Contact Lens Care & Compliance
We Need Daily Lens Cleaners
By Michael A. Ward, MMSc, FAAO
All-in-one multipurpose (MPS) lens care products dominate the soft lens market. MPS products work well for daily maintenance of cleaning, rinsing, and disinfecting for most patients who use two-week and monthly soft lenses. However, patients wearing specialty lenses that are replaced less frequently (quarterly or longer), and occasionally even disposable lens wearers, may require an additional lens cleaner. The expanding availability of more expensive custom designed HEMA and silicone hydrogel (SiHy) soft lenses will likely create an increasing demand for effective daily lens cleaners.
Environmental contaminants, as well as eyelid and tear chemistries (e.g. meibomian gland dysfunction), may contaminate lens surfaces. This is especially true of SiHy lens materials, which according to the Contact Lens Spectrum Annual Report for 2011 (published in January 2012), account for 67 percent of fits and refits in the United States.
The availability of daily contact lens cleaners has diminished significantly as MPS products have captured the market for use with disposable lenses. Only a few remain available, and there are no new entries of which I am aware. Retail shelf space is competitive, and stores—especially the bigbox retailers—want products that turn over quickly.
Ciba Vision discontinued manufacturing Miraflow Extra Strength Daily Cleaner in 2010. It was unsurpassed in removing lipid-based films and makeup from lens surfaces. Miraflow contained purified water, isopropyl alcohol, 15.7% poloxamer 407 and amphoteric 10. It was preservative-free, could be used with all types of soft and hard (PMMA) lenses, and was noted for its lipolytic properties and its significant antimicrobial activity.
Miraflow had a loyal, albeit limited following. Fortunately, Walgreens offers its house branded substitution Extra Strength Cleaner that lists the same ingredients as Miraflow. In a 2007 FDA 510K submission, Sereine Extra Strength Daily Cleaner for Silicone Hydrogel Soft Contact Lenses by Optikem International is similarly listed as containing “the same solution as cleared in 510(k) KOl 1561, which is substantially equivalent to the Miraflow cleaner by Ciba Vision.”
Daily cleaners now available for soft and GP contact lenses include:
Sensitive Eyes Daily Cleaner (Bausch + Lomb) is a sterile, isotonic, buffered solution that contains hydroxypropyl methyl-cellulose, poloxamine, sodium borate and sodium chloride; preserved with edetate disodium (0.5%) and sorbic acid (0.25%).
Opti-Free Daily Cleaner and Opti-Clean II (both Alcon) for soft and GP lenses are buffered, isotonic formulations containing Tween 21 Solubilizer and Microclens special polymeric cleaning agents with edetate disodium 0.1% and Polyquad (polyquaternium-1) 0.001% as preservatives. Both cleaners use small polymeric beads as abrasives to enhance the mechanical stripping of proteins and debris from lens surfaces. Do not use abrasive cleaners on plasma-treated lenses.
Sof/Pro Sterile 'Extra Strength' Cleaner (Lobob) contains three water soluble surfactants and is preserved with sorbic acid 0.1% and trisodium EDTA 0.25%.
Sereine Extra-Strength Daily Cleaner and Walgreens Extra Strength Cleaner have formulations equivalent to Miraflow.
Proper Lens Care
Digitally cleaning contact lenses is well documented to provide enhanced antimicrobial activity, comfort, and clear vision. Daily cleaners are occasionally needed to augment MPS and peroxidebased disinfectants, and daily cleaners will seldom cause ocular irritations if lenses are properly rinsed. CLS
To obtain references for this article, please visit http://www.clspectrum.com/references.asp and click on document #195.
|Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service. You can reach him at email@example.com.|