Contact Lens Care & Compliance
Care Regimens for Hybrid Contact Lenses
BY SUSAN J. GROMACKI, OD, MS, FAAO
By definition, hybrid lenses are comprised of a GP center and a soft (hydrophilic) skirt. They have an advantage in that the rigid portion provides excellent optics, while the soft portion enhances comfort and lens retention. As more is learned about hybrid lenses, there have been modifications in their recommended care.
Current hybrid lenses are approved for six-month replacement. The protocol for all current hybrid lenses includes a digital rubbing step—in the palm of the hand—of both the front and the back of the lens. This must be performed with a soft lens daily cleaner at the end of the lens-wearing day. Then, the daily cleaner must be rinsed off and the lenses disinfected. Patients who have protein deposits may add an enzymatic cleaner to the care regimen. GP daily cleaners or disinfecting/conditioning solutions are contraindicated due to their incompatibility with soft contact lens materials.
SynergEyes’ Duette (HD and Progressive) and UltraHealth lenses contain a high-Dk (130) GP center and a silicone hydrogel skirt. For these new materials, SynergEyes emphasizes that the daily cleaner be rinsed off with non-preserved saline, such as Unisol 4 (Alcon) or PuriLens Plus (PuriLens Inc.). For disinfection, SynergEyes recommends Clear Care (Alcon) or Biotrue (Bausch + Lomb [B+L]).
Renu Fresh (B+L), Opti-Free Express (Alcon), and Complete Easy Rub (Abbott Medical Optics) are also approved by SynergEyes for these lenses. It is important to note that, although the solution is FDA-approved, SynergEyes discovered an incompatibility with Opti-Free Replenish (Alcon) and no longer recommends it for its lenses (Kaseburg, 2007; Achenbach, 2015).
In addition, the company’s website states, “In some patients, the tear chemistry may react with the peroxide to cause a permanent white ring at the junction of the rigid center and soft skirt. This ring does not affect vision or comfort,” (SynergEyes, 2015).
One item unique to UltraHealth is its vaulted design; as a result, prior to application, it needs to be filled with nonpreserved saline or artificial tears, then applied with the head down.
SynergEyes KC and ClearKone (GP Dk=100, HEMA skirt) are designed for diseased (keratoconic) eyes. As such, the manufacturer recommends that nonpreserved solutions be used for both rinsing (e.g., Unisol saline) and disinfection (e.g., Clear Care or Oxysept Ultracare, Abbott Medical Optics).
Recently, SynergEyes stated it will be “performing testing” soon, with potential new solutions added to the list in the next few months (Achenbach, 2015).
In-Office Cleaning and Disinfection
All in-office trial lenses must be cleaned and disinfected prior to reuse. After using a daily cleaner, rinse with a multipurpose solution. Disinfection may be performed with either a hydrogen peroxide or multipurpose solution. If the former, the lens should be transferred to a multipurpose solution for storage. CLS
For references, please visit www.clspectrum.com/references and click on document #232.
Dr. Gromacki is a diplomate in the American Academy of Optometry’s Section on Cornea, Contact Lenses and Refractive Technologies. She practices in Chevy Chase, Md.