contact lens management
CHRISTOPHER W. LIEVENS, O.D., M.S.
Offer Patients A Practical Solution
Lens-care solution offers disinfecting and reconditioning systems and more.
Because eyecare practitioners are concerned about the effect multipurpose disinfecting solutions (MPS) may have on the ocular surface, several contact lens (CL) solution manufacturers have strived to create lens-care solutions that arent only effective at killing harmful microorganisms, such as Acanthamoeba, but are also safely formulated. Add reliability and convenience, and youve got Opti-Free RepleniSH CL solution, from Alcon.
Opti-Free RepleniSH is fashioned with a disinfecting system consisting of Polyquad (polyquaternium-1) and Aldox (myristamidopropyl dimethylamine). I have found that most lens-care solutions contain preservatives that are biguanide-based, have p-hydroxymercuribenzoate (PHMB) derivatives (Polyaminopropyl biguanide, Polyhexanide and Polyhexamethylene biguanide) or contain the preservative Alexidine.
In theory, the Polyquad preservative complex is too large for absorption and release from a lens matrix.1 Minimizing the uptake and release of the preservative into the lens helps to maintain an intact corneal barrier.2
A 2006 study that measured the uptake of various MPS into group-IV contact lenses revealed that Alexidine- and PHMB-based MPS showed significant preservative uptake into the lenses as compared with the Polyquad solution.1 Previous studies have shown that such preservative uptake could contribute to significant levels of ocular surface staining.3-6
Opti-Free RepleniSHs reconditioning system, TearGlyde (Tetronic 1304 and C9-ED3A nonanoyl ethylenediaminetriacetic acid), works with the patients own tear components to retain moisture on the lens surface.7 In a study in which group-IV lenses were soaked in various lens-care solutions overnight, then worn and removed for wetting angle measurements, Opti-Free RepleniSH had the lowest wetting angle of all the solutions tested. Even after 14 hours of wear, the wetting angle of the lens surface was still low with Opti-Free RepleniSH.8
Corneal staining and solution biocompatibility
At the Association for Research in Vision in Ophthalmology (ARVO) meeting last year, Dr. Gary Andrasko, an optometrist from Columbus, Ohio, presented clinical research on acute corneal staining associated with various silicone hydrogel lenses and MPS. (Visit www.staininggrid.com.) Compared with other MPS, the Polyquad system has provided the least amount of corneal staining with all the contact lenses tested thus far.3
Opti-Free RepleniSH helps to ensure ocular surface integrity and can enhance lens wear comfort, even in some of the most problematic patients.
PRESERVATIVES AND ANTIMICROBIALS: Polyquad (polyquaternium-1)and Aldox (myristamidopropyl dimethylamine)0.0005%.
RECONDITIONING SYSTEM: TearGlyde; Tetronic 1304 and C9-ED3A (nonanoyl ethylenediaminetriacetic acid)
CLEANING AND BUFFERING AGENT: Sodium citrate
DEMULCENT AND OSMOLARITY AGENT: Propylene glycol.
References available upon request.
DR. LIEVENS IS AN ASSOCIATE PROFESSOR AND THE CHIEF OF PRIMARY CARE AT THE SOUTHERN COLLEGE OF OPTOMETRY. HE IS ALSO EMPLOYED IN PRIVATE PRACTICE AND AT AN OPHTHALMOLOGY REFERRAL CENTER. E-MAIL HIM AT CLIEVENS@SCO.EDU
Optometric Management, Issue: April 2007