Once-a-Month Contact Lenses

B O S T O N, Nov. 29 -- Millions of Americans may be able to see more clearly longer with the approval of new continuous monthly-wear contact lenses — but some doctors advise they blink twice before using them.

The Food and Drug Administration has given the nod to two month-long continuous wear contacts: CIBA Vision's Focus Night & Day and Bausch & Lomb's PureVision. The lenses are now available to consumers by prescription.

Makers say the new lenses can be worn continuously, both day and night, for up to 30-days — a dramatic increase from the one-week lenses previously available. Wearers can go an entire month without having to worry about replacing their contacts, potentially saving users money on both lenses and necessities like cleaning and saline solutions, contact cases, as well as saving time not having to clean or care for them.

The lenses, which are designed to be thrown away at the end of the 30-day period, will cost approximately $30 per month, roughly double the price tag of daily and weekly disposable lenses, but similar to the cost of specialty tinted lenses or special lenses for astigmatisms.

An estimated 30-40 million people wear contact lenses in the United States, a $1.5 billion a year industry; 12-13 million may be eligible to wear the new 30-day lenses.

Experts are Cautious

But some experts are approaching the new lenses with caution.

Dr. Jay Pepose, professor of clinical ophthalmology at Washington University School of Medicine in St. Louis notes that certain problems, like eye infections, may not be seen in clinical trials because study subjects are carefully selected and closely supervised by physicians.

"In the real world, the epidemiological studies still suggest that overnight use of a contact lens increases the risk of infection, and this is compounded if the patient is a smoker," says Pepose.

Experts also note that the long-term effects of contact lenses on the cornea can take years, or even decades to assess.

Completely New and Different Technology

Both lens makers assert these lenses use completely new and different technology and are safer than previous month-long lenses because they allow more oxygen to permeate the lens while the eyelids are closed during sleep.

Low oxygen can lead to corneal swelling and other eye problems that can seriously, and permanently, jeopardize one's eyesight. Both companies report minimal overnight corneal swelling, and less redness and irritation than observed in regular soft contact lens wearers.

The FDA restricted earlier versions of month-long contact lenses to one-week wear after concerns over eye infections and eye ulcers were raised in the 1980s.

Both companies hope these new contacts will be a convenient alternative to laser eye surgery. Margaret Graham, director of corporate communications for Bausch & Lomb, notes, "There has been a great deal of interest in refractive laser surgery, but some don't qualify — maybe their cornea is too thin, but they would love the convenience of these lenses and would be good candidates."

Even for those who are eligible for laser surgery, the procedure is very costly and often not covered by insurance plans.

Graham advises current contact lens wearers to check with their eye doctors to see if they are eligible for the long-wear lenses, work out a wearing schedule and as always, follow proper care instructions.