x-cel contacts product and fitting guide - flexlensflexlens.uy/catalogo.pdf · mean “k” (52.00d...

X-Cel Contacts Product And Fitting Guide

www.xcelcontacts.com

We Fit Your Practice.TM

1

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.

2775 Premiere Parkway, Suite 600 • Duluth, GA 30097 • 800-241-9312 • Fax 800.822.9235

Table Of Contents

Products By Brand

Products By Condition

Consultation Services

Warranties

Materials

Diagnostic Sets for Custom Soft

Diagnostic sets for Specialty GP

Horizon™ & Westhin™ denotes a Westcon™ Design

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Atlantis™ Scleral

Reverse Geometry

Apex™ Keratoconus

Pinnacle™

Pinnacle™ Large Diameter

Pinnacle IC

Titan™ Large Diameter

Solution™ Bifocal

CV-4™ Multifocal

ProPlus™ Multifocal

Essential Solution™

Visions™ Toric

Visions™ Ultrathin

Starlens™

X-Cel Thin™

Flexlens® Arc for Irregular Corneas

Flexlens® Tri-curve Keratoconus

Flexlens® Post Refractive (PRS)

Flexlens® Piggyback

Flexlens® Large Diameter

Flexlens® Aphakic

Flexlens® Toric

Flexlens® Sphere

Westhin™ Toric

Horizon™ Bi-Con Bifocal

Horizon™ Bi-Con Toric

Horizon™ Progressive

Horizon™ Progressive Toric

5-7

8-10

11-13

14-17

18

19

20-22

23

24-25

26-28

29-31

32-34

35-37

2

3-4

79

80

81-82

83

84-86

38-39

40-41

42-44

45-47

48-49

48-49

50-52

53-55

56-58

59-60

61-64

65-69

70-72

73-75

76-78

X-Cel Specialty GPX-Cel Custom Soft

Products By Brand

www.xcelcontacts.com3

Products by Condition

Irregular Cornea

- Atlantis Scleral

- Flexlens ARC

- Titan Large Diameter

- Pinnacle Large Diameter

- Pinnacle IC

- Flexlens Tri-Curve Keratoconus

- Reverse Geometry

Keratoconus

- Flexlens ARC


- Atlantis Scleral

- Apex Keratoconus

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Post Surgical

- Flexlens Post Refractive (PRS)


- Flexlens Piggyback

- Flexlens Large Diameter

- Adult and Pediatric Aphakic

- Atlantis Scleral

- Titan Large Diameter

- Pinnacle Large Diameter

- Pinnacle IC 38

1

38-39

5-7

50-52

48-49

48-49

8-10

40-41

9

5-7

8-10

38-39

42-44

15

11-13

11-13

8-10

14-17

18

19

38-39

50-52

48-49

48-49

2775 Premiere Parkway, Suite 600 • Duluth, GA 30097 • 800-241-9312 • Fax 800.822.9235 4

Products by Condition

Aphakic

- Adult and Pediatric Aphakic

Presbyopia

- Horizon Bi-con Bifocal

- Horizon Bi-con Toric

- Horizon Progressive

- Horizon Progressive Toric

- Solution Bifocal

- CV-4 Multifocal

- ProPlus Multifocal

- Essential Solution

Astigmatism

- Flexlens Toric

- Visions Toric

- Horizon Toric

- Westhin Toric

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Single Vision

- Flexlens Sphere

- Visions Ultrathin

- Starlens

- Pinnacle

- X-Cel Thin

3

19

26-28

29-31

32-34

35-37

53-55

56-58

59-60

61-64

20-22

65-69

20-22

24-25

23

70-72

73-75

45-47

76-78

45-47

A Custom Soft Lens Design for Irregular Corneas

Below are cases where the Flexlens ARC should be considered:

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.


PMD RK RK TRAUMA

POST PK CENTRAL NIPPLE CONE

CONE LARGE SAGGING CONE

FLEXLENS ® ARC

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.

LASIKPKPPRK

Front View Sectional View


Parameter Availability - Available in single, 3, 6 & 12 packs.

MATERIAL Definitive Silicone Hydrogel 74%BASE CURVE 6.0 to 8.7mm in 0.1mm steps FITTING CURVE 8.6 Standard Back Surface Fitting CurveDIAMETER 13.0 to 16.0mm in 0.5mm stepsPOWER +20.00 to -20.00DCYLINDER -0.75 to -10.00D in 0.25D stepsAXIS 1º to 180º in 1 degree stepsPRISM 1.50 standard with 2.00 availableTHICKNESS .30mm or .50mmWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

Basic Fitting InformationFor 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.

Fle

xlen

s® A

RCFLEXLENS ® ARC

FRONTOPTIC ZONE

TORICOPTIC ZONE

PRISM

FITTINGCURVE

PERIPHERALCURVE

PERIPHERALCURVE

FITTINGCURVE

TORICOPTIC ZONE

FRONTOPTIC ZONE

PRISM


FLEXLENS® ARC

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.

Decrease diameter 0.5mm

Increase diameter 0.5mm



Increase prism to 2.00



Problem 1st Change 2nd Change

Troubleshooting

Flatten BC 0.3mm

Steepen BC 0.3mm

Flatten BC 0.3mm

Steepen BC 0.3mm

Steepen BC 0.3mm

Flatten BC 0.3mm

Steepen BC 0.3mm

Go to 0.50 thick lens

Too little or no movement

Excessive movement

Central air bubble

Lens fold

Excessive touch

Unstable over-refraction

Unstable lens rotation

BCVA not achieved with 0.30 thick lens

For Moderate to Advanced Keratoconus

IndicationsExamples 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 needa .65 center thickness to do so.

Below are cases where the Tri-Curve Keratoconus should be considered:

The Tri-Curve Keratoconus Lens is indicated for daily wear use for the correction of refractive ametropia andspecialized use such as atypical ametropia.

PMD RK RK TRAUMA



FLEXLENS® TRI-CURVE


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Basic Fitting InformationA 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 CURVESelect 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 EvaluationWhen evaluating the fit of the Tri-Curve Keratoconus Lens, the lens should exhibit:

• 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


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. Parameter Availability - Available in single, 3, 6 & 12 packs.

BASE CURVE 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsPOWERS +30.00 to –30.00D in 0.25D stepsCENTER THICKNESS .45 to .65mmWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

Fle

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Push Up TestIf 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 PowerIf 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.

