contact lens care
How Private-Label Solutions Affect Your Practice
BY MICHAEL A. WARD, MMSC, FAAO

The contact lens industry continues to enjoy steady growth (about 9 percent last year), largely as a result of technological advances in lens materials and designs along with more comfortable and and convenient lens care products. Unfortunately, a significant number of contact lens patients drop out of lens wear each year because of discomfort that they often perceive as dryness. Many of these 'dry eye' symptoms are in fact the manifestation of care product/lens incompatibilities.

Solutions May Affect Comfort

Lens care product toxicities or care product/lens incompatibilities can result in a compromised epithelial surface. We see this surface breakdown as staining when we remove the contact lens and instill fluorescein. Such surface breakdown (even sub-clinical epithelial disruptions) can cause dry eye-like symptoms, which may lead to dropout. Further, any breakdown in the epithelium's barrier function compromises this most important defense mechanism of the eye, creating portals of entry for microbial invasion.

Manufacturers have formulated new multipurpose solution (MPS) products to work with silicone hydrogel lens materials, which have surface chemistries that differ from older-generation HEMA-based lenses. In addition to having a higher modulus, silicone hydrogel materials have lower water contents but higher amounts of bound water, lower levels of total protein uptake but higher binding of denatured proteins, and a greater affinity for surface lipid uptake.

The latest generation MPS formulas provide better comfort, wetting and lens/solution compatibility. All four major MPS brands are reformulated to work with silicone hydrogel products. Private-label products are typically older-generation versions that were formulated before silicone hydrogels entered the market.

Private-Label Differences

Private-label products accounted for greater than 30 percent of disinfectant ounce sales in the first nine months of 2005 (A.C. Nielsen, September 2005). That percentage is larger than any single branded share.

Private-label solutions aren't really generic. Among pharmaceuticals, a generic drug has the same formulation as the branded product. Private-label MPS contact lens care products may contain different formulations under the same brand name. As a hypothetical example, Big Store brand Dryz in April may be a two-generation-ago, biguanide-preserved product, while the same blue and white bottle of Dryz in November may contain a three-generation-ago, polyquaternium-pre- served product. It's the same product name, box color, size and shape, so patients would reasonably assume that it's the same product. The changing ingredients set the stage for possible solution reactions.

Educate and Recommend

To avoid these complications, ensure that your patients are using your recommended lens care products. New-generation MPS formulas are kinder and gentler to the eye and are made to work with new-generation silicone hydrogel lens materials. When patients resort to private-label solution use, they run the risk of lens/solution incompatibilities. This may lead to dryness symptoms and dropout — both of which are bad for the industry and bad for your practice.

Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service.