Presentation1

Contact Lens Care

Systems

What every optometrist should know about prescribing the right solution for each contact lens patient

In recent times, we have seen the emergence of serious ocular infections and

In recent times, we have seen the emergence of serious ocular infections and resultant contact lens solution recalls.

Fall 2005 (CIBA VISION discontinues all lens

care products)

Summer 2006 ( B&L recalls ReNu MoistureLoc)

Fall 2006 ( AMO recalls Complete Moisture

Plus)Winter 2006 ( B&L recall of ReNu

MultiPlus)

A Few Bad Years!

ReNu recallBausch + Lomb company acknowledged that polymers in this particular lens solution formulation easily formed microbial films under certain conditions that resulted from poor patient compliance.

These conditions included:Topping off contact lens solution

not replacing the lens case regularly

not closing the bottle top between uses

When fitting patients with contact lenses, optometrists utilize their expertise to choose lenses with

attributes that will best meet each patient’s vision and eye health

needs.

Once the lens has been chosen, should practitioners go one step

further and prescribe a contact lens solution?

A patient who: is not prescribed a contact lens solution

receives no explanation as to why a certain solution is best

A patient who: is not prescribed a contact lens solution

receives no explanation as to why a certain solution is best

may resort to picking a product based solely on the sale price or available coupons.

Shortcuts and ways to “save” solution or extend contact lens wear are common, even among our best patients.

To underscore the importance of their recommendation, optometrist should write solution recommendations on a

prescription pad

There are two types of contact lens care systems:

There are two types of contact lens care systems:

multipurpose contact lens solutions (MPS)

hydrogen peroxide-based care systems(HPB)

Multipurpose contact lens solutions are dual-purpose liquids :

Clean

disinfect

Multipurpose Contact Lens Solutions

Multipurpose solutions also are called "no-rub" solutions:

because they are designed to adequately clean and disinfect lenses with a simple rinse-and-store method, eliminating the need to mechanically rub the lenses to remove lens deposits.

many eye care professionals recommend adding a short, 10-second period of mechanical rubbing as part of the cleaning regimen with multipurpose solutions.

less expensive

easier to use than hydrogen peroxide-based solutions,

therefore contact lens wearers are more likely to use multipurpose

solutions properly

Multipurpose solutions benefits:

Multipurpose solutions disadvantage:

recent years there has been a global recall of at least one brand of a multipurpose contact lens solution because of an outbreak of fungal eye infections associated with the product

the preservatives(varying molecular weights)

Wetting agents(harbor opportunistic microbes)

challenge of cleaning and disinfecting the newest contact lens material: silicone hydrogel.

Why recall?

provide effective lens disinfection

no product recalls have occurred due to outbreaks of eye infections.

low amounts of corneal staining

Hydrogen Peroxide-Based solution

one-step

two-step process

Lens disinfection with HPB lens care systems

Both one-step and two-step HPB lens care systems after lens disinfection and prior to wearing the lenses

require neutralization of the hydrogen peroxide solution.

because hydrogen peroxide is an effective disinfecting agent,

because hydrogen peroxide is an effective disinfecting agent,

but it is toxic to the cornea and must be converted to saline with a neutralizing agent to avoid eye injury.

the lenses are placed in a holder within a cylindrical contact lens case.

the case is filled with a 3 percent solution of hydrogen peroxide.

The bottom of the case contains a solid disk of a material that immediately begins neutralizing the hydrogen peroxide.

one-step HPB systems:

the contact lens are placed in a lens case filled with only the hydrogen peroxide for a specified period of time

A neutralizer is then added to the case to convert the disinfectant to harmless saline

two-step systems

Hydrogen peroxide care systems are preservative-free and therefore are often recommended for contact lens

wearers who :

Hydrogen peroxide care systems are preservative-free and therefore are often recommended for contact lens

wearers who :

may be sensitive to preservatives found in multipurpose contact

lens solutions

one-step HPB:may not expose contacts to full-strength hydrogen peroxide for an adequate period of time

Hydrogen Peroxide-Based solution disadvantage:

one-step HPB:may not expose contacts to full-strength hydrogen peroxide for an adequate period of time

two-step HPB :users will forget the neutralizing step

and incur a painful eye injury

Hydrogen Peroxide-Based solution disadvantage:

Opti-Free RepleniSH (Alcon) and Clear Care (CIBA Vision)

Clear Care could provide longer wear times than the other MPS system

compared the performance of MPS systems vs. hydrogen peroxide systems

Biotrue inspired by the biology of the eye to make wearing

contact lenses easie.

pH in the range of healthy tears

keep lenses moist for up to 20 hours

can be used with all soft and silicone hydrogel lenses.

Keeps beneficial tear proteins alive

BAUSCH + LOMB

renu® fresh

renu sensitive(will soon be available in a convenient clear bottle,

and both the carton and bottle are 100% recyclable)

BAUSCH + LOMB

AQuify® 2004

PRO-GUARD™ lens case.(reduce lens case contamination when used

with Aquify)

ideal for patients that wear their lenses for extended periods during the day.

CIBA VISION

Clear Care 2001one bottle 3% hydrogen peroxide solution

kills bacteria and germs

The bottle is marked with a red tip( caution patients from directly putting in

their eyes.)

CIBA VISION

OPTI-FREE® RepleniSH 2006:

provide a high level of moisture for patients wearing all types of contact lenses

Wetting agent -TearGlyde® formulation( provides the lenses with a layer of moisture all day)

ALCON

OPTI-FREE PureMoistWetting agent -HydraGlyde® Moisture

Matrix( surrounds lenses in a cushion of moisture to keep contacts hydrated)

dual disinfectants POLYQUAD® and ALDOX

can also be used for sensitive eyes

reduces lipid deposition and removes protein deposits.

RevitaLens OcuTec - 2010

combines the disinfection of a peroxide system with the convenience of a multi-purpose solution

OcuTec- antimicrobial activity even under non-compliant

conditions

-a high effectiveness against Acanthamoeba (single-celled living organism)

AMO

- low rates of corneal staining and adverse effects

- - effective protein removal

leading to tolerability

less redness

less end of day dryness

Oxysept

hydrogen peroxide disinfection solution/neutralizer

Neutralized Oxysept is also nearly identical to natural tears (viscosity and surface tension)

the neutralizing tablet eliminates the risk of residual peroxide

a natural B12 color has been added ideal for sensitive eyes

AMO

Thank you for your attention

We welcome your

questions ,suggestions, comments!