Patient Symptoms Objective Findings Possible Cause Plan

Poor visual acuity on delivery or first follow-up

Unacceptable vision on eye chart Incorrect refraction or over-refraction Order new lens based on new refraction or over-refraction

Lens not centered Base curve too flat Steepen base curve by 0.3mm

Diameter too small Increase diameter by 0.5mm

Fluctuating vision

Base curve too flat Flat Fit = patient will exhibit “clear, blur, clear” when blinking

Steepen base curve by 0.3mm

Base curve too steep Steep Fit = patient will exhibit “blur, clear, blur” when blinking

Flatten base curve by 0.3mm

Sphero-cylindrical over-refraction provides good vision

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

Vision decreases during the day

Scleral indentation Lens is too steep Flatten base curve by 0.3mm

Lens is too large Decrease diameter by 0.5mm

Corneal edema Lens is too thick; material does not provide enough oxygen

Increase water content of lens material, or decrease center thickness

Lens is too steep Flatten base curve by 0.3mm

Initial discomfort Improper fit Evaluate fit

Incompatibility with solutions Change patient’s care system

Discomfort at day’s end

Excessive movement Base curve too flat Steepen base curve by 0.3mm

Diameter too small Increase diameter by 0.5mm


Base curve too steep Flatten base curve by 0.3mm

Diameter too large Decrease diameter by 0.5mm

Lens dehydrating on eye Decrease water content of lens

Scleral indentation Base curve too steep Flatten base curve by 0.3mm


Lens dislodges during wear Superior to inferior edge lift Base curve too flat Steepen base curve by 0.3mm


10

Troubleshooting



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Soft Contact Lens Following Corneal Refractive Surgery

Lens DesignThe 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 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsPOWER +30.00 to –30.00D in 0.25D stepsWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.

RK RKPOST LASIK

FLEXLENS® PRS


LASIKPRK

Basic Fitting Information*If fitting a patient in the Definitive 74%, adjust the Base Curve 0.3mm steeper or the Diameter 0.3mm larger.

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 TestIf 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 EvaluationWhen evaluating the fit of the Post Refractive Lens, the lens should exhibit:

• 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 • Visual acuity within two lines of best corrected vision

Post-Op K’s Range Base Curve Diameter Pre-Op K’s Range Base Curve Diameter37.75 - FLATTER 9.0 15.0 41.75 or FLATTER 9.0 15.0

38.00 - 41.00 8.7 15.0 42.00 - 45.00 8.7 15.041.25 - STEEPER 8.4 15.0 45.25 - STEEPER 8.4 15.0

ANTERIOROPTIC ZONE

FLANGE

INTERMEDIATEZONE

TRANSITIONZONE

AOZ(Variable OZ)

LENS DIAMETER (15.0mm)

BC (8.7mm)

AOZ – Anterior Optic ZonBC – Base Curve


12

Flex

lens

® Pos

t Ref

ract

ive L

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FLEXLENS® PRS


AOZ - Anterior Optic ZoneBC - Base Curve



Unacceptable vision on eye chart Incorrect refraction or over-refraction

Order new lens based on new refraction

Lens not centered Base curve too flat Steepen base curve by 0.3mmFluctuating vision Center thickness too thin Increase center thickness to .45mm

Sphero-cylindrical over-refraction provides good vision

Cylinder over-refraction 2.00 diopters and under; center thickness too thin

Increase center thickness to .45mm

Cylinder over-refraction over 2.00 diopters

Change to Flexlens ARC lens design, Atlantis Scleral, Piggyback lens design or utilize spectacles over lenses


Scleral indentationLens is too steep Flatten base curve by 0.3mmLens is too large Decrease diameter by 0.5mm

Corneal edema

Lens is too thick; material does not provide enough oxygen

Increase water content of lens material, or decrease center thickness

Lens is too steep Flatten base curve by 0.3mmLens is too large Decrease diameter by 0.5mm

Deposits

Incompatibility with material Change to lower water content

Care system not followed or not adequate

Discuss care system with patient and change as necessary

Initial discomfortImproper fit Evaluate fitIncompatibility with solutions Change patient’s care system

Discomfort at day’s end

Excessive movementBase curve too flat Steepen base curve by 0.3mmDiameter too small Increase diameter by 0.5mm

Too little or no movementBase curve too steep Flatten base curve by 0.3mmDiameter too large Decrease diameter by 0.5mmLens dehydrating on eye Decrease water content of lens

Scleral indentationBase curve too steep Flatten base curve by 0.3mmDiameter too large Decrease diameter by 0.5mm

Troubleshooting

13

FLEXLENS® PRS


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For Advanced Keratoconus

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 • Refractive corneal surgery • Pellucid marginal degeneration • Corneal trauma • Terrien’s marginal degeneration • Corneal surface disease • Penetrating Keratoplasty

Lens DesignThe 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:

Parameter Availability - Available in single, 3, 6 and 12 packs.

BASE CURVE 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsANTERIOR CUT-OUT DIAMETER 6.5 to 12.5mm in 0.1mm stepsPOWER PlanoWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.

PMD RK RK TRAUMA



LASIK

FLEXLENS® PIGGYBACK


PRK

15

Basic Fitting Information*If fitting a patient in the Definitive 74%, adjust the Base Curve 0.3mm steeper or the Diameter 0.3mm larger.

SOFT LENS BASE CURVEThe 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” 52.00D @ 180 / 57.00D @ 090 Flat “K” 52.00D = 6.49mm Diagnostic lens 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 EvaluationWhen evaluating the fit of the Piggyback lens, the soft lens should exhibit:

• Lens centration with 1.0 to 1.5mm of limbal draping


Flex

lens

® Pig

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Push Up TestIf 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 InsertOnce 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.






Unacceptable vision on eye chart Incorrect refraction or over-refraction Order new GP lens based on new refraction or over-refraction

GP Lens not centered 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

Soft lens not centered 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


Corneal edema

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 lens dislodges

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 Reduce GP diameter to fit into cut-out

Deposits

Incompatibility with material 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 Reduce GP diameter to fit into cut-out

Initial discomfort

Excessive movement 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

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.

Troubleshooting



FLEXLENS® LARGE DIAMETER

Custom Soft Large DiameterThe 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.

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.

BASE CURVE 7.0 to 11.0mm in 0.1mm stepsDIAMETER 16.1 to 24.0mm in 0.1mm stepsPOWER +30.00 to -30.00D in 0.25 stepsMATERIALS Methafilcon A 55%WARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

Standard Parameters - Available in single, 3, 6 & 12 packs.

Lens Design

Horizon Sphere isavailable in the same parameters


BASE CURVE 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsPOWER +00.00 to +50.00D in 0.25D stepsWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

Adult & PediatricThe 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.

19


FLEXLENS® APHAKIC


Horizon Aphakic isavailable in the same parameters


Horizon Toric isavailable in the same parameters

Designed for Success. Guaranteed to Fit.

