
+1.00 to +3.00D
Minimum, Medium, Maximum, Extra Maximum
90 +/- 20
On geometric center (GC)
0.5, 1.0mm above GC
0.5, 1.0, 1.5, 2.0mm below GC
On request only
Recommended in Fluoroperm 30, 60, Paragon Thin, Paragon HDS and HDS 100
CUSTOM PARAMETERS (additional $20.00 fee)
BASE CURVE
DIAMETER POWER
ADD POWER
53
6.49 to 9.01mm
8.0 to 11.0mm
+10.00 to -20.00D
+1.00 to +3.00D
Step 1
Select Base Curve
Step 2
Determine Distance
Corneal Toricity
On K to 0.50D
0.75D to 1.25D
1.50D to 2.00D
2.25D to 2.75D
Base Curve
On K
0.25D steeper than K
From the base curve selection and spectacle Rx, utilize the optical concepts of SAM (steeper add minus)
and FAP (flatter add plus) to determine the distance power.
Power
Step 3
Choose the add power directly from the patients refraction results.
Determine Near
Power
Step 4
Choose the lens diameter basd on HVID measurements minus 2.5mm.
Choose Diameter
For example: 11.8mm HVID 2.5mm = 9.3mm diameter
Step 5
Based on the lower lid position order the segment position either 1.0mm below geometric center (BGC) or
1.5mm BGC.
Choose Segment
Position
Example:
Step 6
Choose Prism and
Lower lid at limbus
1.0mm BGC
Lower lid above limbus
1.5mm BGC
• Always begin with medium prism
•Available materials include Fluoroperm 30, 60, Paragon Thin, Paragon HDS and HDS100
• PlasmaEYEZ treated
Material
54
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Decrease Edge Lift
Peripherally
Clean Lens
New Lens
Change Material
Surface Non Wetting
Clean Lens
Older Lens
Order New Lens
Too Much Edge Lift
Poor Distance Acuity
Poor Near Acuity
Lens Riding High
Increase Prism (Minimum to Medium, Medium to
Maximum, Maximum to Extra Maximum)
Seg Height too High
Reduce Seg Height by .5mm
Seg Height too Low
Increase Seg Height by .5mm
Lens Sits Under Lower Lid
Truncated by .4mm
Excessive Nasal Rotation/
Excessive Temporal
Rotation
55
Increase Prism
CV-4™ MULT IFO C A L
Easy to Fit 4 Dimensional Multifocal
For the presbyopic patient whose distance refractive error is between -16.00 and +16.00, with near power addition
up to +3.00. CV-4, a spherical base curve design with simultaneous near, intermediate and distance optics on the
anterior surface gives us the best of all worlds.
Lens Design
The CV-4 Multifocal is a progressive aspheric front surface multifocal GP lens that can be fit by using the patients
pupil size, corneal measurements, and spectacle Rx.
The lens has a spherical back surface design with standard single vision curves, allowing the lens to be fit as easily
as any single vision GP lens. The front surface incorporates aspheric progressive power optics. The center portion of
the lens has low eccentricity that provides clear distance vision, while the adjacent mid-peripheral area has a more
rapid rate of flattening to provide near power.
BASE CURVE
DIAMETER POWER
ADD POWER
PUPIL DIAMETER
CENTER THICKNESS
MATERIAL*
WARRANTY
6.80 to 8.55mm
9.0 to 10.0mm
+16.00 to -16.00D
+1.00 to +3.00D in 0.25D steps
3.0 to 5.5mm
Calculated by design
Recommended in Boston XO
*PlasmaEYEZ treated
Base Curve Selection:
• Choose Base Curve the same as for spherical single vision GP fits. CV-4 Base Curve Selection Chart can be used
for guidance.
• Goal is to fit a lens that positions centrally.
Diameter Selection
• Suggested beginning diameter range between 9.2mm to 9.8mm.
Distance Power Selection
•Use full spherical distance power based on patient’s spectacle Rx. Calculate for vertex distance effect if over +/4.00D. Adjust for SAM and FAP from the CV-4 Base Curve Selection Chart.
Visual Acuity Analysis
• Both distance and near vision should be evaluated with the patient holding his/her head in the straight-ahead
position.
• Some translation may occur upon downward gaze. This should not affect near acuity.
56
Basic Fitting Information (cont.)
