contact lens care
Caring for Soft Prosthetic Lenses
BY SUSAN J. GROMACKI, OD, MS, FAAO

Fitting soft prosthetic contact lenses is a rewarding aspect of contact lens practice. But after diligent work on your part (and likely expenditure for your patient), it's important to avoid the potential for color fading.

Color matching to the contralateral iris is the most difficult part of the fitting process. The companies that produce these colors work diligently to help provide the optimal match, incurring much expenditure on their own (especially if the lens is hand painted). As a result, most prosthetic lens makers don't provide exchanges once the doctor dispenses the final lens -- all the more reason to prevent the lens from fading. The lens materials and manufacturing processes differ from company to company. As a result, each has its own recommendations for cleaning lenses. The companies and their recommendations are:

Adventures in Color Technology produces custom-transparent and hand-painted opaque iris contact lenses and black occluders. Its warranty covers color fading for the life of the lens. Recommended (for opaque and black contact lenses): UltraCare, Consept F (AMO); AOSept, AOSept Clear Care, Pure Eyes or MiraSept (CIBA Vision).

Contraindicated: saline containing EDTA, ReNu (Bausch & Lomb), Opti-Free (Alcon).

Alden Optical provides black pupil or iris tints using a non-opaque, front-surface dye. Recommended: any approved solution, heat.

CIBA Vision produces its stock opaque prosthetic lenses (previously a Wesley-Jessen product) using a dot matrix pattern on the front surface of the lens. Recommended: any approved solution, with Clear Care preferred.

Contraindicated: any abrasive daily cleaner, saline containing sorbic acid.

CooperVision produces stock opaque prosthetic contact lenses that have a front-surface dye. Recommended: any H₂O₂ or cold system.

Contraindicated: heat.

Crystal Reflections provides custom transparent and hand-painted opaque iris lenses and black occluders. Recommended (for opaque and black lenses): Pliagel (Alcon) or Lens Plus Daily Cleaner (AMO); AOSept or LenSept disinfectant (CIBA); PuriLens (PuriLens, The LifeStyle Company, Inc.).

Contraindicated: "no rub" multipurpose contact lens solutions, ReNu saline (B&L), UltraCare (AMO), Sensitive Eyes Plus Saline Solution (B&L), B&L Maximum Strength Allergy Drops, Moisture Drops and Artificial Tears (B&L); Miraflow and Quick Care (CIBA Vision); Blairex Lens Lubricant; for high water content lenses, saline containing sorbic acid.

Custom Color Contacts hand paints its own 48.5 percent water HEMA lens, then seals it with a second HEMA layer on top. Recommended: Miraflow (CIBA) daily cleaner, Opti-Free or ReNu disinfectant, SupraClens enzyme (Alcon).

Contraindicated: heat, H₂O₂.

Specialty Tint custom tints transparent colors using a dye bath method. Recommended: Opti-Free (Alcon).

Note: Please contact the companies to learn of any changes in manufacturing processes or lens materials.

Figure 1. Iridodialysis patient before and after application of CooperVision Custom Prosthetic Lens.

Dr. Gromacki is in group practice in Burke, Virginia, and has served as a faculty member at the University of Michigan Department of Ophthalmology and Visual Sciences.