High Minus Drill Mount

**Joann Raytar** · 09-29-2003, 07:52 PM

We have a patient who has a total power of -9.00 @ 90 and currently wears Varilux comfort. She wants a Silhouette Minimal Art frame.

Any suggestions for a lens choice? Right now, I am thinking Seiko Proceed in 1.67 with AR.

(Pete - any idea on when Comfort 1.67 will become available?)

**chip anderson** · 09-29-2003, 08:10 PM

Excellent choice, use smallest lens width you can and not bind on temples. Use long inserts.

**sticklert** · 09-29-2003, 08:15 PM

Jo,

I work for HOYA. I have seen some really nice 1.7's going out the door. HOYA has 3 progressives to choose from:

HOYA Wide 18 minimum Fitting Hight
Summit ECP 18 minimum
Summit CD 14 minimum

I think if you keep the eye size down so that their is as little decentration as possible, and with the combination of the 1.0 Center Thickness you will be pleasantly surprised.

Todd

**PAkev** · 09-29-2003, 09:34 PM

I usually don't do PAL's over the -5.00 range but I guess it is possible with the appropriate lens materials and a patient willing to recognize the respective costs.

Not sure if you do the finishing and drilling work but you may want to calculate the Edge thickness so that you will have adequate post lenghth. If the plastic sleeve takes up more than 25 percent of the distance before contacting the post, I would be concerned about wobbling temples.

Kevin

**Joann Raytar** · 09-29-2003, 10:02 PM

She has been doing fine with her current progressive; I am just concerned about an extreme switch in lens design after all her years in a Comfort.

I wonder if Minimal Art is the right way to go. Would a standard bolted assembly work better for this one?

**Billy Brock** · 09-30-2003, 07:54 AM

hi Jo,

I just finished a -12.00 in a 43 eye ..... pd layout worked out to be OC which really helped ......... used a Minima titanium mounting, Hoya 1.6 index ......... did a hint of roll & polish just to knock off the sharp edge.......... turned out beautifully and the lady is a full time wearer of her glasses

B

**Robert Martellaro** · 09-30-2003, 05:13 PM

Jo,

I have not had one Comfort to Panamic non-adapt. The Proceed 2 has a shorter corridor which might be necessary for the size frame that is required for this Rx.

I believe Silhouette recommends a maximum thickness of 6mm at the post for the reason given my Kevin. A 1.67 with a lens size less than 46mm should be under 6mm at the post if the per lens decentration is no more than 2 or 3mm, and if the power at 180 is not too much more than -9.00.

When I show my clients how small the lens has to be to make the fitting manageable they usually follow my advice and opt for a more traditional frame (not too many presbyopes look good in a really small and/or round frame). But when they do look good and the client is motivated I will not discourage the selection of a three piece in a medium plus or high minus.

The only advantage of using a bolt and nut mounting is the ability to use a thicker/larger lens. If your client needs a larger frame (for cosmetic reasons) so be it. Otherwise I feel that the Silhouette is a vastly superior product.

Robert

**Joann Raytar** · 09-30-2003, 08:44 PM

Thanks Robert!

I found a Safilo J 44 eye that is pretty much the same shape she would have to go with to keep the decentration to a minimum while having a deep enough B measurement to fit a PAL.

I have her coming in with her contacts in so she can really see how small this frame is going to end up.

**skirk1975** · 10-07-2003, 06:27 PM

The seiko 1.67 should be an excellent choice due to the fact that it contains the MR10 polymer that makes it safe to drill.

**Hansel** · 11-07-2003, 06:59 PM

I think you need to talk the patient out of this frame. This is a dispensing nightmare waiting to happen. A high-minus patient like this will expect their lenses to look like demo lenses, but there is no material available that will meet his/her expectations. Just my opinion here...

**Texas Ranger** · 11-08-2003, 11:10 AM

Jo, we have done several of these situations in the 1.67 Panamic, which is just an updated Comfort, a -9.00 would be no problem at all; needs to have the Crizal AR, too. most of these we've had very happy clients in about a 45.20 size with a b of about 31, seg hts work out to be about 19, leaving a 12mm distance area; the 1.67 lenses are 30% thinner than 1.60; and if you have thicker lenses that they recommend, you can countersink the back side hole mounts with a dremel tool; not a really big problem...