Following Initial Fit:
1. Allow lens to settle for up to 20 minutes
2. Over-refract to determine distance Rx
3. Over-refract to determine near Rx
4. Re-check pupil size
5. Communicate any subjective patient complaints to an X-Cel Consultant.
3.0mm
3.5mm
4.0mm
4.5mm
5.0mm
5.5mm
Empirical Fitting Procedure
1. Measure patient’s pupil size (each eye) using the Pupil Diameter Guide above.
(measure in normal room illumination)
2. Select Base Curve and Diameter from Selection Chart.
3. Select Distance Power using full spherical power from spectacle Rx, calculating for vertex effects if greater than
+/- 4.00. Adjust for SAM or FAP based on base curve selection.
4. Select near power using full add power from spectacle Rx.
5. Order Lens from X-Cel Contacts.
Base Curve Selection Chart
57
Corneal Astigmatism
Choose Base Curve
NONE
On Flat K
9.2mm – 9.8mm
0.25D to 0.50D
9.2mm – 9.8mm
0.75D and greater
9.2mm – 9.8mm
Diameter
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Clean Lens
New Lens
Surface Non Wetting
Older Lens
Change Material
Clean Lens
Order New Lens
Poor Near Acuity
Pupil Zone too Small
Enlarge pupil zone by .5mm
Lens Decentered High
Pupil Zone too Large
Decrease Pupil Zone by .5mm
Lens Decentered Low
58
PROPLUS™ MULT IFO C A L
This Plus will Add up to Patient Satisfaction
For the presbyopic patient whose distance refractive error is between a +10.00 to -15.00, combined with a spectacle
near power addition of between +0.75 to +2.50. Most beneficial to early presbyopes having trouble with the rule
astigmatism of 0.50 to 2.25 diopters.
Lens Design
ProPlus is a bi-aspheric multifocal GP lens that is easy to fit by using the patients corneal measurements and
spectacle Rx. The center portion of the lens has low eccentricity that provides clear distance vision, while the
adjacent mid peripheral area has a more rapid rate of flattening to provide near power. The ProPlus aspheric
optics provide intermediate vision, making this design a great choice for patients who spend multiple hours on the
computer.
BASE CURVE
DIAMETER POWER
ADD POWER
DISTANCE ZONE
MATERIAL*
WARRANTY
6.90 to 8.50mm
8.5 to 11.0mm
+10.00 to -15.00D
+0.75D to +3.00D in .25D steps
3.3mm to 3.9mm (3.6mm is default)
3.3mm distance zone for +2.50 ADD power and higher
Recommended in Boston XO Ice Blue color
*PlasmaEYEZ treated
59
Corneal Cylinder
Base Curve
0.00D to 1.00D
1.12D to 1.87D
2.00D to 3.00D
3.00D and higher
PROPLUS™ MULT IFO C A L
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Steepen Peripheral Curve
Clean Lens
New Lens
Surface Non Wetting
Older Lens
Change Material
Clean Lens
Order New Lens
Steepen Peripheral Curve
Too Much Edge Lift
Poor Near Acuity
Lens Riding High
Distance Zone too Small
Increase Distance Zone by .3mm
Lens Sits on Lower Lid
Distance Zone too Large
Decrease Distance Zone by .3mm
60
ESSENT IAL SOLU TION ™
The Only Segmented Translating Multifocal That Gives
Extra Add
For the midlife to mature presbyopic patient whose distance refractive error is between a -10.00 and +6.00, combined
with a near power addition of between +.75 and +3.50.
Lens Design
The initial premise for the Essential Solution design was to be able to deliver excellent vision not only at distance
and near, but at the all important intermediate range. This is achieved by combining the aspheric back surface of the
Essential multifocal with the near vision benefits of the X-Cel Solution front surface, segmented, translating design.
This combination results in a high performance design with a thinner lens profile that delivers up to 3.50 diopters of
add power, providing excellent near correction for even the most mature presbyopes.
The design is quite thin for a ballasted lens and the decreased lens mass makes for a very comfortable fit. And
importantly, the unique front surface provides distance and near optical centers that are adjacent to each other
delivering “no jump” optics. Thus, the patient has no image jump when looking from distance to reading tasks.
