contact lens care

Options for Discontinued Lens Care Products

BY MICHAEL A. WARD, MMSC, FAAO

I've recently received numerous inquiries regarding the availability of certain lens care products, specifically a GP multipurpose product and proteolytic enzyme tablets.

Discontinued GP Solution

Unique-pH (Alcon Labs) GP contact lens solution is no longer available. Alcon discontinued production of Unique-pH in July 2007. A company spokesperson explained that it was a business decision due to declining sales.

It's always disturbing to see contact lens products leave the market, because you know that it was the perfect product for a certain segment of the lens-wearing population. In this particular case, it was also a primary solution used in wet shipping plasmatreated GP lenses from the laboratories.

I contacted several major GP labs — in a very non-scientific way — and discovered that Boston Simplus Multi-Action Solution (Bausch & Lomb) is now the main product that lens laboratories in the United States use for shipping GP lenses in the wet state to practitioners.

B&L initially introduced Boston Simplus in 2003 as a multipurpose GP product. Simplus is particularly known as an effective remover of tear deposits including lipids, proteins and environmental components. It has essentially the same preservation system as the Boston Advance Comfort Formula (B&L). Both are preserved with chlorhexidine gluconate (0.003%) and polyaminopropyl biguanide (0.0005%). Edetate disodium (0.05%) is also listed in the Boston Advance formula. This combination of chlorhexidine and polyaminopropyl biguanide is extremely effective against a wide range of microbes.

Discontinued Enzymatic Tablets

A related topic of inquiry involves the availability of enzymatic cleaners, specifically in tablet form. Many GP lens wearers require weekly enzymatic cleaners, especially our atopic and keratoconus patients.

Three chemical proteolytic enzymes have historically been formulated for contact lens use: papain (from papaya), pancreatin (from pork proteases) and subtilisin (endopeptidase isolated from Bacillus subtilis). Each is safe for all lens materials. These protein removers were originally available in tablet form to be mixed with saline and/or hydrogen peroxide solutions. Companies have manufactured more recent formulations in liquid form to be added to lens storage solutions for added convenience.

Enzymatic tablets are indeed hard to find. One product (ProFree GP, Advanced Medical Optics/Exaeris) that was due to relaunch in Q4 2007 remains elusive. I found the following products available on the Internet, but less available in retail outlets:

● Enzymes in tablet form — Ultrazyme (AMO, subtilisin A), Unizyme Enzymatic Cleaner (CIBA Vision, subtilisin A), ProFree GP (papain).

● Enzymes in liquid form — Boston One Step Liquid Enzymatic Cleaner (B&L, subtilisin), Opti-Free SupraClens Daily Protein Remover (Alcon, pancreatin).

Boston's liquid enzyme is restricted for GP use only; patients may use the other enzymes on either soft or GP lenses, but must follow directions for each.

If All Else Fails, Look Online

Because soft disposable contact lenses constitute the majority of today's market, enzymatic cleaners are less needed and increasingly less available. However, certain patients still require them to maintain comfortable lens wear. Products are readily available on the Internet, but less so at retail outlets. Make sure to advise patients to check the expiration date of any hard-to-find products they order online. CLS

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