Contact Lens Care & Compliance
GP Contact Lens Care Pearls
By Michael A. Ward, MMSC, FAAO
The Gas Permeable Lens Institute (GPLI), the educational division of the Contact Lens Manufacturers Association (CLMA), hosts monthly webinars open to all practitioners on GP lens fitting and management. Here are a few lens care points that I presented during our July webinar.
Lens Solutions and Care
• Surface cleaning/debulking with digital rub and rinse is necessary for good comfort and vision. Inadequate surface cleaning results in irregular, hydrophobic surfaces that may create a debris attachment cycle, further leading to decreased vision, comfort, and wearing time.
• Abrasive cleaners (e.g. Boston Daily Cleaner, Bausch + Lomb [B+L] and OptiClean II, Alcon) are especially good at removing attached proteins. Nonabrasive, solvent-type cleaners (e.g. Optimum ESC, Lobob, and MeniCare GP CDS, Menicon) are good at removing oils and organics.
• Miraflow (no longer available) equivalents (Walgreens Extra Strength Daily Cleaner, Walgreens and Sereine Extra Strength Daily Cleaner, Optikem International) are exceedingly good at removing oils and makeup from lens surfaces. They may also be used on soft lenses.
• Hydrogen peroxide disinfection (e.g. Clear Care, Alcon) works well to mitigate protein buildup on GP lenses. Do not store a “spare” lens set in these vials due to lack of preservation.
• Boston Laboratory Cleaner (B+L) and Progent (Menicon) are effective at removing manufacturing residues on new GP lenses.
• Scleral lenses up to 16.5mm may be treated with Progent by using the Clear Care case—without the platinum disc (Figure 1).
Figure 1. The Clear Care lens holder will accommodate up to 16.5mm GPs. Remove the platinum disc from the Clear Care case and it can be used with Progent in place of the standard lens holder.
• Proteolytic enzymes may be used to treat GP contact lenses. Papain is no longer available. Pancreatin (SupraClens, Alcon) and Subtilisin-A (Ultrazyme, Abbott Medical Optics; Unizyme, Alcon; and Boston Liquid Enzyme, B+L) are in a liquid form that may be added to GP lens storage solutions.
• Treating GP lenses with oxygen plasma is a very effective cleaning method to remove any remaining residues (oils, waxes) from the lens manufacturing process. Benefits of plasma treatment are lost if the lens is dry (statically charged). Even when lenses are kept wet, the surface effect will wear off over time.
• When fitting GP contact lenses over soft lenses in a tandem (piggyback) fashion, it is important that GP lens solutions do not come into contact with the soft lenses. Use only soft lens care products when placing a GP lens onto a soft lens.
• Scleral lenses are just large GP lenses. Therefore, any approved GP lens care product may be used to clean/store/disinfect scleral lenses. However, the fluid placed into the lens reservoir during lens application should only be isotonic, non-preserved solutions. We use only unit-dose, non-preserved, sterile saline.
• GP contact lenses should be stored dry for long-term storage. Use a daily cleaner and disinfect prior to re-use.
• All lens storage cases should be emptied, rinsed, wiped, and air-dried between uses.
• For a list of approved GP wetting/rewetting drops and their ingredients, see “Approved GP Wetting Drops,” Contact Lens Spectrum January 2011. CLS
|Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service. He is also an advisor to B+L and Alcon as well as a member of the GPLI Advisory Panel. You can reach him at email@example.com.|