My OD is a proponent of the the little suction cup
thingies. He said that there is some reason to believe
that, over time, pulling on your eyelids to do the blink
removal is not a good thing.  Your eyelids lose tension?
I have two suction thingies. One has a hole down the
middle through the suction cup and the barrel. You
can squeeze the barrel to release the suction. I use
this one for insertion. Stick it on the lens in the lens
case, apply to eye, squeeze the barrel to release.
I also use it for removal but the suction is not quite
as "positive" as the other one which is completely
solid. With the solid one you barely have to touch it
to the lens and it's locked on. You have to sort of
press it gently to your palm and slide the suction
cup sideways to release.

I think an added benefit is that I am never handling
clean lenses with my fingers.  I use the solid one to
remove at night, rub with cleaner, and place in solution
overnight. In the morning I use the hollow one to remove
the lenses from the solution and insert. I dump my solution
in the morning so during the day I use the hollow one to
remove, drop in empty lens case, apply drops to the lens
and reinsert.

My impression is that compliance with soft lenses is
far greater. Fit with soft lenses is MUCH easier. Soft
lenses are MUCH more comfortable initially and usually
somewhat more comfortable after the adaptaion period.
I have the impression that RGPs are never more comfortable
than soft lenses. I think many never get past the adaption
period. It requires some dedication on the patient's part.

By the way, I believe if you go without your RGPs for a
few days straight you will have to go through the adaption
period again.

I had a bad experience with my first OD. I think he just
wanted to do the $300 2 or 3 visit fit and here you go with
your year's supply thing. I wanted multifocals and I'm
very particular about sharp vision. I wanted to try RGPs.
His first response was "Oh, no. You don't want those".
I pressed on subsequent visits and he dismissed it with
something about how they didn't have good O2 transmission
and relied on tears moving O2 under the lenses to the
eye...  I'm really grateful for the information I got here.

I couldn't really see with the multifocals we tried (all
2 different designs). I did NOT want a monovision
solution (tried it - couldn't deal with driving and not
being able to see looking left). Towards the end he
would tell me "90% of people would be happy with
the vision you're getting) I just took my years supply (went
into the trash can) and moved on to another OD. He
understood my desire to try RGPs but wanted to try
a couple of different designs and makes of soft lenses
first. I had my heart set on trying the Tangent Streak
trifocals which he had never dealt with before (the lens
and the company) and he was open to experimenting
with that. I didn't fit the recommended profile for success
with these... very mild distance and a +2 add. Heavy
computer user.  I tried the soft lenses and we moved
on to the RGPs. He worked with me for 3 months with
a half hour to hour of chair time almost every week and
4 or 5 different tries at getting the fit right.  The things
kept rotating so we had to try some rather odd combinations
of truncation and ballast. End result: I'm absolutely
thrilled.

Initially I found the edges VERY noticeable. To the extent
of it seeming like I was looking through a viewer. He said
they like to go with the smallest diameter possible for
O2 and fit. We went to the maximum recommended
diameter and it was greatly improved. I now have to look
for the edges and can only find them to the horizontal
outside.

Ask your doc about Systane Free before insertion. Made
a difference for me.

-Quick

I can't speak for all ODs, but I can speak for myself:

I certainly fit far less RGPs than I used to and the number one reason
for this are silicone hydrogel contact lenses.

RGPs were/are far more healthy for my patients than HEMA lenses are. I
cannot say the same when comparing them to silicone hydrogel contact
lenses.

The benefits of initial comfort, no real adaptation period, having
spare pairs via disposable/frequent replacement schedule, better for
*certain* dry eyed patients than RGPs, less chair time, having trials
in the office outweigh the benefits of RGPs for most patients.

I still fit RGPs on new patients, but rarely for spherical
refractions.  Mostly for those with corneal cylinder or unacceptable
vision with soft contact lenses.

RGPs are definitely still a great option for some patients.

I just have found them to be less so as time goes on.  Not that RGPs
have gotten worse -- on the contrary, they have improved (slightly)
over time.  It's just that with silicone hydrogel contact lenses, soft
lenses have gotten SO much better.