Lens DesignThe 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 ParametersBASE CURVE 8.0 to 9.2mm in 0.1mm stepsDIAMETER 13.5 to 15.0mm in 0.1 stepsPOWER +10.00 to -10.00D in 0.25D stepsCYLINDER -0.50 to -10.00D in 0.25D stepsAXIS 1º Increments up to 180ºCENTER THICKNESS .16mm at -3.00D

Parameter Availability - Available in single, 3, 6, & 12 packsBASE CURVE 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsPOWER +40.00 to –40.00D in 0.25D stepsCYLINDER –0.50 to –10.00D in 0.25D stepsAXIS 1º increments up to 180ºWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.


FLEXLENS® TORIC

21

FLEXLENS® TORIC


Flex

lens

® Tor

ic L

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Basic Fitting InformationThe Flexlens Toric Lens is fit using a nomogram method which utilizes the Flat keratometry value.

Flat “K” Reading Suggested Base Curve Suggested Diameter 45.00D and steeper 8.0mm to 8.3mm 14.0 43.25D to 44.75D 8.3mm to 8.6mm 14.0 or 14.5 41.25D to 43.00D 8.6mm to 8.9mm 14.5 or 15.0 41.00D and flatter 8.9mm to 9.2mm 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 over-refraction then re-order based on new lens that incorporates the cross cylinder as determined by your over-refraction.


22

Troubleshooting

FLEXLENS® TORIC

Poor visual acuity on delivery or first

follow-up

Lens rotates 10 degrees or less

Sphere/cylinder off axis

Base curve too flat

If over-refraction yields good results, reorder new powers indicated

Steepen base curve by 0.3mm and incorporate over refraction. Re-order new lens (as long as O/R is stable and consistent).

Increase diameter 0.5mm and incorporate over refraction. Re-order new lens (as long as O/R is stable and consistent).

Increase diameter by 0.5mmDiameter too small

Diameter too small

Diameter too small

Lens too steep

Lens too steep

Diameter too small

Base curve too flat

Improper fit

Base curve too steep

Increase diameter by 0.5mm


Evaluate fit





Steepen base curve by 0.3mmBase curve too flat

Lens is too large

Lens is too large

Base curve too flat

Diameter too small

Incompatibility with solutions

Diameter too large

Lens dehydrating on eye



Change patient’s care system

Decrease diameter by 0.5mm

Decrease water content of lens



Lens rotates 10 degrees or more

Lens does not rotate but is decentered

Scleral indentation

Corneal edema Material does not provide enough oxygen

Change to a higher water content material

Discuss care systems with patient and change as necessary

Lower water content material.

Lens rotates out of position at days end

Slight edge lift

Excessive movement


Deposits

Patient Symptoms Objective Findings Possible Causes Plan


Unstable vision

Initial discomfort

Discomfort at days end


Care system not followed or inadequate

Incompatibility with material

Occasional rotation of lens

Horizon Sphere is available in the same parameters and is available

for tinting. See Below:

For An Exact Fit Every Time

Lens DesignStandard 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 ParametersBASE CURVE 8.0 to 9.2mm in 0.1mm stepsDIAMETER 13.5 to 15.0mm in 0.1mm stepsPOWER +10.00 to –10.00D in 0.25D steps


BASE CURVE 6.0 to 11.0mm in 0.1mm stepsDIAMETER 10.0 to 16.0mm in 0.1mm stepsPOWER +40.00 to –40.00D in 0.25D stepsWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.


FLEXLENS® SPHERE

23 www.xcelcontacts.com

Original Eye Color

Aqua

BlueGreen

Brown

Soft Toric Contact Lens for Daily Wear

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 8.0 to 9.5mm in 0.1mm stepsDIAMETER 13.5 to 15.5mm in 0.1mm stepsPOWER +20.00 to -20.00D in 0.25D stepsCYLINDER -0.50 to -10.00D in 0.25D stepsAXIS 1º increments up to 180ºWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.

24

WESTHIN™ TORIC


WESTHIN™ TORIC

Poor visual acuity on delivery or first

follow-up

Lens rotates 10 degrees or less

Sphere/cylinder off axis

Base curve too flat

If over-refraction yields good results, reorder new powers indicated

Steepen base curve by 0.3mm and incorporate over refraction. Re-order new lens. (as long as O/R is stable and consistent).

Increase diameter 0.5mm and incorporate over refraction. Re-order new lens. (as long as O/R is stable and consistent).

Increase diameter by 0.5mmDiameter too small

Diameter too small

Diameter too small

Lens too steep

Lens too steep

Base curve too flat

Improper fit

Base curve too steep



Evaluate fit





Steepen base curve by 0.3mmBase curve too flat

Lens is too large

Lens is too large

Base curve too flat

Diameter too small

Incompatibility with solutions

Diameter too large

Lens dehydrating on eye



Change patient’s care system


Decrease water content of lens



Lens rotates 10 degrees or more

Lens does not rotate but is decentered

Scleral indentation

Corneal edema Material does not provide enough oxygen

Change to a higher water content material

Discuss care systems with patient and change as necessary

Lens rotates out of position at days end

Slight edge lift

Excessive movement


Deposits

Patient Symptoms Objective Findings Possible Causes Plan


Unstable vision

Initial discomfort

Discomfort at days end

Troubleshooting


Care system not followed or inadequate

Lower water content material.Incompatibility with material

Occasional rotation of lens Diameter too small

HORIZON™ BI-CON BIFO CAL

Soft Bifocal Contact Lens for Daily Wear

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 8.0 to 9.2mm in 0.1mm stepsDIAMETER 14.0 to 15.0mm in 0.1mm stepsSPHERE RANGE +20.00 to -20.00D in 0.25 stepsADD POWER Up to +4.00 ADD in 0.25 stepsADD ZONE 1.8, 2.0, 2.5, 3.0, 3.5, 4.0WARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.


27


Basic Fitting Information:

Step 1Select a Lens fromthe Diagnostic Set

Step 2Insert lens

Step 3Push Up Test

From the keratometry reading select the initial base curve from the chart

Flattest Keratometry measurement Suggested base curve38.00 to 41.00 8.9 or flatter41.25 to 45.00 8.6 to 8.945.25 to 48.00 8.3 or steeper

From the horizontal visible iris diameter choose the initial diameter from the chartHVID measurement Suggested diameterLess than 11.0mm 14.0mm or smaller11.0mm to 12.0mm 14.5mmGreater than 12.0mm 15.0mm or largerSelect a trial lens for the dominant eye with a 2.5mm near zone and a 3.0mm near zone for the non-dominant eye.

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.

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.

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.

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.


