Manufacturer Guidelines for Current No-rub Solutions
BY SUSAN J. GROMACKI, OD, MS, FAAO
Every year or so I write a column that outlines manufacturers' directions for cleaning soft contact lenses with no-rub chemical solutions. Since my last column, "No Rub Read the Fine Print, Part 2," in April 2004, three of the major manufacturers have developed new, improved no-rub solutions. The improvements range from tweaking the active ingredient/preservative to adding important wetting agents. I'll provide the run-down on manufacturers' instructions for the new leading multipurpose solutions. (The instructions for Bausch & Lomb's ReNu MultiPlus remain unchanged from 2004.)
But first, have you noticed the words no rub are getting less and less evident on solution labeling? I've always recommend rubbing anyway, especially for silicone hydrogel materials to reduce lipid deposits. As we know, many patients misinterpret "no rub" to mean simply removing the contact lens from the eye and dropping it into a solution-filled case, whereas all no-rub solutions require a rinsing step to be effective.
Patients who have difficulty complying with multi-step lens care regimens are often attracted to multipurpose solutions that don't require a rub step. In a study presented at the American Academy of Optometry 2005 Annual Meeting, Christina Schnider, OD, from Vistakon found that adding a rub step to both MPS and peroxide cleaning regimens improves the solutions' efficacy even in a patient population prone to deposits.
So, here are the latest instructions for the newer no-rub solutions, taken from each solution's packaging, current as of press time.
Opti-Free Replenish (Alcon)
"Thoroughly rinse each side of the lens (5 seconds) with Opti-Free Replenish... If your eye care professional directs you to rub your lenses, place several drops on the contact lens and rub for several seconds. Then follow the directions above...If using Opti-Free Supraclens Daily Protein Remover, follow these directions, including rinsing before putting the lenses on your eyes."
This solution requires a six-hour soak for disinfection, and patients can store lenses in the solution for up to 30 days.
Complete MoisturePlus (AMO)
"Rinse each side of the lens for 5 seconds...your doctor may recommend additional care procedures (such as rubbing your lenses). This may be particularly important if lenses are kept longer than 90 days...place 3 drops or more of solution on each lens surface and gently rub for at least 10 seconds."
This solution requires a four-hour soak for disinfection, and patients can store the lenses in Complete for up to 30 days.
Aquify (CIBA Vision)
"5 Minute Express Option (With a Rub). Apply at least 3 drops of Aquify on each side of the lens and gently rub the lens 10 seconds per lens side. Rinse the lens thoroughly with Aquify."
"No Rub Directions for Use. Thoroughly rinse each side of the lens with Aquify..."
This solution requires a four-hour soak without the rub, and patients can store lenses in the case for up to 30 days.
I will update this list periodically if any additional procedural changes occur. Until then, keep in mind that a proactive approach to good lens care goes a long way in preventing noncompliance and its resulting complications.
For references, please visit www.clspectrum.com/references.asp and click on document #131.
Dr. Gromacki has a specialty contact lens and post-surgical co-management practice as part of a multi-subspecialty ophthalmology group in Ann Arbor, MI.