contact
lens care
Choosing
Piggyback Lens Care Products
BY
MICHAEL A. WARD, MMSC, FAAO
Silicone hydrogel materials have revolutionized
the soft contact lens industry. As a group, these materials offer superior oxygenation
to the cornea, perform well in dry eye conditions and may
be associated with a lower incidence of severe corneal infection. Silicone hydrogel
lenses have also revitalized the use of GP/soft contact lens (SCL) tandem lenses
and dramatically increased their success over the use of HEMA-based tandem lens
fits.
The current generation of silicone hydrogel and GP materials
has broadened our armamentarium of contact lens correction options. Older piggyback
lens systems using HEMA-based soft lenses had limited success largely because of
barrier-induced hypoxia.
Using silicone hydrogel soft lenses with high-Dk GP lenses has
proven quite successful, particularly for use over irregular corneal surfaces such
as keratoconus, penetrating keratoplasty and following refractive surgery.
Selecting Lens Care
When choosing lens care for GP/SCL lens systems, consider these
three factors:
1. You can use soft (silicone hydrogel) lens care products with
GP lenses.
2. You should NOT use GP lens care products with soft lens materials.
3. GP and silicone hydrogel lenses require regular cleaning and
rinsing.
Step-by-Step Cleaning
I've found the following lens products work well with GP/SCL tandem
lens systems.
When using soft multipurpose (MPS) lens disinfection, follow these
steps.
Evening
• Remove the GP lens and clean it with a GP daily cleaner
(Boston Advance Formula Cleaner [Bausch & Lomb], Optimum Extra Strength
Cleaner [Lobob Laboratories]). Thoroughly rinse the cleaner from the lens as directed.
• Store the GP lens in a soft lens MPS.
• Remove and rub/rinse, store the soft lens separately in
soft lens MPS.
Morning
• Rinse lenses with fresh MPS and place soft lens and GP
lens on the eye.
• Rinse lens cases and leave open to air dry.
When using peroxide-based lens disinfection, follow these steps.
(Note: UltraCare (AMO) is contraindicated for use with PureVision (Bausch &
Lomb) lenses.)
Evening
• Remove and clean/rinse the GP lens using a GP daily cleaner
as described above.
• Store GP lens in peroxide disinfection system according
to product instructions
• Remove, rub, rinse and store the soft lens separately in
the peroxide disinfection system according to product instructions.
Morning
• Rinse soft and GP lenses and place both on the eye. The
GP lens surface may not wet properly when taken directly from the peroxide care
system. Use a soft lens MPS as a wetting agent for the GP lens before placing on
the eye.
Do not use GP wetting solution when placing a GP lens over a SCL
lens to avoid contaminating the SCL.
Rewetting Drops
When choosing rewetting drops:
• Only use drops that are approved for use on soft lenses
such as Blink Contacts Lubricant Eye Drops (AMO) and Aquify Long-Lasting Comfort
Drops (CIBA Vision).
• Limit preserved drops and medications to four times a day
over lenses. If more frequent rewetting is indicated, use preservative-free drops.
Mr. Ward is an instructor
in ophthalmology at Emory University School of Medicine and Director, Emory Contact
Lens Service.
Contact Lens Spectrum, Issue: January 2006