Contact Lens Care & Compliance
Compliance With Daily Disposable Contact Lenses
BY SUSAN J. GROMACKI, OD, MS, FAAO
Daily disposable contact lenses represent a growing segment of the soft lens market in the United States, where they now comprise 17 percent of all fits and refits. Their usage is even greater overseas, where they represent roughly 35 percent of contact lens sales in Europe and 55 percent in Asia (Nichols, 2012).
These statistics shouldn’t be surprising, since daily disposables offer convenience, particularly for part-time wearers and people who travel and they provide new-lens comfort every day. In comparison with frequent replacement (2 weeks or more) daily disposable lens wear has been shown to minimize lens deposition and tarsal abnormalities and provide better subjective vision and overall satisfaction (Solomon et al 1996).
What’s more, daily disposable lens wear eliminates the need for care solutions and with them, the possibility of preservative uptake and release from lens care products. It also eliminates the need for a lens storage case, a potential source for contamination. Perhaps the most important benefit of daily disposable contact lenses is the elimination of concern regarding compliance with lens care required with re-usable lenses.
Many practitioners have difficulty monitoring how closely their patients follow their lens wear and replacement instructions. When questioned, many patients, especially part-time lens wearers, have difficulty remembering how frequently they replace their lenses.
A peer-reviewed paper by Dumbleton et al (2010) presents substantive data on compliance rates with soft contact lens replacement frequency. The researchers analyzed responses from 2,232 patients wearing silicone hydrogel and daily disposable lenses in North America. They found that those who wear daily disposable contact lenses reported the highest rates of compliance. In the United States, patients wearing daily disposables said they “always” replace their lenses as recommended by the manufacturer 82 percent of the time, as compared with 34 percent for 1-month lenses and 25 percent for 2-week lenses. When factoring out patients whose practitioners instructed them to replace the lenses less frequently than the manufacturer recommends, the compliance rates for lens replacement were 88 percent for daily disposables, 73 percent for monthly lenses and 48 percent for biweekly lenses. What do these numbers mean for our patients? Good compliance means cleaner lenses, which ultimately should help reduce the incidence of many contact lens-related complications. On the other hand, there is more to compliance than just replacement. For daily disposable lenses, overnight wear and re-use without disinfection are perhaps of the greatest concern.
Chalmers and colleagues (2010) reviewed the records of 1,276 soft lens wearers, representing 4,120 office visits and found no significant correlation between daily disposable lenses and inflammatory or infectious events. More recently, in a carefully controlled evaluation of 166 symptomatic soft contact lens related corneal infiltrative events, use of daily disposable lenses was found to be protective (over 12x) in comparison to reusable lenses (Chalmers 2012).
Although compliance alone will never completely safeguard patients from the potential of complications, it is clearly a step in the right direction. Daily disposable lens wear provides the practitioner and patient with the most compliant-friendly way to wear contact lenses. CLS
For references, please visit www.clspectrum.com/references.asp and click on document SE2013.
Dr. Gromacki is a diplomate in the American Academy of Optometry's Section on Cornea, Contact Lenses and Refractive Technologies and practices in Chevy Chase, Md.