As practitioners, we must be aware that our contact lens brand and modality choice, as well as the solution combination, are vital to patient comfort. Patient discomfort (burning, stinging) can directly correlate with staining of the cornea. Since today’s practitioners are fitting dailies at increasing rates, the battle between market contact lens solutions has dwindled somewhat.
The following list represents the opinions of the author and not Eyes On Eyecare®. For more information on this topic, please check out our other content on contact lenses!
Since 2002, Dr. Andrasko’s staining grid has been the standard for assessing which contact lens solution to prescribe to a patient based on their contact lens brand. The staining grid looks at market solutions vs. corneal staining with various lens brands. Dr. Andrasko looked at the biocompatibility of more than 100 lens and solutions combinations.
The main outcome of the staining grid studies was that multi-purpose solutions containing polyquad and aldox consistently showed less staining on corneas no matter the brand worn. Hydrogen Peroxide solution results were similar. Polyhexamethylene biguanide (PHMB)-based solutions showed less consistency, and more staining and discomfort was noticed by practitioners and patients respectively.
Overnight, as the lens is soaked in the solution, the lens matrix absorbs the solution’s preservatives. When the patient wears the lens, the preservatives are released into the tear film, and if high enough may cause toxicity. These cells appear hyperfluorescent underneath the slit lamp and indicate that the living membranes of the epithelium cells are being affected.
While it is helpful to use the historic staining grid when prescribing, find it’s also vital to consider the individual patient’s needs and lifestyle when making a final recommendation.
Best contact solution for monthly lens wearers
CLEAR CARE actively cleans and removes debris from lenses without the patient’s participation. This is extremely important because it prevents lens discomfort and dryness and, by extension, results in less contact lens wearer dropouts. We all know as a patient wears a lens, they will start to feel the dryness at weeks 3-4 due to debris on the lens, and if we can keep the lens clean, we will impact the dry eye experienced by the patient.
What’s in it?
- High-grade H202 for superior cleaning and disinfecting (3%)
- Propriety Pluronic 17R4- surfactant that cleans & removes protein deposits
- Basket-mount platinum disc- optimized neutralization
- CLEAR CARE® PLUS is the only peroxide solution that has HydraGlyde® Moisture Matrix, which is a special wetting agent designed to recondition soft lenses and surround them with long-lasting moisture.
Best contact solution for eye sensitivity or preservative allergies
Personally, CLEAR CARE is my only choice for patients with previous sensitivities to lens solutions or to certain preservatives. The end result after neutralization is saline which most patients can tolerate.4
What makes it unique?
- CLEAR CARE AND CLEAR CARE PLUS Solutions do not contain added preservatives
- CLEAR CARE and CLEAR CARE PLUS result in a gentle saline solution that is similar to natural tears