Step 4Final Evaluation

28


Excessive Movement

Poor Centration

Excessive rotation, more than 20 degrees

Unsatisfactory visual acuity for near

No Movement




Adjust add power




Increase zone diameter .5mm

Decrease zone diameter .5mm in both eyes


Increase zone diameter .5mm in both eyes

Decrease add power on the dominate eye

Fit problem, normally corrected with a change in base curve or diameter

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


Patient Symptoms Plan

Unsatisfactory visual acuity for distance

Ghosting at distant vision

Ghosting at near vision

Lack of intermediate vision

Fluctuating vision or over-refraction fails to give

acceptable visual acuity

Troubleshooting


29

HORIZON™ BI-CON BIFO CAL TORIC

Soft Bifocal Contact Lens for Presbyopic Patients

Lens Design


BASE CURVE 8.0 to 9.2mm in 0.1mm stepsDIAMETER 14.0 to 15.0mm in 0.1mm stepsSPHERE RANGE +20.00 to -20.00D in 0.25 stepsCYLINDER RANGE -0.50 to -10.00D in 0.25 stepsBIFOCAL ADD POWER +0.50 to +4.00D in 0.25 stepsAXIS 1º increments up to 180ºWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable

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.

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.


30




Step 2Insert lens

Step 3Push Up Test


Flattest Keratometry measurement Suggested base curve38.00 to 41.00 8.9 or flatter41.25 to 45.00 8.6 to 8.945.25 to 48.00 8.3 or steeperFlatter than 38.00 or steeper than 49.00 Call for consultation









Once the ideal fit is achived 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.





Excessive Movement

Poor Centration



No Movement




Adjust add power





Decrease zone diameter .5mm in both eyes



Decrease add power on the dominate eye






Ghosting at distant vision

Ghosting at near vision

Lack of intermediate vision



Troubleshooting


HORIZON™ PRO GRESSIVE

Soft Contact Lens for Presbyopic PatientsThe 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.

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 8.0 to 9.2mm in 0.1mm stepsDIAMETER 14.0 to 15.0mm in 0.1mm stepsPOWER +20.00 to -20.00D in 0.25D stepsADD ZONE Dominant or Non-dominantADD POWER Up to to +3.50 in 0.25 stepsWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable


Lens Design





Step 2Insert lens

Step 3Push Up Test















Excessive Movement

Poor Centration



No Movement









Order new lenses after determination of adjusted near power using hand-held lenses







Troubleshooting


HORIZON™ PRO GRESSIVE TORIC

Soft Contact Lens Option for Your Astigmatic PresbyopesThe 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.

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 8.0 to 9.2mm in 0.1mm stepsDIAMETER 14.0 to 15.0mm in 0.1mm stepsPOWER +20.00 to -20.00D in 0.25D stepsCYLINDER RANGE -0.75 to -5.00D in 0.25D stepsAXIS 1º increments up to 180ºADD POWER Up to +3.50 ADD 0.25D stepsWARRANTY Initial lens: Unlimited exchanges and cancellation within 90 days Annual supplies: Non-warranted and non-refundable


Lens Design





Step 2Insert lens

Step 3Push Up Test















Excessive Movement

Poor Centration



No Movement









Order new lenses after determination of adjusted near power using hand-held lenses







Troubleshooting

ATLANTIS™ SCLERAL


It’s a 1-2-3 Fit StrategyAtlantis 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.

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.

Lens Design

Below are cases where the Atlantis Scleral should be considered:

PMD RK RK TRAUMA



LASIKPKPPRK


ATLANTIS SCLERAL

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.

Basic Fitting Information

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

BASE CURVE 6.50 to 9.00mm, 7.03 to 9.00mm, 7.18 to 9.00mmDIAMETER 15.0, 16.0 and 16.5 POWER +20.00 to -20.00D in 0.25D stepsMATERIAL Boston XO and Boston XO2COLOR Ice Blue, ClearWARRANTY Two exchanges per eye or cancellation within 90 days

Standard Parameters

REVERSE GEOMETRY


Optimal StabilizationThe 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.

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

Lens Design

Below are cases where the Reverse Geometry should be considered:

LASIK RK PRK PKP

BASE CURVE 6.00 to 12.00mmDIAMETER 8.0 to 12.6mmPOWER +50.00 to -50.00D in 0.25D stepsWARRANTY Two exchanges per eye or cancellation within 90 days

Standard Parameters


REVERSE GEOMETRY

Excessive Movement

Decentration in any Direction

Bearing in Intermediate

Restricted Movement

Steepen base curve by .50D

Increase Diameter by .3mm

Steepen Reverse Curve and Peripheral curves by 1.00mm each

Decrease OZ by .3mm

Flatten Reverse Curve and Peripheral curve by 1.00mm each

Flatten base curve by .3mm

Flatten Base Curve by .50D

Steepen Peripheral Curves by 1.00mm with a .2 width

Centrally

Peripherally

Flatten Reverse Curve and Peripheral curves

Flatten Reverse Curve by .75mm


Bubbles

Troubleshooting

APEX™ KERATO CONUS


Fitting ForgivenessApex 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.

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.

Lens Design

Below are cases where the Apex Keratoconus should be considered:

CENTRAL NIPPLE CONE


BASE CURVE 4.96 to 8.44mmDIAMETER 7.9 to 10.5mmPOWER +30.00 to -30.00DPERIPHERY Steep, Medium, FlatWARRANTY Two exchanges per eye or cancellation within 90 days

Standard Parameters



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 1Select Base Curve

Step 2Evaluate Diameter

Step 3Determine Periphery

Step 4Determine Power

• 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.

• 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.

• 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.



Lens Riding High

Excessive Movement

Too Much Edge Lift

Restricted Movement

Not Enough Edge Lift

Lens Riding Low

Steepen Base Curve by 1.00 D

Steepen Base Curve by 1.00 D

Reduce Edge Lift (Flat to Medium, Medium to Steep)

Decrease Diameter by .3mm



Change Material


Order New Lens

Reduce Diameter by .3 mm


Increase Diameter by .3 mm

Flatten Base Curve by 1.00D

Increase Edge Lift (Steep to Medium, Medium to Flat)

Flatten Base Curve by 1.00D

Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Decrease Edge Lift (Flat to Medium, Medium to Steep)

Clean Lens

Movement with Blink Flatten Base Curve by 1.00D

No Movement Decrease Diameter by .3mm

Patient Symptoms PlanPossible Causes

Bubbles

Surface Non Wetting

Troubleshooting


PINNACLE™

Aspheric Comfort DesignFor the myopic or hyperopic patient who shows moderate to high amounts of with the rule corneal and refractive astigmatism.

The Pinnacle lens design is a continuous aspheric concave geometry design with adjustable edge lifts to aid in fit and comfort.