BASE CURVE
DIAMETER DISTANCE POWER
ADD POWER
PRISM BALLAST
PRISM AXIS
SEGMENT POSITION
MATERIAL*
WARRANTY
7.10 to 8.20mm in .10mm steps
9.0,9.3, 9.6mm
+6.00 to -10.00D
+0.75 to +3.50D
Minimum, Medium, Maximum
90 +/- 20
1.0 and 1.5mm below geometric center (BGC)
Recommended in Boston XO Ice Blue color
Two exchanges per eye and cancellation within 90 days for 80% credit
*PlasmaEYEZ treated
61
ESSENT IAL SOLU TION ™
STEP 1: Select Base Curve and Distance Power Adjustment
FLAT K
BASE CURVE SELECTION
DISTANCE POWER ADJUSTMENT
40.50
8.20
-0.50
40.75
8.10
-0.75
41.00
8.10
-0.50
41.25
8.00
-1.00
41.50
8.00
-0.75
41.75
7.90
-1.00
42.00
7.90
-0.75
42.25
7.90
-0.50
42.50
7.80
-0.75
42.75
7.80
-0.50
43.00
7.70
-0.75
43.25
7.70
-0.50
43.50
7.60
-0.75
43.75
7.60
-0.50
44.00
7.50
-1.00
44.25
7.50
-0.75
44.50
7.50
-0.50
44.75
7.40
-0.75
45.00
7.40
-0.50
45.25
7.30
-1.00
45.50
7.30
-0.75
45.75
7.30
-0.50
46.00
7.20
-0.75
46.25
7.20
-0.50
46.50
7.10
-1.00
46.75
7.10
-0.75
47.00
7.10
-0.50
62
ESSEN T IAL SOLU TION ™
Step 2
Provide the patient’s spectacle add power and add +0.50D
Step 3
Start at 1.0mm BGC (Only 1.0 and 1.5 are available)
Step 4
9.3mm diameter, prism included
Determine Near
Power
Choose Segment
Position
Order Lens
Step 5
Example
63
Spectacle Rx = -2.00 -0.75 x 180, +2.00 Add
K’s 42.50 @ 180/43.25 @90
Initial Lens Selection:
Base Curve = 7.80mm
Distance Power = -2.75 (-2.00 + -0.75)
Add Power = +2.50D
Diameter = 9.3mm Seg Position = 1.0mm BGC Prism Ballast
ESSEN T IAL SOLU TION ™
Troubleshooting
Patient Symptoms
Possible Causes
Steepen Base Curve by .10mm
Lens Riding High
Lens Riding Low
Plan
Movement with Blink
No Movement
Excessive Movement
Flatten Base Curve by .10mm
Restricted Movement
Centrally
Bubbles
Peripherally
New Lens
Surface Non Wetting
Older Lens
Flatten Base Curve by .10mm
Clean Lens
Change Material
Clean Lens
Order New Lens
Too Much Edge Lift
Decrease Diameter by .3 mm
Poor Distance Vision
Poor Near Vision
Segment Line too Low
Segment Line too High
Lower Seg Height by .5mm
Lens Rides too High
Increase Prism
Segment line too low
Medium
Medium
Raise
Segtoheight
by .5mm
Increase
Lens rides Under Lower
Lid Prism
Medium toby
Maximum
Truncated
.4mm
Not Enough Prism
Increase Prism
Maximum to Extra Maximum
Excessive Nasal or
Temporal Rotation
64
VISION S™ TORIC
Easy to Fit Toric Gas Perm
Visions™ Toric is an excellent design of choice for those patients who require the benefit of the Visions UltraThin
back surface aspheric geometry.
Lens Design
Visions Toric is an aspheric back surface design available as a bitoric or front toric. The lens design features a thin
lens profile and edge design. This design is utilized when the corneal cylinder exceeds 2.50 diopters or when there is
more than 1.00 diopter of against the rule astigmatism.
BASE CURVE
7.10 to 8.49mm
DIAMETER 9.3, 9.6mm
POWER
+6.00 to -10.00
CYLINDER
-1.50 to -4.00 Front Toric
-1.50 to -5.00 Bitoric
MATERIAL
Paragon HDS and Paragon Thin
COLOR
UV Blue
WARRANTY
65
VISION S™ TORIC
Visions FRONT TORIC Basic Fitting Information
Step 1
Select Base Curve
Step 2
Choose Diameter
Corneal Cylinder
Base Curve
Plano to 1.00 D
1.12 to 1.50D
1.62 to 2.00D
2.12 to 2.50D
1.62D to 2.00D
2.75 or more
2.12D to 2.50D
Base Curve
39.75 to 43.00D
9.6mm
43.12 to 47.50D
9.3mm
Diameter
Step 3
Sphere Power
Determine Power
1. Convert the spectacle Rx to minus cylinder. If converting is necessary rotate the axis to
90 degrees.
2. Vertex the sphere power of the spectacle prescription to the corneal plane, if necessary.
3. Using SAM/FAP (steeper add minus/flatter add plus) adjust the spherical component in
an equal amount to the flat meridian base curve adjustment.
