contact lens care and compliance

A Roundup of the Latest Contact Lens Care News

BY SUSAN J. GROMACKI, OD, MS, FAAO

Although it seems to be a slow time in the contact lens care industry with no recent new products or recalls, there is actually a lot of new information. Here are some recent developments.

• Abbott Laboratories recently purchased Advanced Medical Optics. So far there have been no changes for practitioners — even the acronym AMO will remain intact. We hope that Abbott continues the strong support of eye-care education and professional organizations.

• Despite the recent economic crisis, Novartis (parent of CIBA Vision) has reiterated its commitment to purchasing 77 percent of Nestle AG's stake in Alcon. It has already bought the first 25 percent and plans to complete the purchase between January 2010 and July 2011.

• CIBA has discontinued the no-rub instructions for Aquify. Directions now include a rub, rinse, and a five-minute to overnight soak.

• Four more solutions are now recommended for use with the SynergEyes (SynergEyes, Inc.) lens family: ReNu MultiPlus (Bausch & Lomb), Complete Easy Rub and Oxysept UltraCare (both AMO), and Aquify.

• A new B&L multipurpose solution is in the pipeline — four patents were approved in December 2008. Alcon and Vistakon are also reportedly developing new lens care products.

• There are also some "outside of the box" ideas for lens disinfection currently in developmental stages. Included among them is the utilization of dissolved ozone to disinfect lenses (QuickPure). Although commercialization of this technology is several years away, Alab LLC anticipates a 6 log kill of Acanthamoeba trophozoites and cysts in approximately three-to-five minutes.

FDA Meeting Aftermath

With the Microbiological Testing for Contact Lens Care Products workshop complete (see my April 2009 column), the U.S. Food and Drug Administration is working on the details of adding Acanthamoeba as a challenge organism.

After the meeting, The American Optometric Association and the American Academy of Optometry said that they intend to support the FDA and the contact lens industry in efforts to:

1. Enhance standards on microbial efficacy of care regimens without adversely impacting toxicity on the eye of those regimens.

2. Utilize Acanthamoeba castellanii cysts and trophozoites until more species and strains can be added or substituted based on evidence as it becomes available in the future.

3. Where feasible, make testing conditions closer to that occurring in "real world" situations (e.g., with lenses in the storage compartment and/or with use of "organic soil"). Other potential ways of screening care regimens could include biofilms, encystment rates, and aggregation of cells. Also, make testing more representative of "worst case" scenarios, taking into consideration known areas of noncompliance such as topping off or evaporation from storage cases.

4. In labeling, encourage patients to rub and rinse. However, some allowance should be made for those care regimens that meet the new antimicrobial guidelines without rubbing.

5. Develop labeling to indicate under what circumstances, if any, can tap water be brought into contact with storage cases, and otherwise promote proper storage case hygiene.

6. The groups recommended the development of an ongoing surveillance program to provide data useful in detecting trends in Acanthamoeba keratitis disease patterns, more rapidly identifying Acanthamoeba keratitis outbreaks, and contributory factors. CLS

Dr. Gromacki is a Diplomate in the Cornea and Contact Lens section of the American Academy of Optometry. She lives in West Point, New York.