Lens Design

BASE CURVE 6.00 to 9.90mmDIAMETER* 7.5 to 9.9mmPOWER +60.00 to -60.00DPERIPHERY Steep, Medium, FlatWARRANTY Unlimited exchanges and cancellation within 90 days

*Base curve radius restricts diameter range available.

Standard Parameters

PINNACLE™




Step 2Choose Diameter

Step 3Determine Periphery

CORNEAL

BASE CURVE

BASE CURVE

DIAMETER

Plano to 1.00D On Flat K

1.12D to 1.50D

7.10 to 7.38mm

0.25D steeper than Flat K

8.7 mm 9.0 mm 9.3 mm

9.0 mm 9.3 mm 9.6 mm

9.3 mm 9.6 mm 9.9 mm

Small Recommended Large

2.12D to 2.50D

8.13 to 8.49mm


1.62D to 2.00D

7.42 to 8.08mm


2.62D or more Discuss with Consultant

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


PINNACLE™

Lens Riding High

Excessive Movement

Too Much Edge Lift

Restricted Movement


Lens Riding Low

Steepen Base Curve by .50 D












Flatten Base Curve by .50DCentrally

PeripherallyDecrease Edge Lift (Flat to Medium, Medium to Steep)

Movement with Blink Steepen Base Curve by .50D



Bubbles

Troubleshooting


*Base curve radius restricts diameter range available on both Large Diameter and IC.

PINNACLE™ LARGE DIAMETERPINNACLE™ IC


Solutions for Irregular CorneasPinnacle 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.

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.

Lens Design


Standard Parameters - Pinnacle Large Diameter

Standard Parameters - Pinnacle IC

LARGE SAGGING CONELASIKPKPPRK

RK RK TRAUMA

Below are cases where either Pinnacle design should be considered:


PINNACLE™ LARGE DIAMETERPINNACLE™ IC


Troubleshooting

Possible Causes

Lens Riding High

Excessive Movement

Too Much Edge Lift

Restricted Movement


Lens Riding Low














PeripherallyDecrease Edge Lift (Flat to Medium, Medium to Steep)



Bubbles

TITAN™ LARGE DIAMETER


For the Management of Irregular Corneal ConditionsGood 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

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.

Lens Design

Below are cases where the Titan should be considered:

LARGE SAGGING CONE

PMD RK RK

LASIKPKPPRK



BASE CURVE 6.75 to 9.93mmDIAMETER 11.3 to 12.3mm in 0.1mm stepsPOWERS +60.00 to -60.00DEDGE LIFT Steep, Medium, FlatMATERIAL Recommended in Optimum ExtraWARRANTY Two exchanges per eye or cancellation within 90 days

Parameter Availability



Step 2Evaluate Fluorescein

Step 3Evaluate Diameter

and Periphery


Start with a diagnostic lens that is approximately one diopter flatter than the flattest K, regardless of the amount of corneal astigmatism.

It is suggested that the steeper edge lifts be “earned”.

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.

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 PCToo much edge lift = order Steep PCWhen the most appropriate base curve is determined, refract over the lens to determine the final power.

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.



Lens Riding High

Excessive Movement

Too Much Edge Lift

Restricted Movement


Lens Riding Low







Change Material


Order New Lens







Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Decrease Edge Lift (Flat to Medium, Medium to Steep)

Clean Lens




Bubbles

Surface Non Wetting

Troubleshooting


SOLUTION™ BIFO CAL

A Solution for an Age Old ProblemFor 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.

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.

Lens Design

BASE CURVE 7.14 to 8.44mmDIAMETER 8.5 to 10.0mmPOWER +6.00 to -10.00DADD POWER +1.00 to +3.00DPRISM BALLAST Minimum, Medium, Maximum, Extra MaximumPRISM AXIS 90 +/- 20SEGMENT POSITION On geometric center (GC) 0.5, 1.0mm above GC 0.5, 1.0, 1.5, 2.0mm below GCTRUNCATION On request onlyMATERIAL Recommended in Fluoroperm 30, 60, Paragon Thin, Paragon HDS and HDS 100WARRANTY Two exchanges per eye or cancellation within 90 days

CUSTOM PARAMETERS (additional $20.00 fee)

BASE CURVE 6.49 to 9.01mmDIAMETER 8.0 to 11.0mmPOWER +10.00 to -20.00DADD POWER +1.00 to +3.00D






Step 2Determine Distance

Power

Step 3Determine Near

Power


Step 6Choose Prism and

Material

Step 5Choose Segment

Position

Corneal Toricity On K to 0.50D 0.75D to 1.25D

0.25D steeper than K

1.0mm BGC

1.50D to 2.00D


Lower lid above limbus

2.25D to 2.75D


1.5mm BGC

Base Curve

Example:

On K

Lower lid at limbus

Choose the add power directly from the patients refraction results.

Choose the lens diameter basd on HVID measurements minus 2.5mm.

For example: 11.8mm HVID 2.5mm = 9.3mm diameter

• Always begin with medium prism•Available materials include Fluoroperm 30, 60, Paragon Thin, Paragon HDS and HDS100• PlasmaEYEZ treated

Based on the lower lid position order the segment position either 1.0mm below geometric center (BGC) or 1.5mm BGC.

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.

Lens Riding High

Excessive Movement

Too Much Edge Lift

Poor Near Acuity

Restricted Movement

Poor Distance Acuity

Excessive Nasal Rotation/ Excessive Temporal

Rotation

Lens Riding Low



Increase Seg Height by .5mm


Reduce Seg Height by .5mm


Change Material


Order New Lens




Truncated by .4mm

Increase Prism


Increase Prism (Minimum to Medium, Medium to Maximum, Maximum to Extra Maximum)


Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Lens Riding High

Seg Height too High

Seg Height too Low

Lens Sits Under Lower Lid

Decrease Edge Lift

Clean Lens




Bubbles

Surface Non Wetting

Troubleshooting



BASE CURVE 6.80 to 8.55mmDIAMETER 9.0 to 10.0mmPOWER +16.00 to -16.00DADD POWER +1.00 to +3.00D in 0.25D stepsPUPIL DIAMETER 3.0 to 5.5mmCENTER THICKNESS Calculated by design MATERIAL* Recommended in Boston XOWARRANTY Two exchanges per eye or cancellation within 90 days

*PlasmaEYEZ treated

Easy to Fit 4 Dimensional MultifocalFor 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.

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 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.

Lens Design



CV-4™ MULTIFO CAL


Following Initial Fit:1. Allow lens to settle for up to 20 minutes2. Over-refract to determine distance Rx3. Over-refract to determine near Rx4. Re-check pupil size5. Communicate any subjective patient complaints to an X-Cel Consultant.

