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Contact Lens Care Solutions
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Contact Lens Care Solutions
Ngaire Franklin takes a closer look at the contact lens care market, covering sensitivity,
toxicity and effectively of current and past care regimens.
One of the great challenges of contact lens
practice is ensuring that lenses placed on the human eye
will not be a source of contamination or infection or cause
inflammation.
The perceived simple solution to this problem is probably
to use daily replacement lenses whenever possible.
Factors which limit the use of daily lenses are range of
prescriptions available, although manufacturers are
increasing these ranges all the time so that now high
prescriptions and many astigmats can benefit from this
mode of wear. Cost may be a factor if the patient wishes
to wear lenses every day or very frequently. Some
patients who need to wear lenses for long hours or even to
sleep in may need lenses with increased oxygen
permeability. Until recently, daily disposable lenses have
been widely available in conventional hydrogel materials.
Johnson & Johnson now introduced Acuvue TruEye™,
which are a silicone hydrogel daily lens (Figure 1). These
lenses were released to all UK based practitioners in the
autumn of 2008. Johnson & Johnson have launched these
in the UK in advance of making them available to the rest
of the world in part because of the very high percentage
of daily wear lens wearers in Britain (approximately 30%).
It will be interesting to see how soon the other companies
introduce a similar product on to the market.
solutions. Patients who wish to wear lenses on an
irregular basis have the reassurance that if they are using
daily lenses then the lens comes from an uncontaminated
source provided that they have been properly educated in
hand washing procedures. Daily lenses still remain a very
convenient mode of wear for many people.
When considering cleaning systems for contact lenses
three main lens types need to be considered, rigid lenses
almost exclusively now made from gas permeable
materials, hydrogel materials and silicon hydrogel
materials.
The practitioner will want to know that any cleaning
system will effectively reduce the level of contamination
on a lens after wear to the point where the lens will not
present any hazard to the eye when reinserted. They will
also need to know that the regime will be simple enough
for patients to actually bother cleaning lenses at all. The
practitioner will also reasonably expect to derive some
income from the sale of contact lens cleaning products.
From the patients perspective the system needs to be
effective, simple to use, and affordable.
Research commissioned by Bausch & Lomb1 into patient’s
wearing habits “demonstrate that 98 % of all contact lens
wearers are not fully compliant when it comes to
executing the correct care regime at insertion and
removal of contact lenses”. This is despite the fact that
“93 % of contact lens wearers believe that not following
the recommended lens care regime does increase the risk
of contracting eye infection”1
This means that from the contact lens practitioner’s point
of view that there is a huge opportunity for improvement
and something of a challenge too.
In taking up this challenge the practitioner needs to
consider what is actually achieved “by cleaning” using
currently available care systems.
Figure 1 1day Acuvue TruEye™. A silicone hydrogel daily disposable lens,
introduced to the UK market, in autumn 2008.
It is important to differentiate between sterilization,
disinfection and cleaning:
The only cloud on this horizon is that increasingly research
is showing that the incidence of microbial keratitis (MK)
seems to remain at a similar figure for all modalities of
wear. Obvious sources of contamination of daily lenses
would include poor hand hygiene and reuse of lenses
particularly if cleaning of the lenses is not carried out
between wearing them. Daily lenses would still seem to
be a first choice for anyone who is sensitive to cleaning
Sterilization
Sterilization will eliminate all living microorganisms,
including acanthamoeba cysts and bacterial spores. This is
achieved during the manufacture of lenses by the
application of heat in an autoclave so that temperature
and pressure are elevated, typically 115-118oC for 30
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minutes (Figure 2). Lenses when they arrive from the
manufacturer will be sterile. Once the packaging has
been opened the lenses will not be sterile.
Care regimes used by
sterilization of lenses.
patients
will
not
achieve
Disinfection
Disinfection depending on the antimicrobial ingredients
used will eliminate a range of microorganisms however
bacterial spores and acanthamoeba cysts may survive. If
lenses are not disinfected then microbial keratitis (MK) is
more likely to occur. Brennan and Coles2 found that
contact lens wearers are 60 times more likely to develop
MK than are non-wearers.
Current care regimes licensed for use in the United
Kingdom if used correctly will disinfect lenses effectively
against a specified range of organisms.
Cleaning and Rinsing.
When a lens is removed from the eye the most effective
way of removing surface deposits and debris is to
mechanically rub and then rinse the lens with an
appropriate solution prior to placing the lens in
disinfecting solution (Figure 3). This process contributes
greatly to the elimination of microorganisms and may
account for up to 99% of the disinfection process if done
properly. In recent years attempts have been made to
design solutions which are effective without a rub and
rinse stage but increasingly both anecdotal and scientific
evidence suggest that leaving out this stage is a step too
far3. Practitioners and solution manufacturers are again
advising patients that they should be including a rub and
rinse stage during the lens cleaning procedures.
