Optimizing Practice Success With GP Lenses
BY EDWARD S. BENNETT, OD, MSED, FAAO; ROBERT M. GROHE, OD, FAAO; & ROBERT L. DAVIS, OD, FAAO
In contact lens practice today, GP lenses continue to play an important role in practice success. This month, we address six key practice management issues related to GP lenses.
Initial Surface Wettability
Initial manufacturing-induced wettability problems with GP lenses have decreased greatly in recent years because most laboratories have switched from using pitch polish—which was notorious for staying on the lens surface and causing wettability issues—to using water-soluble polishing compounds that do not result in wettability issues. Plasma treatment will provide optimal GP surface wettability. An overnight soak in an approved GP conditioning solution is important before dispensing.
Instruct both staff (who handle GP lenses) and patients to not allow any cosmetics, creams, lotions, or sprays to come in contact with the eyes and lenses, as this can compromise wettability. For patients receiving their lenses directly from a lab, be aware of the care instructions provided by the shipping laboratory as they may be contrary to your instructions and, if so, instruct the patient accordingly.
Many of today’s more standard designs can be successfully fit without diagnostic lenses, although designs that offer a fitting inventory are a good option.
For patients who need specialty designs, we recommend a standard, intralimbal, and scleral design fitting set as well as a reverse geometry fitting set for some post-surgical patients. A translating bifocal/trifocal fitting set and a corneal reshaping fitting set (depending upon the design) are also often beneficial.
Clean diagnostic lenses immediately after use and disinfect them for a minimum of 10 minutes in an approved hydrogen peroxide system. Store diagnostic lenses dry for long-term storage, then clean and rinse them with an appropriate wetting/conditioning solution before application.
Spare Pair Storage
Advise patients to store their spare pair dry. Ideally, they should clean their lens(es) and perform overnight disinfection before application. This will also help optimize initial surface wettability. When GP lenses are stored in solution, the solution may evaporate and leave a solidified form of crusting in the lens well and may become contaminated. When wet storage is recommended, instruct patients to clean the lenses and change the storage solution every week to minimize contamination.
Numerous resources are available to help you optimize patient success with GP lenses. The best resources are the laboratory consultants, who can guide you through every step of the process, provide diagnostic sets, and tell you what information they need (i.e., photos, topography, etc.) to manufacture custom GP lenses. No GP-related question is a dumb question, and they are eager to help your patients become successful GP wearers.
The GP Lens Institute (www.gpli.info) offers educational pamphlets as well as a CD on care and handling, not to mention many resources on GP lens fitting and problem-solving. A relatively new website, www.contactlenssafety.org, provides 50 common patient questions about contact lenses—most pertaining to care and compliance—with answers provided by experts in the profession. CLS
Dr. Bennett is assistant dean for Student Services and Alumni Relations at the University of Missouri-St. Louis College of Optometry and is executive director of the GP Lens Institute. You can reach him at firstname.lastname@example.org. Dr. Grohe specializes in contact lenses and anterior segment in his suburban Chicago practices and is associated with the Northwestern University School of Medicine. Dr. Davis is a cofounder of EyeVis Eye and Research Institute and practices in Oak Lawn, Ill. He has received research funds from SynergEyes, CooperVision, Alcon, and ZeaVision and has a proprietary interest in SpecialEyes.