Empirical Fitting Procedure1. 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.


CV-4™ MULTIFO CAL

Basic Fitting Information (cont.)

Base Curve Selection Chart

On Flat K 9.2mm – 9.8mmNONE

0.25D steeper than Flat K 9.2mm – 9.8mm0.25D to 0.50D

0.50D steeper than Flat K 9.2mm – 9.8mm0.75D and greater

Corneal Astigmatism Choose Base Curve Diameter

3.0mm 3.5mm 4.0mm 4.5mm 5.0mm 5.5mm

CV-4™ MULTIFO CAL


Lens Riding High

Excessive Movement

Poor Near Acuity

Restricted Movement


Lens Riding Low



Decrease Pupil Zone by .5mm


Steepen Base Curve by .50D


Change Material


Order New Lens





Enlarge pupil zone by .5mm


Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Pupil Zone too Small

Lens Decentered High

Pupil Zone too Large

Lens Decentered Low

Clean Lens




Bubbles

Surface Non Wetting

Troubleshooting


PROPLUS™ MULTIFO CAL

This Plus will Add up to Patient SatisfactionFor 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.

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.

Lens Design


BASE CURVE 6.90 to 8.50mmDIAMETER 8.5 to 11.0mmPOWER +10.00 to -15.00DADD POWER +0.75D to +3.00D in .25D stepsDISTANCE ZONE 3.3mm to 3.9mm (3.6mm is default) 3.3mm distance zone for +2.50 ADD power and higherMATERIAL* Recommended in Boston XO Ice Blue colorWARRANTY Two exchanges per eye or cancellation within 90 days

*PlasmaEYEZ treated


0.00D to 1.00D 0.75D steeper than Flat K

1.12D to 1.87D 1.00D steeper than Flat K


Discuss with Consultant

2.00D to 3.00D

3.00D and higher

Corneal Cylinder Base Curve

PROPLUS™ MULTIFO CAL


Lens Riding High

Excessive Movement

Too Much Edge Lift

Poor Near Acuity

Restricted Movement


Lens Riding Low



Steepen Peripheral Curve



Increase Distance Zone by .3mm


Change Material


Order New Lens




Decrease Distance Zone by .3mm


Steepen Base Curve by .50D


Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Lens Riding High

Distance Zone too Small

Lens Sits on Lower Lid

Distance Zone too Large

Steepen Peripheral Curve

Clean Lens




Bubbles

Surface Non Wetting

Troubleshooting


ESSENTIAL SOLUTION™

The Only Segmented Translating Multifocal That Gives Extra AddFor 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.

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.

Lens Design

BASE CURVE 7.10 to 8.20mm in .10mm stepsDIAMETER 9.0,9.3, 9.6mmDISTANCE POWER +6.00 to -10.00DADD POWER +0.75 to +3.50DPRISM BALLAST Minimum, Medium, MaximumPRISM AXIS 90 +/- 20SEGMENT POSITION 1.0 and 1.5mm below geometric center (BGC)MATERIAL* Recommended in Boston XO Ice Blue colorWARRANTY Two exchanges per eye and cancellation within 90 days for 80% credit

*PlasmaEYEZ treated





FLAT K BASE CURVE SELECTION DISTANCE POWER ADJUSTMENT

40.50 8.20 -0.50

42.00 7.90 -0.75

43.50 7.60 -0.75

45.25 7.30 -1.00

41.00 8.10 -0.50

42.50 7.80 -0.75

44.00 7.50 -1.00

45.75 7.30 -0.50

41.50 8.00 -0.75

43.00 7.70 -0.75

44.50 7.50 -0.50

46.25 7.20 -0.50

40.75 8.10 -0.75

42.25 7.90 -0.50

43.75 7.60 -0.50

45.50 7.30 -0.75

41.25 8.00 -1.00

42.75 7.80 -0.50

44.25 7.50 -0.75

46.00 7.20 -0.75

41.75 7.90 -1.00

43.25 7.70 -0.50

45.00 7.40 -0.50

44.75 7.40 -0.75

46.50 7.10 -1.00

46.75 7.10 -0.75

47.00 7.10 -0.50

STEP 1: Select Base Curve and Distance Power Adjustment

Step 2Determine Near Power

Step 3Choose SegmentPosition

Step 4Order Lens

Step 5Example

Start at 1.0mm BGC (Only 1.0 and 1.5 are available)

9.3mm diameter, prism included

Spectacle Rx = -2.00 -0.75 x 180, +2.00 AddK’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

Provide the patient’s spectacle add power and add +0.50D




Segment Line too Low

Maximum to Extra Maximum

Medium to Maximum

Medium to Medium

Increase PrismIncrease Prism



Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low

Steepen Base Curve by .10mm

Steepen Base Curve by .10mm




Change Material


Order New Lens



Decrease Diameter by .3 mm

Flatten Base Curve by .10mm

Flatten Base Curve by .10mm

Clean Lens

Centrally

New Lens

Peripherally

Older LensClean Lens

Movement with Blink Steepen Base Curve by .10mm



Bubbles

Surface Non Wetting

Troubleshooting

Poor Distance Vision

Lower Seg Height by .5mm

Increase Prism

Poor Near Vision

Excessive Nasal or Temporal Rotation

Truncated by .4mm

Raise Seg height by .5mm

Increase PrismNot Enough Prism

Lens Rides too High

Segment Line too High

Lens rides Under Lower Lid

Segment line too low


VISIONS™ TORIC

Easy to Fit Toric Gas PermVisions™ Toric is an excellent design of choice for those patients who require the benefit of the Visions UltraThin back surface aspheric geometry.

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.

Lens Design

BASE CURVE 7.10 to 8.49mmDIAMETER 9.3, 9.6mmPOWER +6.00 to -10.00CYLINDER -1.50 to -4.00 Front Toric -1.50 to -5.00 BitoricMATERIAL Paragon HDS and Paragon ThinCOLOR UV BlueWARRANTY Unlimited exchanges and cancellation within 90 days


Visions FRONT TORIC Basic Fitting Information

1.62D to 2.00D

2.12D to 2.50D


Plano to 1.00 D 0.25D steeper than Flat K


2.75 or more

39.75 to 43.00D


9.6mm

1.12 to 1.50D 0.50D steeper than Flat K


Base Curve

43.12 to 47.50D

Diameter

9.3mm



VISIONS™ TORIC



Sphere 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.



