contact lens care
Cleaning and Disinfecting Hybrid Contact Lenses
BY SUSAN J. GROMACKI, OD, MS, FAAO
Hybrid contact lenses are unique in that they consist of a rigid GP center and a soft, hydrophilic skirt. Over the years, these lenses have proven useful for keratoconus. The rigid portion of the lens provides good optics, while the soft periphery enhances comfort and prevents lens dislocation.
With the introduction of the SynergEyes (SynergEyes, Inc.) family of lenses in 2005, hybrid lenses have become a popular option not just for keratoconus, but for patients of all types.
GP disinfecting/conditioning solutions are contraindicated for hybrid lenses due to their incompatibility with soft lens materials. As a result, it's important to prescribe a system approved for both soft and rigid lens materials, such as Clear Care (CIBA Vision).
Note that Clear Care has "no rub" clearance for only soft materials. Its GP instructions state, "Apply 2-4 drops of Clear Care and rub…Return the lenses to the appropriate holder … thoroughly rinse for 5 seconds through the basket." The lenses must then soak for six hours to achieve full disinfection and neutralization.
Hybrid Lens Care
Let's look at two hybrid lenses and their recommended lens care.
Softperm (CIBA Vision) This lens was launched in 1989 as an improved version of the Saturn II lens. Its rigid center has a diameter of 8.0mm, optic zone of 7.0mm, Dk of 14 and an average center thickness of 0.08mm (–3.00D lens). The soft skirt has a water content of 25 percent and a mean thickness of 0.08mm. The overall diameter is 14.3mm. The lens is available in base curves from 6.5mm to 8.1mm and in powers from +6.00D to –16.00D. It's long been a staple for keratoconus patients who desire better comfort and/or lens retention. Yearly replacement is recommended.
The recommended care system is Clear Care.
SynergEyes (SynergEyes, Inc.) This lens is currently available in A (ametropia) and KC (keratoconus) designs. The SynergEyes PS (post-surgical) and Multifocal are currently available in some regions of the country. The rigid portion of the lens has an 8.4mm diameter, 7.8mm optic zone and a Dk of 100. The average center thickness for a –3.00D lens is 0.15mm. The soft periphery has a water content of 27 percent and a mean thickness of 0.16mm. The A lens offers base curves from 7.1mm to 8.0mm, two skirt radii and powers from +20.00D to –20.00D. The KC lens comes in BC 5.7mm to 7.1mm, three skirt radii and powers from plano to –20.00D. The diameter is 14.5mm, and recommended lens replacement is every six months.
The recommended care systems are Clear Care and Opti-Free Express (Alcon).
SynergEyes also emphasizes digitally rubbing then thoroughly rinsing lenses with Opti-Free Express before disinfection. The company states that studies have shown a potential incompatibility with Opti-Free Replenish (Alcon). Thus, it's no longer a recommended care system for SynergEyes lenses.
A Step Ahead
Beginning in September, SynergEyes began providing a complimentary Patient Care Kit for every purchase of a first-fit annual supply of lenses. This includes a 4-ounce bottle of Opti-Free Express, contact lens case, application and removal DVD, instructions for contact lens care and removal and product brochure. This is a welcome step to ensure good compliance with lens care. CLS
To obtain references for this article, please visit http://www.clspectrum.com/references.asp and click on document #145.
Dr. Gromacki is a Diplomate in Cornea and Contact Lenses in the American Academy of Optometry. She has a specialty contact lens and post-surgical co-management practice as part of a multi-subspecialty ophthalmology group in Ann Arbor, MI.