Sources of Contamination
Once sterile packaging has been opened contamination
can reach lens surfaces and potentially the eye from,
•
•
•
•
•
Hands during lens insertion
The atmosphere
Lens care products
Contact lens cases (Figure 4)
The eye itself
Contaminants can include,
•
Figure 2. Sterilisation using an autoclave. Both pressure and temperature
are elevated: Lenses are heated to 115-118 0 C
Figure 3: Evidence suggests that mechanical rubbing is still the most
effective way of removing surface deposits.
•
•
•
•
•
•
•
•
Microorganisms including bacteria, viruses, fungi,
protozoans, chlamydiae, actinomycetes and prions
Cellular debris
Tear constituents including proteins mucous and lipids
Skin lipids
Debris from fingers
Cosmetics
Air borne contamination
Care products
By products produced by interactions between any of
the above
Figure 4: Practitioners will regularly ask to check the state of a patient’s
contact lens case. Filthy cases will harbour a large variety of harmful
contaminants including whether or not the case lives in the average
female hand bag (supposition)
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Any care regime will therefore potentially need to have
the capability to remove the above kinds of contaminant
or reduce them to a level that the eyes own defence
systems can cope with.
then additional processes such as the use of a separate
surfactant cleaner and possibly additional protein removal
measures will probably need to be added to the cleaning
regime.
Currently available soft lens care systems fall broadly into
two main types:
Peroxide based systems and Multipurpose “all in one”
systems. The practitioner will need to decide which
system is most appropriate for the lens type being used
and the individual patients need. Consideration will also
need to be given as to when a surfactant cleaner will be
appropriate and whether a specific protein remover will
be needed in addition to the normal daily care regime.
There are increasingly limited rigid lens care systems
available reflecting the decline in use of rigid lenses both
in the UK and globally. These also fall into two main
types, multipurpose or surfactant cleaner plus
conditioning and soaking solution. Again the practitioner
will need to give thought as to whether an additional
protein remover will be needed. Some rigid lens wearers
use peroxide systems that were originally produced for
soft lens wearers and find peroxide an effective way to
clean rigid lenses.
Proprietary saline solutions are suitable for rinsing any
type of contact lens. Tap water should never be used with
soft lenses. Current advice to rigid lens wearers is that
they should not use tap water either as acanthamoeba in
particular is found in tap water especially where lime
scale is a problem, which is in many parts of Britain
(Figure 5). The other problem with tap water in the UK is
that it is stored in tanks in the loft in many homes, this is
unusual in most of Europe, and this is another factor
thought to contribute to acanthamoeba infection which is
relatively high in Britain. However to put this into true
perspective acanthamoeba infection is still extremely
rare.
It is however difficult to treat especially if
advanced, causes tremendous pain and is easily missed in
early stages. Practitioners should always consider this an
option for patients presenting with ocular pain in the
absence of clinical signs of anything very much wrong with
the eye.
Multipurpose Systems
These are also described as “all in one” solutions as one
solution is used to clean as in rub clean, then soak the
lenses usually overnight to complete the disinfection
process (Figure 6). Various preservatives are used to
disinfect lenses. These solutions when used correctly will
be effective against a range of organisms and work well
with lenses that are replaced regularly i.e. monthly or bimonthly. They may not be suitable for patients who are
prone to solution sensitivity. If patients are using lenses
for longer than 1 month, the next replacement
frequencies tend to be 3 months, 6 months or annually,
Figure 5 Lime scale build-up on a bathroom tap provides a favourable
microenvironment for acathamoebae.
Figure 6 Multipurpose solutions clean, rinse, disinfect, and store soft
lenses: Examples include ReNu (Bausch & Lomb) and Complete (Advanced
Medical Optics). Each promote disinfection by removing and killing a
broad range of bacteria and microorganisms.