1.62 to 2.00D

2.12 to 2.50D


VISIONS™ TORIC

Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low






Order New Lens







Clean Lens

Centrally

New Lens

Peripherally





Bubbles

Surface Non Wetting

Visions FRONT TORIC Troubleshooting

VISIONS™ TORIC


Visions BI-TORIC Basic Fitting Information:Corneal Cylinder Flat Meridian Base Curve

Fit Visions Ultra Thin

0.50D flatter than Flat K

0.50D flatter than Flat K


Steep Meridian Base Curve

Plano to 2.50D Fit Visions Ultra Thin

4.87 to 6.00D 0.75D flatter than Steep K

39.75 to 43.00D

2.62 to 4.75D 0.50D flatter than Steep K

6.12D or more Discuss with Consultant

Base Curve

43.12 to 47.50D

Diameter

9.6 mm

9.3 mm




Sphere Power1. 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 Power4. 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 PowerSphere: 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.


VISIONS™ TORIC

Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low






Order New Lens







Clean Lens

Centrally

New Lens

Peripherally





Bubbles

Surface Non Wetting

Visions BI-TORIC Troubleshooting

VISIONS™ ULTRATHIN


Easy to Fit Gas PermThe 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

Visions is an ultra-thin single vision aspheric lens design. It features an aspheric back surface with a thin lens profile and edge design.

Lens Design

BASE CURVE 7.10 to 8.49mmDIAMETER 9.0, 9.3, 9.6mmPOWER +6.00 to -10.00DMATERIAL Paragon HDSCOLOR BlueWARRANTY Unlimited exchanges and cancellation within 90 days




1.12 to 1.50D

7.10 to 7.38mm





Diameter

1.62 to 2.00D

7.42 to 8.08mm

2.12 to 2.50D

8.13 to 8.49mm

2.62D or more

Base Curve

Small

8.7mm

9.0mm

9.3mm

Large

9.3mm

9.6mm

9.9mm

Recommended

9.0mm

9.3mm

9.6mm













Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low












Peripherally




Bubbles

Troubleshooting


STARLENS™

Highest Level of Design PerformanceStarlens 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.

The Starlens is an aspheric peripheral design with a thin edge to optimize comfort.Lens Design

BASE CURVE 6.50 to 8.65mmDIAMETER 7.5 to 11.5mmPOWER +20.00 to -20.00DMATERIAL AnyWARRANTY Unlimited exchanges and cancellation within 90 days


STARLENS™




1.12 to 1.50D

7.10 to 7.38mm





Diameter

1.62 to 2.00D

7.42 to 8.08mm

2.00 to 2.50D

8.13 to 8.49mm

2.75D or more

Base Curve

Small

8.7mm

9.0mm

9.3mm

Large

9.3mm

9.6mm

9.9mm

Recommended

9.0mm

9.3mm

9.6mm

Corneal Cylinder Base CurveStep 1Select Base Curve








STARLENS™

Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low



Reduce Edge Lift

Increase Edge Lift



Change Material


Order New Lens







Clean Lens

Centrally

New Lens

Peripherally

Older Lens

Decrease Edge Lift

Clean Lens




Bubbles

Surface Non Wetting

Troubleshooting

X-CEL THIN™


Advanced DesignX-Cel Thin™ is an excellent alternative for Polycon or Fluorocon patients, or when a thin lens profile is a must.

The X-Cel Thin design is a thin lens design using similar design configurations and center thickness as a polycon design.

Lens Design

Parameter AvailabilityBASE CURVE 7.00 to 8.44mmPOWER +8.00 to -17.00D DIAMETER 8.5 to 10.0mmMATERIAL Boston ESWARRANTY Unlimited exchanges and cancellation within 90 days



1.12 to 1.50D

7.10 to 7.38mm





Diameter

1.62 to 2.00D

7.42 to 8.08mm

2.12 to 2.50D

8.13 to 8.49mm

2.62D or more

Base Curve

Small

8.7mm

9.0mm

9.3mm

Large

9.3mm

9.6mm

9.9mm

Recommended

9.0mm

9.3mm

9.6mm

Corneal Cylinder Base CurveStep 1Select Base Curve








X-CEL THIN™

X-CEL THIN™


Lens Riding High

Excessive Movement

Too Much Edge Lift


Restricted Movement

Lens Riding Low






Order New Lens


Order New Lens






Clean Lens

Centrally

New Lens

Peripherally





Bubbles

Surface Non Wetting

Troubleshooting


CONSULTATION SERVICES

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.

The X-Cel Contacts Consultation Team We Put All the Pieces Together


Flexlens® & Westcon™ Initial Lens Unlimited exchanges and cancellation Annual Supplies Non-warranted and non-returnable

WARRANTIES90 DAY POLICIES

Unlimited Exchanges and Cancellation within 90 days All Spherical and Toric Designs Comfort Designs: Visions Ultrathin, Pinnacle, X-Cel® Thin, Starlens, Envision

Two exchanges per eye or cancellation within 90 days

CV-4™ Multifocal Solution™ Bifocal ProPlus™ Multifocal Titan™ Atlantis™ Scleral Apex™ Keratoconus Reverse Geometry 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.


PARAGON VISION SCIENCES

BOSTON

LENS MATERIALS

Boston© XO

Pargon HDS©

*ISO.Fatt Method

Boston© EQUALENS©

Boston© EQUALENS© II

Boston© IV

Paraperm© 02

Boston© II

Boston© EO

Paragon ThinTM

Boston© ES

Boston© XO2

Paragon HDS© 100

Fluoroperm© 30

Fluoroperm© 60

Fluoroperm© 92

Fluoroperm© 151

100*

58*

47*

85*

19*

16*

12*

58*

29*

18*

141*

100*

30*

60*

92*

151*

1.415

1.449

1.439

1.423

1.469

1.473

1.471

1.429

1.463

1.443

1.424

1.442

1.466

1.453

1.453

1.422

1.27

1.16

1.19

1.24

1.10

1.12

1.13

1.23

1.45

1.22

1.19

1.1

1.14

1.15

1.1

1.1

49 degreescaptive bubble

14.7***62****

12.8***61****

42***70****

12.8***61****

14.7***62****

16***64****

42***70****




23***61****





UV Blue, Ice Blue, UV Ice Blue, Green, UV Green, Violet, Red,

Yellow, Clear, UV Clear

Blue, UV Blue Crystal Blue, UV Crystal Blue, Green, UV Green,

Forest Green, Violet

Sapp Blue, UV Sapp Blue, Emerald Green, UV

Emerald Green, Clear

UV Blue

Sapphire Blue, UV Saph Blue, Emerald Green,

Blue, UV Blue, Maj Blue, Crystal Blue, Gray, UV Gray, Green, UV Green,

ClearGreen, UV Green, Blue, UV Blue, Crystal Blue,

Brown, Clear

Blue, UV Blue, Green, UV Green, Clear

Blue, UV Blue

UV Blue, Red, Yellow

Blue

Clear, Blue, Electric Blue, Green,

Cool Green

Blue

Blue, UV Blue, Ice Blue, UV Electric Blue

Green, Gray, Brown

Blue, UV Blue, Ice Blue, Green, Gray,

Brown

Blue, UV Blue, Ice Blue, UV Ice Blue, UV

Green, Violet, Red,Yellow, Clear, UV Clear

Name

Name

Wetting Angle

Wetting Angle

Color

Color

Refactive Index

Refactive Index

Specific Gravity

Specific Gravity

FluorosiliconeAcrylate




Silicone Acrylate

Silicone Acrylate

Silicone Acrylate










Material Type

Material Type

DK

DK


PARAGON VISION SCIENCES (Cont.)

