Contact Lens Care & Compliance
Effects of Using Generic and Private-Label Care Solutions
By Karen K. Yeung, OD, FAAO and Susan J. Gromacki, OD, MS, FAAO
Approximately 28 percent of all contact lens wearers use generic care solutions (Nielsen, 2011). Most use their practitioner-recommended care solution in their first year after being fit into contact lenses, but this compliance wanes as patients become more experienced with lens wear. Studies show that 25 percent to 31 percent of patients do not use the same lens care solution that was recommended to them one year earlier (Claydon et al, 1997; Miller et al, 2010), with cost as the primary reason for switching brands (Bui et al, 2010). More interestingly, two-thirds of non-compliant patients perceived that they were compliant with their practitioner's care solution recommendation (Miller et al, 2010).
Solutions and Complications
My colleagues and I found that patients using generic/private-label contact lens care solutions have higher rates of lens-related complications. Patients using generic lens care solutions and wearing GP contact lenses had on average 0.96 complications per eye. Those wearing soft contact lenses and using generic solutions had 1.11 complications per eye. This is in contrast to those using Optimum (Lobob Laboratories), which had the lowest complications per eye (0.25 complications) among GP lens care solutions, and those using Opti-Free Replenish (Alcon), which had the lowest complications per eye (0.5 complications) for soft contact lens wearers (Forister et al, 2009).
The higher complication rate may result from patients who are already noncompliant because they may not be using the lens care solution originally prescribed. Though we did not look at solutions specifically, our subsequent study revealed that patients who are less compliant do have higher rates of lens-related complications (Yeung et al, 2010).
Another possible cause for the higher rate of lens-related complications with the use of private-label/generic lens care solutions may be their higher frequency of corneal staining with specific contact lenses (Andrasko and Ryen, 2008). Corneal staining increases with larger uptakes of preservatives and their fast release into the low-osmolarity tears on the eye (Rosenthal et al, 2006).
Solution Choice Does Matter
The latest-generation lens care solutions are made specifically for the newest silicone hydrogel contact lenses by improving comfort and lens compatibility while increasing disinfection. Bausch + Lomb's Biotrue was formulated to improve compatibility with the eyes by matching the pH of natural tears. Abbott Medical Optics recently launched its RevitaLens Ocutec, a multipurpose disinfecting solution with emphasis on a high disinfection rate similar to that of hydrogen peroxide-based lens care solutions. Alcon just launched its Opti-Free PureMoist with poly-oxyethylene-poly-oxy-butylene, a new wetting agent designed to improve the wettability properties for prolonged comfort of silicone hydrogel lenses.
Contact lens care solutions are just as important to the success of lens wear as are the lenses that we prescribe. In addition to the brand and parameters of lenses, we should also include the brand of lens care solution on contact lens prescriptions. Through patient education, we can improve patient compliance and, ultimately, patient ocular health. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #189.
Dr. Yeung is a director of Optometry at the University of California, Los Angeles. She is a Diplomate in Cornea and Contact Lenses of the American Academy of Optometry with expertise in contact lenses and keratoconus. She is highly involved in clinical research, having published dozens of peer-reviewed articles, and she has lectured nationally in the areas of silicone contact lenses and keratoconus. Dr. Gromacki is a Diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry. She is chief research optometrist at Keller Community Hospital in West Point, N.Y.