4. The resultant power is the sphere component.
Cylinder Power
1. Subtract the corneal cylinder from the refractive cylinder.
2. The resultant power is the cylinder component.
Axis
1. Use the original or transposed axis for the final lens power prescription.
66
VISION S™ TORIC
Visions FRONT TORIC Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
New Lens
Clean Lens
Surface Non Wetting
Clean Lens
Older Lens
Order New Lens
67
Too Much Edge Lift
VISION S™ TORIC
Visions BI-TORIC Basic Fitting Information:
Step 1
Select Base Curve
Step 2
Choose Diameter
Step 3
Determine Power
Corneal Cylinder
Flat Meridian Base Curve
Steep Meridian Base Curve
Plano to 2.50D
Fit Visions Ultra Thin
Fit Visions Ultra Thin
2.62 to 4.75D
0.50D flatter than Flat K
0.50D flatter than Steep K
4.87 to 6.00D
0.50D flatter than Flat K
0.75D flatter than Steep K
6.12D or more
Base Curve
Diameter
39.75 to 43.00D
9.6 mm
43.12 to 47.50D
9.3 mm
Sphere Power
1. Convert the spectacle Rx to minus cylinder, if necessary.
2. Vertex the power component to the corneal plane, if necessary.
3. Add +0.50D to the spherical component.
Cylinder Power
4. Add the spherical and cylinder components together.
5. Vertex the resultant cylinder component, if necessary.
6. Change the cylindrical component by +0.50D or +0.75D according to the steep meridian
base curve adjustment.
Final Lens Power
Sphere: Use the adjusted sphere power from steps 1 through 3 above.
Cylinder: Convert from drum reading by subtracting the two power components. The
resultant power is the final cylinder power.
68
VISIONS™ TORIC
Visions BI-TORIC Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
New Lens
Clean Lens
Surface Non Wetting
Clean Lens
Older Lens
Order New Lens
69
Too Much Edge Lift
VISIONS™ ULT R ATHIN
Easy to Fit Gas Perm
The Visions Ultrathin lens was developed for today’s busy contact lens practice and those new to GP fitting.
Practitioners find it a great first lens choice and alternative to soft torics. The exceptional handling, health benefits
and visual acuity make it a great choice for many contact lens candidates. Visions is designed to be an everyday lens
of choice. Ideal patients for Visions would include any patient who would benefit by having a spare pair or who are:
• New to contact lens wear
• Young or active
• Frequent travelers
• Exposed to irritating and hard environments
Lens Design
Visions is an ultra-thin single vision aspheric lens design. It features an aspheric back surface with a thin lens profile
and edge design.
BASE CURVE
DIAMETER POWER
MATERIAL
COLOR
WARRANTY
7.10 to 8.49mm
9.0, 9.3, 9.6mm
+6.00 to -10.00D
Paragon HDS
Blue
70
VISION S™ ULT R ATHIN
Step 1
Select Base Curve
Step 2
Corneal Cylinder
Base Curve
Plano to 1.00D
On Flat K
1.12 to 1.50D
1.62 to 2.00D
2.12 to 2.50D
2.62D or more
Base Curve
Diameter
Choose Diameter
Step 3
Determine Power
Small
Recommended
Large
7.10 to 7.38mm
8.7mm
9.0mm
9.3mm
7.42 to 8.08mm
9.0mm
9.3mm
9.6mm
8.13 to 8.49mm
9.3mm
9.6mm
9.9mm
Determine the lens power to be ordered. First, vertex the distance power of the spectacle
prescription to the corneal plane, if necessary.
Next adjust for tear layer effects depending on the base curve selected. When fitting steeper
than K, compensate for the tear layer effect with minus power. When fitting flatter than K,
compensate for the tear layer effect with plus power.
71
VISIONS™ ULT R ATHIN
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Too Much Edge Lift
72
STARL E N S ™
Highest Level of Design Performance
Starlens is for the myopic or hyperopic patient who shows low to moderate amounts of with the rule astigmatism.
It is most beneficial to the higher myope.
Lens Design
The Starlens is an aspheric peripheral design with a thin edge to optimize comfort.
BASE CURVE DIAMETER
POWER
MATERIAL
WARRANTY
73
6.50 to 8.65mm
7.5 to 11.5mm
+20.00 to -20.00D
Any
STARL E N S ™
Step 1
Select Base Curve
Step 2
Corneal Cylinder
Base Curve
Plano to 1.00D
On Flat K
1.12 to 1.50D
1.62 to 2.00D
2.00 to 2.50D
2.75D or more
Base Curve
Diameter
Choose Diameter
Step 3
Determine Power
Small
Recommended
Large
7.10 to 7.38mm
8.7mm
9.0mm
9.3mm
7.42 to 8.08mm
9.0mm
9.3mm
9.6mm
8.13 to 8.49mm
9.3mm
9.6mm
9.9mm
74
STARL E N S ™
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Decrease Edge Lift
Peripherally
Clean Lens
New Lens
Change Material
Surface Non Wetting
Clean Lens
Older Lens
Order New Lens
Reduce Edge Lift
Too Much Edge Lift
Increase Edge Lift
75
X-CEL THIN ™
Advanced Design
X-Cel Thin™ is an excellent alternative for Polycon or Fluorocon patients, or when a thin lens profile is a must.