CONTAMAC

FLEXLENS / WESTCON SOFT LENS MATERIALS

Paraperm© EW

Optimum Classic

Benz G3X 49%

Optacryl© 60

Optimum Comfort

Benz G5X 59%

Optimum Extra

Contaflex 55%

Optimum Extreme

Contaflex 45%

74% Definitive Silicone Hydrogel

*Refactive index and specific gravity (hydrated)*Flexlens is not available in Polymacon 38%. Westcon is not available in Definitive Silicone Hydrogel.

Contaflex 38%

56*

26

15

18*

65

21

100

19.5

125

13.8

7.9

60

1.467

1.450

1.425

1.467

1.437

1.401

1.431

1.40

1.432

1.42

1.438

1.3750 at 20ºC1.3750 at 35ºC

1.07

1.19

1.136

UV Blue, UV Glacier Blue, UV Green, UV Gray, UV Glacier B1

Blue, Clear

UV Blue, UV Green, UV Gray, UV Forest Green,

UV Brown

Blue, Clear

Clear, UV Blue, UV Green, UV Gray, UV Clear, UV Glacier B1

UV Blue, Clear

UV Blue, UV Green, UV Gray, UV Glacier B1

Blue, Clear

Blue, Clear

Blue, Clear

1.13

1.17

1.18

1.16

1.099

1.15

1.17

1.17

1.048

Name

Name

Name

Wetting Angle

Wetting Angle

Color

Color

Color

Refactive Index

Refactive Index

Refactive Index

Specific Gravity

Specific Gravity

Specific Gravity

Silicone Acrylate

Roflufocon A

Hioxifilcon B

Silicone Acrylate

Roflufocon C

Hioxifilcon A

Roflufocon D

Methafilcon A

Roflufocon E

Hefilcon A

Polymacon

Efrofilcon A

26***64****

12

25***59****

6

3

6

Material Type

Material Type

Material Type

DK

DK

DK

*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

LENS MATERIALS

GP materials shaded in blue cannot be plasma treated. All other materials are plasma treated unless specified.

Blue, Clear

Blue, Green

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 ARC (18 LENS SET) - $299.00

DIAGNOSTIC SETS FORCUSTOM SOFT

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 90 180 135 45 90 180 135 45 90 180

Diameter 14.0 14.0 14.5 14.5 14.5 14.5 15.0 15.0 15.0 15.0

FLEXLENS TORIC (10 LENS SET) - $250.00

FLEXLENS PIGGYBACK (10 LENS SET) - $250.00

FLEXLENS TRI-CURVE KERATOCONUS (10 LENS SET) - $250.00

FLEXLENS PEDIATRIC APHAKIC (7 LENS SET) - $250.00

FLEXLENS PRS (7 LENS SET) - $250.00

Other Diagnostic Sets available upon request.


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

Base Curve 7.2 7.2 7.5 7.5 7.5 7.5 7.8

Diameter 11.5 11.5 11.5 12.0 12.0 12.5 13.0

Spherical Power +20.00 +25.00 +25.00 +20.00 +25.00 +25.00 +25.00

Base Curve 7.8 8.1 8.4 8.7 9.0 9.3 9.6

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

Base Curve

6.6 6.9 7.2 7.5 7.8 8.1 8.4 8.7 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

Center Thickness

.12mm .12mm .12mm .12mm .12mm .12mm .12mm .12mm .12mm .12mm

Anterior Cutout

10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm 10.2mm


DIAGNOSTIC SETS FORSPECIALT Y GP

APEX STANDARD (24 LENS SET) - $299.00

ADDITIONAL (10 LENS SET) - $399.00

ESSENTIAL SOLUTION (12 LENS SET) - $399.00

CV-4 (12 LENS SET) - $399.00

ATLANTIS (24 LENS SET) - $499.00

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

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

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

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

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)


PINNACLE LARGE DIAMETER (16 LENS SET) - $320.00

REVERSE GEOMETRY (15 LENS SET) - $270.00

DIAGNOSTIC SET FORSPECIALT Y GP

PINNACLE (12 LENS SET) - $240.00

PRO PLUS (12 LENS SET) - $200.00

SOLUTION BIFOCAL (24 LENS SET) - $399.00

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


Base Curve 51.00D (6.62) to 36.00D (9.38)

Power -3.00D


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

Base Curve 41.12D (8.20) to 35.87D (9.40)

Power Plano

Diameter 10.5mm

Optical Zone Various OZ and Reverse Curves

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

Optical Zone 1.5mm smaller than OAD

Prism Ballast Medium

Segment Position 1.0mm below geometric center (BGC)

DIAGNOSTIC SETS FORSPECIALT Y GP

X-CEL THIN (12 LENS SET) - $299.00

TITAN (26 LENS SET) - $400.00

TITAN (13 LENS SET) - $200.00

STARLENS (12 LENS SET) - $200.00

VISIONS (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



Base Curve 46.00D (7.34) to 40.50D (8.33)

Power -3.00D

Diameter 9.2mm in Base Curves from 7.34 to 7.76



Base Curve 47.00D (7.18) to 35.00D (9.64)

Power +5.00D to Plano


Edge Lift Medium, Flat

Material Recommended in Optimum Extra

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 Recommended in Optimum Extra

Base Curve 46.25D (7.30) to 40.75D (8.28)

Power -3.00D

Diameter 9.0mm in Base Curves from 7.30 to 7.38



2775 Premiere Parkway, Suite 600, Duluth, GA 30097 | 800.241.9312


CALIFORNIA800.342.2724

FLORIDA800.432.3838

GEORGIA800.241.9312

MARYLAND800.221.9235

MINNESOTA800.926.6822

PENNSYLVANIA800.245.0797

WASHINGTON800.426.6241

WESTCON800.346.4303

x-cel contacts product and fitting guide - flexlensflexlens.uy/catalogo.pdf · mean “k” (52.00d...

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