ProPlus

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The ProPlus Multifocal

• Bi-aspheric multifocal lens
• Center distance
• Peripheral near

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The ProPlus Fitting Goals

• Position centered or slightly tucked under the
  upper lid

• Lens should move freely with the blink

• Use the same fluorescein evaluation techniques as
  with single vision designs

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The ProPlus Fitting Goals

• Center distance optics should position over the
  pupil during primary gaze in normal room lighting

• Lens translates when the patient looks down to
  read

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Best Candidates for ProPlus

• New presbyopic patients who require good vision
  in all areas

• -20.00D to 10.00D distance
• 1.00D to 2.00D ADD
• 0.50D to 2.25D astigmatism

• Intermediate vision for computer users

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Distance Zone

• Recommended distance zone is 3.6mm
• For larger or smaller pupils 3.9mm or 3.3mm
  distance zones are available
• For powers 3.00D or higher, a 3.3mm distance
  zone is suggested

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Lens Diameter

• Most patients have an average size cornea,
  measuring 11.5mm to 11.8mm horizontally

• Recommend a 9.5mm diameter lens for most eyes

11.5mm 11.8mm
Average corneal diameter
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Base Curve

• Use nomogram to select initial base curve

• Only consideration is amount of corneal
  astigmatism

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Empirical or Diagnostic Fitting

• Fit empirically using Ks and spectacle Rx, base
  curve selection chart, along with the recommended
  diameter and distance zone parameters

• Diagnostic lens fitting is also possible

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ProPlus Fitting System
Discussion of fitting steps
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Step 1

• Transpose spectacle Rx to minus cylinder form

• Determine spectacle add power

• Take keratometry measurements

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Step 2

• Base curve determined by the amount of corneal
  astigmatism

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Step 3

• Select the recommended parameters
• Diameter 9.5mm
• Distance zone 3.6mm

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Step 4

• Determine lens power

• Vertex spectacle Rx to corneal plane

• Adjust for tear layer effects (SAM and FAP)
  depending on base curve selected

• Determine the patients spectacle add power and
  add 0.50D

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Vision Evaluation

• Allow the lens to settle
• Test the patient's binocular distance and near
  visual acuity
• Over-refract

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Fitting Steps - Example
Spectacle Rx K Readings K Difference
-3.75 -0.75 x 180 ADD 1.50D 41.75 _at_ 180, 42.50
_at_ 90 0.75D 0.25D steeper than K
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Fitting Steps - Example
Spectacle Rx K Readings K Difference
-3.75 -0.75 x 180 ADD 1.50D 41.75 _at_ 180, 42.50
_at_ 90 0.75D 0.25D steeper than K

• Lens diameter
• Base curve
• Distance zone size
• Distance power
• Add power

9.5mm 42.00D (7.94mm) 3.6mm -4.00D 2.00D
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Problem Solving

• Problem Solving
• Lenses moves excessively
• Lenses dont translate
• Poor near or distance vision

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Problem Solving

• Lens moves excessively
• Steeper base curve
• Lens doesnt center
• Change the base curve
• Increase the diameter

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Problem Solving

• Patient with poor near acuity and good distance
  acuity
• Check head position when reading
• Decrease the size of the distance zone

Good head position
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Problem Solving

• Lens doesnt translate or move with the blink
• Flatter base curve

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Problem Solving

• Patient with good near acuity and poor distance
  acuity
• Check lens centration
• Check over-refraction
• Increase distance zone size

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ProPlus Lens Parameters
Base Curve Power Add Diameter Distance
Zone Material
6.00mm to 9.00mm -20.00D to 20.00D 0.75D to
2.50D (0.25D steps) 8.5mm to 11.00mm (in 0.1mm
steps) 3.3mm to 3.9mm (3.6mm is default)
3.3mm distance zone for 3.00D power and
higher Boston XO, Boston EO
or Boston ES
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ProPlus Multifocal

• Lenses packaged in screw top contact lens case
• Shipped in hydrated state for convenience and
  improved initial comfort
• Clean lenses prior to dispensing to patient

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X-Cel Warranty

• 90 day guaranteed fit
• 100 credit on two exchanges per eye
• Call or e-mail our experienced fitting
  consultants

gahouse_at_walman.com mdhouse_at_walman.com mnhouse_at_wal
man.com olhouse_at_walman.com
pahouse_at_walman.com cahouse_at_walman.com sehouse_at_walm
an.com
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