Lens Design
The X-Cel Thin design is a thin lens design using similar design configurations and center thickness as a polycon
design.
BASE CURVE POWER
DIAMETER
MATERIAL
WARRANTY
7.00 to 8.44mm
+8.00 to -17.00D
8.5 to 10.0mm
Boston ES
76
X-CEL THIN ™
Step 1
Select Base Curve
Step 2
Corneal Cylinder
Base Curve
Plano to 1.00D
On Flat K
1.12 to 1.50D
1.62 to 2.00D
2.12 to 2.50D
2.62D or more
Base Curve
Diameter
Choose Diameter
Step 3
Determine Power
Small
Recommended
Large
7.10 to 7.38mm
8.7mm
9.0mm
9.3mm
7.42 to 8.08mm
9.0mm
9.3mm
9.6mm
8.13 to 8.49mm
9.3mm
9.6mm
9.9mm
77
X-CEL THIN ™
Troubleshooting
Patient Symptoms
Possible Causes
Plan
Lens Riding High
Lens Riding Low
Movement with Blink
No Movement
Excessive Movement
Restricted Movement
Centrally
Bubbles
Peripherally
Clean Lens
New Lens
Surface Non Wetting
Older Lens
Order New Lens
Clean Lens
Order New Lens
Too Much Edge Lift
78
C ONSULTAT ION SERVIC E S
The X-Cel Contacts Consultation Team
We Put All the Pieces Together
X-Cel Contacts has enjoyed a reputation for our unparalleled customer service while being committed and
passionate to manufacturing innovative and quality gas permeable and custom soft lenses. With 18 NCLE
certified consultants offering over 325 years of experience to assist you with your specialty contact lens
patients, we feel there is no fit too challenging. We believe your patient is our patient too so we are happy to
assist you with all of your contact lens patients!
How our consultation team can assist you:
• Call or Email an X-Cel Consultant with K’s refraction, patient history, topography and current lens Rx and
we can design the best GP or custom soft lens for your patient.
• In-office fitting with 3 or more patients and our consultant will come to your office and assist you with
fitting the patients in our GP or custom soft lens designs at no charge.
• Diagnostic Set fitting with either a loaner or purchase a diagnostic set.
79
WARR AN TIE S
90 DAY POL IC IE S
Flexlens® & Westcon™
Initial Lens
Annual Supplies
Unlimited exchanges and cancellation
Non-warranted and non-returnable
Unlimited Exchanges and Cancellation within 90 days
All Spherical and Toric Designs
Comfort Designs: Visions Ultrathin, Pinnacle, X-Cel® Thin, Starlens, Envision
CV-4™ Multifocal
Solution™ Bifocal
Apex™ Keratoconus Reverse Geometry
ProPlus™ Multifocal
Titan™
Atlantis™ Scleral
Essentials & Essentials X-Tra
Clearion
Multivision
Target/Circular: One exchange per eye, 50% credit on additional exchanges or cancellation within 90 days.
Essential Solution/Tangent Streak (all products): Two exchanges per eye and cancellation for 80% credit within 90 days.
Lifestyle: 50% credit on all exchanges and returns.
Dyna Intralimbal: $69.50 credit on all exchanges and returns.
Unilens GP: 100% credit on all exchanges and returns.
Rose K/Rose K2/Rose K2 IC: Two exchanges per eye, $50.00 credit per lens upon cancellation.
CRT (Corneal Refractive Therapy): You will be invoiced full price by your Authorized CRT Laboratory for the
replacement lens. Once your returned lens is processed, a credit will be issued by your Authorized CRT Laboratory for
the price of the lens. It is best to return the lens in its original vial, if possible. The lens must be received by Paragon
within 45 days of the replacement lens order to receive full credit. Once a spare lens has been purchased from a CRT
warranty Rx Lens, exchanges will no longer be accepted.
SureFit Program: Non-dispensed, opened and unopened, CRT SureFit lenses (two per eye) must be returned to Paragon
in the pre-paid, self-addressed envelope within 90 days of the original invoice date to avoid additional charges of $92.50
per lens. A $25 cancellation fee applies wihin 90 days of invoice date.
