CONTACT LENS MANAGEMENT
No-Rub's the Word
No-rub solutions and customized comfort can help boost your practice.
By Mary Jo Stiegemeier, O.D., F.A.A.O.

The trend in solution sales over the past 10 years has been toward simpler products -- increased multipurpose solutions and decreased hydrogen peroxide. Multipurpose solutions now represent 80% of the chemical disinfectant sales in the U.S. market.

Non-compliance the norm

Simpler products are important to contact lens wearers. Through telephone surveys and consumer focus groups, we know that these patients are increasingly non-compliant with their care regimens.

Many eyecare practitioners feel that one-third of their patients follow advice as prescribed, one-third follow it in a half-hearted only way and one-third don't bother to follow it at all.

And as we know, the more complex a regimen, the less likely the patient will follow it. What do we have help remedy this dangerous situation? Products that make care easier and serve more than one purpose.

Rubbing contact lenses to clean them has long been a part of every care regimen, but patients find this step inconvenient and often omit it. Consumer focus groups show that 50% of all wearers seldom, or never, rub their lenses.

A masked telephone survey of 200 O.D.s who fit at least 25 patients per month revealed that the idea of a no-rub product was attractive to 65% of those practitioners. In addition, 70% of the doctors indicated that the no-rub product would give them a safety net to compensate for patient non-compliance.

Addressing needs

Manufacturers have responded to this data.

• Alcon's Opti-Free Express Multi-purpose Disinfecting Solution recently received FDA approval for stand-alone disinfection without rubbing for all soft lenses. Safely eliminating the rubbing step requires a significantly enhanced disinfecting solution with greater cleaning, protein removal and antimicrobial capability.
  This product achieved the same level of disinfection efficacy without a rub as conventional products achieved with a rub. It also clinically demonstrated the ability to keep contact lenses clean.
• Bausch & Lomb's ReNu MultiPlus Multi-Purpose Solution has also joined the no-rub ranks. This multi-purpose disinfecting solution for soft contact lenses exceeded the minimum FDA/ISO "stand alone"disinfection efficacy criteria. The company notes that while excellent disinfection is essential, other purposes such as cleaning protein, lipids and environmental debris plus rewetting are also key to successful contact lens wear.
• Allergan also recently announced that clinical studies show that its Complete Brand Multi-purpose Solution conditions lenses in addition to cleaning (without rubbing) and disinfecting them. It uses a unique time-released formula.
• FDA approval is pending for CIBA Vision's AOSept to become a one-bottle solution with a no-rub indication. The company hopes to receive approval by summer of 2001.

Customizing effects

A few new solutions for rigid gas permeable (RGP) lenses have changed preservatives -- Optimum by Lobob Laboratories is one example. The company used to use benzaldehyde, which could irritate the eye, but now it uses 4% purified benzyl alcohol, which has no interaction with lens material and doesn't cause irritation.

Other solutions have enhanced lipid removal (Allergan's Claris System, distributed by Menicon, for instance) and are improving the comfort and wearability of RGP contact lenses.

Another new product that was just introduced for RGP lenses is Unique pH Multi-Purpose Solution from Alcon. It contains a proprietary ingredient that adjusts the solution characteristics as a function of pH. The product changes to a thicker solution based on the eyes' tear pH to provide"customized" lens wearing comfort for the patient.

Tear products and lens lubricants are improving, too. There's even a lens lubricant (Alcon's Clerz Plus Lens Drops) that can prevent protein buildup on the lens surface while the patient is wearing the lenses.

No excuses

With products like these new solutions, it's possible to achieve improved patient compliance, resulting in cleaner lenses, improved comfort and, ultimately, more satisfied contact lens patients who keep coming back.

Dr. Stiegemeier is in practice in Beachwood, Ohio.