contact lens care

A New Method for Cleaning Soft Contact Lenses

BY SUSAN J. GROMACKI, OD, MS, FAAO

We have traditionally instructed patients to rub and rinse their soft contact lenses in the palm of their hand, one lens at a time. Lately, I've been recommending a new cleaning technique for my patients who use a one-bottle hydrogen peroxide system — and they have embraced it with great success.

Why Rubbing is Important

In the wake of the Fusarium and Acanthamoeba keratitis outbreaks, the FDA, CDC and AOA all recommend digitally rubbing soft contact lenses to remove debris and pathogens. In addition, it's well documented that silicone hydrogel materials deposit lipids more readily than do traditional hydrogels. As a result, experts recommend a rub step for silicone hydrogels prior to disinfection with all care systems.

Figure 1. This method allows patients to rub and rinse both lenses at the same time.

However, when using a rub step with one-bottle hydrogen peroxide disinfection systems (Clear Care [CIBA Vision] and One Step [Sauflon Pharmaceuticals]), the potential exists for transferring hydrogen peroxide from the index finger (after rubbing the first lens) into the second eye. The slight stinging sensation can become more pronounced for new wearers, as a prolonged removal process can introduce even more H₂O₂ into the eye.

A Different Rubbing Technique

As a result, I devised the following method for my patients:

1. Thoroughly wash hands with fragrance-free soap.
2. Remove your right contact lens. Place it in Position 1 (Figure 1) in the palm of your opposite hand.
3. Remove your left contact lens. Place it in Position 2.
4. Place three drops of H₂O₂ solution on each lens.
5. Rub the right lens for 10 seconds.
6. Rub the left lens for 10 seconds.
7. Turn the left contact lens over and rub its other side for 10 seconds.
8. Turn the right contact lens over and rub its other side for 10 seconds.
9. Rinse both contact lenses with additional hydrogen peroxide.
10. Place the right lens, then the left, into the appropriately marked R/L domed lens holder.
11. Fill the lens case to the fill line with H₂O₂ solution.
12. Place the lens holder into the lens case. Close the cap tightly and store lenses for at least six hours to disinfect and neutralize.

In its package insert, CIBA recommends a similar method for cleaning GP lenses, but I believe my method is more efficient than rubbing and rinsing each lens individually. Soft lenses, unlike GPs, do stay in place nicely in both palm positions. CIBA's instructions warn that some users may experience a mild, temporary bleaching of the fingers or hands, so it's recommended to wash and rinse hands after rubbing lenses with H₂O₂.

As long as patients perform the removal and cleaning in a consistent order, they should not experience the problem of switching the contact lenses. In addition, this method is applicable for all soft lens care systems. CLS

To obtain references for this article, please visit http://www.clspectrum.com/references.asp and click on document #149.

Dr. Gromacki is a Diplomate in Cornea and Contact Lenses in the American Academy of Optometry. She has a specialty contact lens and post-surgical co-management practice as part of a multi-subspecialty ophthalmology group in Ann Arbor, MI.