Warranties do not cover add-ons, lost or damaged lenses.
All paperless returns will incur a $3.00 material recovery fee per lens.
All physical returns will incur a $5.00 material recovery fee per lens, and original invoice must accompany lenses.
*The following products must be returned to X-Cel in order to receive credit: TotalVue, Tangent Streak,
Dyna Intralimbal, & Unilens. Any defective lenses must be returned to X-Cel for evaluation and follow-up.
80
LEN S MAT E RIA L S
BOSTON
Name
Material Type
DK
Wetting Angle
Refactive Index
Specific Gravity
Color
Boston© XO
Fluorosilicone
Acrylate
100*
49 degrees
captive bubble
1.415
1.27
Boston© EO
Fluorosilicone
Acrylate
58*
49 degrees
captive bubble
1.429
1.23
Blue, UV Blue, Ice
Blue, UV Electric Blue
Green, Gray, Brown
Boston© ES
Fluorosilicone
Acrylate
18*
52 degrees
captive bubble
1.443
1.22
Blue, UV Blue, Ice
Blue, Green, Gray,
Brown
Boston© XO2
Fluorosilicone
Acrylate
141*
38 degrees
captive bubble
1.424
1.19
Boston©
EQUALENS©
Fluorosilicone
Acrylate
47*
30 degrees
captive bubble
1.439
1.19
Boston©
EQUALENS© II
Fluorosilicone
Acrylate
85*
30 degrees
captive bubble
1.423
1.24
UV Blue, Red, Yellow
Boston© IV
Silicone
Acrylate
19*
17 degrees
captive bubble
1.469
1.10
Blue
Boston© II
Silicone
Acrylate
12*
20 degrees
captive bubble
1.471
1.13
Blue
UV Blue, Ice Blue, UV
Ice Blue, Green, UV
Green, Violet, Red,
Yellow, Clear, UV Clear
Blue, UV Blue, Ice
Blue, UV Ice Blue, UV
Green, Violet, Red,
Yellow, Clear, UV Clear
UV Blue
*ISO.Fatt Method
PARAGON VISION SCIENCES
81
Name
Material Type
DK
Wetting Angle
Refactive Index
Specific Gravity
Color
Pargon HDS©
Fluorosilicone
Acrylate
58*
14.7***
62****
1.449
1.16
Blue, UV Blue
Crystal Blue, UV Crystal
Blue, Green, UV Green,
Forest Green, Violet
Paragon ThinTM
Fluorosilicone
Acrylate
29*
12.8***
61****
1.463
1.45
Sapp Blue, UV Sapp
Blue, Emerald Green, UV
Emerald Green, Clear
Paragon HDS© 100
Fluorosilicone
Acrylate
100*
42***
70****
1.442
1.1
Sapphire Blue, UV Saph
Blue, Emerald Green,
Fluoroperm© 30
Fluorosilicone
Acrylate
30*
12.8***
61****
1.466
1.14
Fluoroperm© 60
Fluorosilicone
Acrylate
60*
14.7***
62****
1.453
1.15
Fluoroperm© 92
Fluorosilicone
Acrylate
92*
16***
64****
1.453
1.1
Blue, UV Blue, Green, UV
Green, Clear
Fluoroperm© 151
Fluorosilicone
Acrylate
151*
42***
70****
1.422
1.1
Blue, UV Blue
Paraperm© 02
Silicone
Acrylate
16*
23***
61****
1.473
1.12
Clear, Blue, Electric Blue,
Green,
Cool Green
Blue, UV Blue, Maj Blue,
Crystal Blue, Gray, UV
Gray, Green, UV Green,
Clear
Green, UV Green, Blue,
UV Blue, Crystal Blue,
Brown, Clear
LENS MAT E RIA L S
PARAGON VISION SCIENCES (Cont.)
Name
Material Type
DK
Wetting Angle
Refactive Index
Specific Gravity
Color
Paraperm© EW
Silicone
Acrylate
56*
26***
64****
1.467
1.07
Blue, Clear
Optacryl© 60
Silicone
Acrylate
18*
25***
59****
1.467
1.13
Blue, Green
Refactive Index
Specific Gravity
Color
*Reversed Fatt Method
**ISO/ANSI Method
***Adapted from “A new method for wetting angle management.”
Medican et al, International Eyecare, 01/1998, Vol. 2, no 1. p 45
****Sessile Drop Technique per ANSI 280.20, 8.11
CONTAMAC
Material Type
Name
DK
Wetting Angle
Optimum Classic
Roflufocon A
26
12
1.450
1.19
UV Blue, UV Glacier
Blue, UV Green, UV
Gray, UV Glacier B1
Optimum Comfort
Roflufocon C
65
6
1.437
1.17
UV Blue, UV Green, UV
Gray, UV Forest Green,
UV Brown
Optimum Extra
Roflufocon D
100
3
1.431
1.16
Clear, UV Blue, UV
Green, UV Gray, UV
Clear, UV Glacier B1
Optimum Extreme
Roflufocon E
125
6
1.432
1.15
UV Blue, UV Green, UV
Gray, UV Glacier B1
GP materials shaded in blue cannot be plasma treated. All other materials are plasma treated unless specified.
