Thursday, June 28, 2007

contact lens solution options

Contact lens care

Brands:
Alcon
- Opti-Free Express: multi-purpose, 6 hours, POLYQUAD (polyquaternium-1) .001%
- Opti-Free Replenish: multi-purpose, 6 hours, POLYQUAD (polyquaternium-1) .001%, plus propylene glycol!

Allergan
- Refresh Contacts: lens rewetting drops and eye drops

CIBA Vision
- AQuify: multi-purpose, polyhexanide 0.0001%, 5 minutes in a special silver-infused case
- Clear Care: peroxide, 1-step in a special case
- Aosept: peroxide, special cup and disc, use with daily cleaner as well
- MiraFlow® Extra-Strength Daily Cleaner: alcohol to dissolve makeup
in South Africa
- Aosept
- SOLO-care Soft: 10 minute soak, polyhexanide 0.001 mg
- Miraflow

Bausch & Lomb
- ReNu: multi-purpose, Dymed® (polyaminopropyl biguanide) 0.00005%
- ReNu MultiPlus: multi-purpose, DYMED ® (polyaminopropyl biguanide) 0.0001%, website has studies about other micro-organisms but not acanthamoeba

AMO
- COMPLETE Moisture PLUS: propylene glycol as a moisturizer!
- UltraCare Disinfecting Solution/Neutralizer: peroxide with tablets and special cup

Thoughts:
- AQuify looks good. Unfortunately, according to one study, the polyhexanide has no anti-acanthamoebic activity below .0005%.
- ReNu's active ingredient (polyaminopropyl biguanide) as well as Opti-Free's (polyquaternium-1) were cited in a study as completely ineffective against acanthamoeba trophozoites and cysts.
- That really only seems to leave the peroxide formulas for cleaning in the US.
- I wish the Oxysept 1 was available in the US as it was tested in South Africa as eliminating acanthamoeba cysts.
- One-step peroxide disinfection systems aren't as effective as they should be against acanthamoeba. "The possible exception was found with use of the AOSept 1-Step system" says one study, though they couldn't figure out why.
- There is a full listing of contact lens care found here.
- OK, now I'm looking at the PuriLens system. Disinfection with UV light? Cool! One study at UofC Berkeley in 1993 indicated that the UV method of contact lens disinfection was effective, tested on 3 common bacteria. A study of the PuriLens system in particular was conducted in 2000 and found superior for disinfection capability. Yet I've never heard it from an eye doctor. Why? Maybe because a recent study from 2004 found that, it too, couldn't handle acanthamoeba. Hmmm.
- "Neutralized AOSept, SOLO-Care Soft, and COMPLETE Comfort Plus were noncytotoxic by all four tests. ReNu MultiPlus and ReNu MPS inhibited the growth of cells after exposure. OPTI-FREE Express (with ALDOX) may have a higher potential for ocular irritation correlating to severe cytotoxicity in vitro." [from a 2002 study]. Cytotoxic, as in damaging to living cells. Yikes.
- "ReNu MultiPlus (Bausch & Lomb, Rochester, NY), AOSEPT (CIBA Vision Corporation, Duluth, GA), and Opti-Free Express with Aldox (Alcon Laboratories, Ft. Worth, TX) were the only lens care products that met the stand-alone criteria for all required microorganisms within their minimum recommended disinfection time." [from a 2001 study]. Given the above information, that leaves only AOSept.
- "Overall, patients using AOSept showed less corneal staining and inflammatory response than patients using ReNu and Opti-Free." [from a 1996 study]. Again, a clear winner.
- "HCE–T cells are significantly more viable when grown on HiDk SiHy contact lenses cycled in Clear Care® or Aquify MPS compared to HiDk SiHy contact lenses cycled in OPTI–FREE Express with Aldox." [from a 2005 study]. That's corneal cells, living better on lenses cleaned with Clear Care, which is (if I understand correctly) the new AOSept.

So, Clear Care, which I've been using for the last year or so anyway, here in the US and I can go to AOSept when we move to southern Africa. Case closed.

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