Contact Lens Care & Compliance
Soft Lens Daily Cleaners
BY SUSAN J. GROMACKI, OD, MS, FAAO
I know what you’re thinking. A column about hydrogel contact lens daily cleaners… really? Although disposable lenses and multipurpose solutions (MPSs) have dominated our soft contact lens practices of late, and rightly so, there is still the need for daily cleaners.
Who Needs Daily Cleaners?
There are three primary groups of patients who benefit from the use of daily cleaners.
Miraflow Enthusiasts Those of us “experienced” enough to remember the AOSept system from Ciba Vision remember how dedicated our patients were to its daily cleaner, Miraflow, and how dismayed many of them were when Ciba discontinued the solution in 2010. Fortunately, there are other isopropyl alcohol-based daily cleaners for these patients (Table 1).
Another practical use for alcohol-based cleaners is in-office. These solutions have the ability to remove light deposition and eliminate small areas of nonwetting on GP lenses, thus providing an efficient alternative to lens polishing.
Alcohol-Based Daily Cleaners
• Sereine Extra Strength Daily Cleaner (Optikem International)
• Walgreens Extra Strength Daily Cleaner (Optikem International)
• Lens Fresh (Orion Vision Group, formerly Marietta)
• Sof/Pro2 Extra Strength Daily Cleaner (Lobob)
Heavy Depositors We all have patients, including those who wear disposable contact lenses, who deposit their lenses more frequently compared to others. They would benefit from the use of a daily cleaner. The deposition can result from inferior tear quality and quantity.
It also can vary by lens material. Hydroxyethyl methacrylate (HEMA) lenses are generally considered to deposit more proteins (from the tears) as compared to silicone hydrogel lenses. Some silicone hydrogels have demonstrated a greater propensity to deposit tear lipids (Subbaraman et al, 2006; Suwala et al, 2007; Santos et al, 2007; Cheung et al, 2007; and others).
Lastly, the environment (e.g., more pollution) can also play a role in how much lenses deposit.
Other Daily Cleaners for Soft Contact Lenses*
• Opti-Free Daily Cleaner (Alcon)
• Opti-Clean II (Alcon)
• Sensitive Eyes Daily Cleaner (Bausch + Lomb)
• Sof/Pro-Clean (Lobob)
* Tyler's Quarterly
Specialty Soft Contact Lens Wearers There are many excellent lens designs, specifically for toric or multifocal patients, that are available only in a quarterly replacement modality. These patients need something a little stronger than an MPS to eliminate buildup or debris. The options include using a separate daily cleaner (Tables 1 and 2) or a regular enzymatic treatment.
Lastly, several excellent custom-designed or specialty soft lenses require a digital rubbing step with a separate daily cleaner as part of their regimen. Two examples are the new lenses for keratoconus—NovaKone (Alden Optical) and KeraSoft IC (Bausch + Lomb). In addition, SynergEyes also requires a separate rubbing step for its new hybrid contact lens, UltraHealth.
Of course, success with a daily cleaner (elimination of microbes and deposition leading to greater comfort, health, and visual acuity) is predicated on its complete rinsing from a contact lens surface. This can be performed with either saline or MPS; water is contraindicated for soft contact lenses. To complete the process, lenses must be disinfected with either an MPS or a hydrogen peroxide-based system. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #214.
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.