FLEXLENS / WESTCON SOFT LENS MATERIALS
Name
Material Type
DK
Refactive Index
Specific Gravity
Color
Benz G3X 49%
Hioxifilcon B
15
1.425
1.136
Blue, Clear
Benz G5X 59%
Hioxifilcon A
21
1.401
1.18
Blue, Clear
Contaflex 55%
Methafilcon A
19.5
1.40
1.099
UV Blue, Clear
Contaflex 45%
Hefilcon A
13.8
1.42
1.17
Blue, Clear
Contaflex 38%
Polymacon
7.9
1.438
1.17
Blue, Clear
74% Definitive
Silicone Hydrogel
Efrofilcon A
60
1.3750 at 20ºC
1.3750 at 35ºC
1.048
Blue, Clear
*Refactive index and specific gravity (hydrated)
*Flexlens is not available in Polymacon 38%. Westcon is not available in Definitive Silicone Hydrogel.
82
DIAG NOST IC SET S FOR
CUSTOM S OFT
FLEXLENS ARC (18 LENS SET) - $299.00
Base Curve
6.0mm to 8.4mm in 0.3mm steps
Power
-6.00
Diameter
14.5
Thickness
For each BC and diameter one thickness at 0.30 and 0.50
FLEXLENS TORIC (10 LENS SET) - $250.00
Base Curve
8.3
8.3
8.6
8.6
8.6
8.6
8.9
8.9
8.9
8.9
Spherical Power
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
Cylinder Power
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
-2.00
Axis
Diameter
90
180
135
45
90
180
135
45
90
180
14.0
14.0
14.5
14.5
14.5
14.5
15.0
15.0
15.0
15.0
FLEXLENS TRI-CURVE KERATOCONUS (10 LENS SET) - $250.00
Base Curve
6.0
6.3
6.6
6.9
7.2
7.5
7.8
8.1
8.4
8.7
Diameter
14.0
14.0
14.0
14.0
14.0
14.5
14.5
14.5
14.5
14.5
Power
-3.00
-3.00
-3.00
-3.00
-3.00
-3.00
-3.00
-3.00
-3.00
-3.00
Center Thickness .45mm .45mm .45mm .45mm .45mm .45mm .45mm .45mm .45mm .45mm
FLEXLENS PEDIATRIC APHAKIC (7 LENS SET) - $250.00
Base Curve
7.2
7.2
7.5
7.5
7.5
7.5
7.8
11.5
11.5
11.5
12.0
12.0
12.5
13.0
+20.00
+25.00
+25.00
+20.00
+25.00
+25.00
+25.00
8.7
9.0
9.3
9.6
Diameter
Spherical Power
FLEXLENS PRS (7 LENS SET) - $250.00
Base Curve
7.8
8.1
8.4
Diameter
15.0
15.0
15.0
15.0
15.0
15.0
15.0
Power
-1.00
-1.00
-1.00
-1.00
-1.00
-1.00
-1.00
Center Thickness
.28mm
.28mm
.28mm
.28mm
.28mm
.28mm
.28mm
Flange Thickness
.10mm
.10mm
.10mm
.10mm
.10mm
.10mm
.10mm
8.1
8.4
FLEXLENS PIGGYBACK (10 LENS SET) - $250.00
Base
Curve
6.6
6.9
7.2
7.5
7.8
9.0
9.3
Diameter
14.5
14.5
14.5
14.5
14.5
14.5
14.5
14.5
14.5
14.5
Power
Plano
Plano
Plano
Plano
Plano
Plano
Plano
Plano
Plano
Plano
.12mm
.12mm
.12mm
.12mm
.12mm
.12mm
.12mm
.12mm
.12mm
.12mm
Center
Thickness
Anterior
Cutout
10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm
Other Diagnostic Sets available upon request.
