Contact Lens Care & Compliance

Who Needs Soft Contact Lens Daily Cleaners?

BY SUSAN J. GROMACKI, OD, MS, FAAO

Daily disposable lenses now comprise 23% of the U.S. soft contact lens market (Nichols, 2015), and for good reason. However, many of the 77% of patients utilizing the other modalities could benefit from a daily cleaner.

The purpose of a daily cleaner is to remove deposits and debris, including microorganisms and cosmetics. It also prepares the lens surface for disinfection and conditioning (Gromacki and Ward, 2013). After the cleaner is thoroughly rinsed off with saline or a multipurpose solution (MPS), the lens can be disinfected with either MPS or a hydrogen peroxide-based system. The result is a cleaner lens with enhanced comfort, health, and visual acuity.

Which Patients Benefit Most from Daily Cleaners?

Heavy Depositors Dry eye can be caused by contact lens wear; it can also complicate lens wear. When the eye has a thin tear film, any impediment to smooth tear flow will cause tear breakup and, as a result, discomfort. A primary example of this is contact lens deposition (Gromacki, 2012). There is a similar parallel with giant papillary conjunctivitis. Lens deposition can irritate the upper tarsal plate and elicit a hypersensitivity reaction, which can cause a proliferation of the papillae as well as hyperemia. These patients require a clean contact lens.

Also, some patients, due to age, environmental pollutants, general health, and/or tear chemistry, simply deposit more on their contact lenses compared to others. A no-rub MPS is often inadequate for removing the debris and deposition on their lenses.

Hybrid Lens Wearers As I wrote in my March 2015 column, GP care solutions are contraindicated for hybrid lenses because of the hydrophilic skirt. In addition, the manufacturer recommends a digital rubbing step with all of its lenses. As a result, soft lens daily cleaners should be prescribed for patients wearing this modality.

Specialty Soft Lens Wearers The Contact Lens Spectrum Reader Profile survey (Nichols, 2015) indicated that 45% of practitioners consider custom soft lenses to have the greatest growth potential among specialty lens options in 2015. And, if the record attendance at this year’s Global Specialty Lens Symposium is any indication, more practitioners are becoming interested in fitting specialty lenses.

Each lens brand and type is different, but most require quarterly replacement. In addition, many of the patients who require these custom lenses have conditions for which a clean lens is paramount for both vision and comfort. Some specialty soft lenses specifically require a digital rubbing step after each lens wear.

Alcohol-Based Cleaners

Although fewer soft lens daily cleaners are available today as compared with two decades ago, there are still plenty of options that can be readily obtained at most pharmacies or online. Table 1 shows a list of currently available soft lens daily cleaners.

Several of these are isopropyl alcohol-based daily cleaners that do an excellent job of removing lipids and mucin (Ghormley, 1986; Brennan and Coles, 2000). Alcohol-based cleaners can also be used in-office. They can remove light deposition and eliminate small areas of nonwetting in GP contact lenses, thus providing an efficient alternative to lens polishing.

It’s Best to Check

As always, please consult each contact lens manufacturer for specific recommendations regarding care of its products. CLS

For references, please visit www.clspectrum.com/references and click on document #234.

Dr. Gromacki is a diplomate in the American Academy of Optometry’s Section on Cornea, Contact Lenses and Refractive Technologies and practices in Chevy Chase, Md.