Please note that the comments below are representative of remarks made in the chat room, and do not necessarily reflect the views of the moderators, the guest expert, or the GPLI. 

• Extended wear is not used extensively in this group's practices; estimates ranged from 1 or 2 patients to 10% at most.
   
• EW is used frequently for ortho-k patients; one participant relates that almost all of his ortho-k patients are in overnight wear of retainer lenses. Some of the group felt this really doesn't qualify as EW.
   
• One comment: "The care of GP's is so easy, most [patients] don't mind taking them out."
   
• High Dk lenses are needed for safe EW wear and to reduce corneal distortion. Equalens 2 got good marks for permeability and strength, the Menicon Z for permeability.
   
• There are scattered reports of microbial keratitis with GP EW but the incidence is very low.
   
• Medico-legal reasons aside, some patients do very well with long-term wear (3 months without removal).
   
• Younger patients seem to do better with EW. Older, drier corneas have an increased O2 demand. The exception are aphakic patients.
   
• Dr. Epstein believes that the future of CLs depends on a safe EW lens. Without this, refractive surgery will take over.
   
• Look for more reports of refractive surgery complications in the coming year.
   
• There is no need for frequent replacement lenses if you resurface them every 3 months, according to one participant. Others felt simply replacing the lens was more efficient. Skill in modification seemed to determine which camp the participant was in.
   
• Actual polishing using a spinner tool was preferred to trying to finger-rub a polish. The participants were concerned that younger ODs don't have lens modification skills.
   
• Comment from one participant: "I have had a few GP patients ask to try SCL disposables...they usually go back to GPs. Sometimes they have to experience the difference in vision to know the value of what they have."
   
• One noted that Dk makes little difference over a certain value. Then success comes down to design & fit.
   
• There was interest in scleral GP's, but some who were using them reported problems including distortion, and lens breaking on the eye.
   
• Try for one month of successful daily wear before releasing the patient to EW.

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