83
8.7
SPECIALT Y G P
APEX STANDARD (24 LENS SET) - $299.00
Base Curve
58.00D (5.82) to 40.00D (8.44)
Power
Plano to -17.00D
Diameter
8.2mm to 10.0mm
Periphery
Medium
Material
Recommended in Boston XO Green
ADDITIONAL (10 LENS SET) - $399.00
Base Curve
68.00D (4.96) to 59.00D (5.72)
Power
-17.00D to -20.00D
Diameter
8.2mm
Periphery
Medium
Material
Recommended in Boston XO Green
ATLANTIS (24 LENS SET) - $499.00
15.0 Diameter
Sagittal Height
Scleral Zone Steep
Scleral Zone Flat
A
40.00 (8.44)
3.394
3.444
3.344
B
42.00 (8.04)
3.681
3.731
3.631
C
44.00 (7.67)
3.998
4.048
3.948
D
46.00 (7.34)
4.349
4.399
4.299
E
48.00 (7.03)
4.754
4.804
4.704
16.5 Diameter
Sagittal Height
Scleral Zone Steep
Scleral Zone Flat
F
43.00 (7.85)
5.072
5.122
5.022
G
45.00 (7.50)
5.627
5.677
5.577
H
47.00 (7.18)
6.338
6.388
6.288
CV-4 (12 LENS SET) - $399.00
Base Curve
46.00D (7.34) to 40.50D (8.33) in .50 steps
Power
-3.00D
Diameter
9.2mm, 9.5mm
Add
+2.00D
Pupil Diameter
4.5mm
ESSENTIAL SOLUTION (12 LENS SET) - $399.00
Base Curve
47.50D (7.10) to 41.12D (8.20) in .50 steps
Distance Power
-3.00D
Add Power
+2.00D
Diameter
9.3mm
Prism Ballast
Medium
Segment Position
1.00mm below geometric center (BGC)
84
DIAG NOST IC SET FOR
SPECIALT Y G P
PINNACLE (12 LENS SET) - $240.00
Base Curve
46.50D (7.26) to 41.00D (8.23)
Power
-3.00D
Diameter
8.9mm in Base Curves thru 7.50
9.2mm in Base Curves from 7.58 to 7.85
PINNACLE LARGE DIAMETER (16 LENS SET) - $320.00
Base Curve
51.00D (6.62) to 36.00D (9.38)
Power
-3.00D
Diameter
10.2mm, 10.5mm
PRO PLUS (12 LENS SET) - $200.00
Base Curve
45.50D (7.42) to 40.00D (8.44)
Distance Power
-2.00D
Add Power
+2.00D
Diameter
9.5mm
Standard Distance Zone
3.6mm
REVERSE GEOMETRY (15 LENS SET) - $270.00
Base Curve
41.12D (8.20) to 35.87D (9.40)
Power
Plano
Diameter
10.5mm
Optical Zone
Various OZ and Reverse Curves
SOLUTION BIFOCAL (24 LENS SET) - $399.00
Base Curve
48.87D (7.20) to 40.26D (8.30) in .10D steps
Distance Power
+2.00 to -2.00D
Add Power
+2.00D
Diameter
9.2mm for Base Curves thru 7.50mm
9.6mm for Base Curves from 7.60 to 8.30mm
85
Optical Zone
1.5mm smaller than OAD
Prism Ballast
Medium
Segment Position
1.0mm below geometric center (BGC)
SPECIALT Y G P
STARLENS (12 LENS SET) - $200.00
Base Curve
46.00D (7.34) to 40.50D (8.33)
Power
-3.00D
Diameter
9.2mm in Base Curves thru 7.42
X-CEL THIN (12 LENS SET) - $299.00
Base Curve
46.00D (7.34) to 40.50D (8.33)
Power
-3.00D
Diameter
TITAN (26 LENS SET) - $400.00
Base Curve
47.00D (7.18) to 35.00D (9.64)
Power
+5.00D to Plano
Diameter
11.8mm, 12.3mm
Edge Lift
Medium, Flat
Material
TITAN (13 LENS SET) - $200.00
Base Curve
47.00D (7.18) to 35.00D (9.64)
Power
+5.00D to -3.00D
Diameter
12.3mm
Edge Lift
Medium, Flat
Material
VISIONS (12 LENS SET) - $200.00
Base Curve
46.25D (7.30) to 40.75D (8.28)
Power
-3.00D
Diameter
86
CALIFORNIA
800.342.2724
FLORIDA
800.432.3838
GEORGIA
800.241.9312
MARYLAND
800.221.9235
PENNSYLVANIA
800.245.0797
WASHINGTON
800.426.6241
WESTCON
800.346.4303
MINNESOTA
800.926.6822
2775 Premiere Parkway, Suite 600, Duluth, GA 30097 | 800.241.9312

X-Cel Contacts Product And Fitting Guide

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