The practitioner also needs to take into consideration the
material used as there is evidence that certain silicon
hydrogel materials when used in combination with some
solutions result in corneal staining. For more Information
see www.staininggrid.com and The Institute for Eye
Research matrix at www.ier.org.au. The staining pattern
by the time the practitioner views it is frequently
described as “doughnut” staining (Figure 7 Top) having
the appearance of a ring doughnut. Immediately after
insertion there will probably be staining over the entire
cornea, as tears start to flush solution from the lens
during wear staining will start to resolve. Tissue recovery
may occur initially where the lens is thinnest and a
majority of lens wearers are myopic so recovery will
generally occur centrally hence the “doughnut” pattern of
stain. There is some debate as to whether this is harmful
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or gives increased potential for infective or inflammatory
events, however patients exhibiting this staining pattern
often notice much improved comfort when the solution is
changed (anecdotal evidence). Patients with this problem
are best seen soon after lenses are inserted, usually early
morning appointments, and it is essential to instil
fluorescein, a Wratten filter will aid visualization (Figure
7 Bottom). This avoids wasting a lot of chair time by
changing lens type unnecessarily.
day allows the eye to recover fully. If reassurance is
required for either patient or practitioner then the patient
can be asked to return either at the end of clinic on the
same day or 24 hours later for a corneal check with
fluorescein.
Catalysts currently used are either the enzyme catalase or
platinum:
•
Catalase can be put into the peroxide either in tablet
form as in Oxysept 1-Step (Figure 8) or as a second
solution stage as utilised by Tesco’s own brand
system. (It maybe that this option is currently in the
process
of
being
discontinued
by
Tesco).
Neutralisation takes 2 hours if using the Oxysept
system or 20 minutes using Tesco’s system.
•
Platinum is incorporated into a disc sitting in the base
of the contact lens case and neutralises hydrogen
peroxide over a period of 6 hours (Figure 9).
Consideration needs to be given to those patients who
most benefit or need to use peroxide cleaning systems.
These might include patients who are sensitive to
preserved solutions or who replace their lenses less
frequently than monthly. Again a rub stage should be
advised with either a few drops of peroxide or a separate
surfactant. This decision might need to be made after
aftercare has been carried out to assess the level of any
lens deposition. The need for additional protein removal
procedures can also be assessed. The easiest way to
incorporate protein removal is to use a tablet of Subtilisin
A that is dropped into the normal disinfecting solution as
frequently as recommended by the practitioner e.g.
weekly.
Figure 7 (Top) “Doughnut” staining found in a patient who switched
from a conventional hydrogel contact lens to a silicone hydrogel.
Practitioners must consider whether the patient's current lens care
system is compatible with the new lens material. (Bottom) The use of a
Wratten filter enhances corneal staining patterns.
Peroxide Systems
These systems use 3% Hydrogen Peroxide as the
disinfecting agent and require a catalyst to neutralise the
peroxide.
Hydrogen peroxide is a very effective
disinfecting agent and will destroy bacteria, viruses, fungi
and acanthamoeba cysts.
Un-neutralised peroxide is a potential hazard and if it gets
onto the eye will result in a painful experience for the
patient. There will probably be some temporary epithelial
disruption and red swollen conjunctiva. This normally
resolves quickly particularly if the patient has the
presence of mind to rinse the eye copiously. Patients will
usually attend immediately, usually first thing in the
morning, wanting to check that no permanent damage has
been done. Normally leaving lenses out for the rest of the
Figure 8 Oxysept® peroxide disinfection system (Advanced Medical Optics).
The case is filled with solution. One neutralization tablet is added and the
case inverted several times to ensure full neutralisation. Following a
minimum of a six hour soak, the tablet will have coloured the solution pink
indicating that the lenses are neutralised and are ready to wear.
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imadazoline derivatives. Other cleaning agents may be
used in combination with surfactants. These include,
•
•
•
isopropyl alcohol, found in MiraFlow®, (Ciba Vision)
which acts as a lipid solvent and has some
preservative action (Figure 10)
polymeric beads that have a very mild abrasive action
and
chelating agents e.g. EDTA (ethylene diaminetetraacetic acid) which remove mineral ions.
Figure 9: Aosept®(CIBA Vision) utilises a platinum coated disc to neutralise
the hydrogen peroxide, over a minimum period of 6 hours.
It is important to remember that once the peroxide has
been neutralised the lenses will be sitting in saline and if
there are any residual microbes in the solution then they
will potentially start to multiply.
Standards
The current standard to which contact lens solutions are
manufactured is BS EN ISO 14729:2001. This standard is
identical to EN ISO 14729:2001 and ISO 14729:2001.
This standard relates to Contact lens care products and
covers microbiological requirements and test methods for
products and regimens for the hygienic management of
contact lenses.
The challenge organisms used in this standard include
bacteria, yeast and mould and are Stapphylococcus
aureus, Pseudomonas aeruginosa, Serratia marcescens,
Candida albicans and Fusarium solani.
There is currently no requirement for contact lens
solutions to be effective against acanthaeomeba.
Figure 10 MiraFlow(Ciba Vision) is a preservative free, alcohol based
daily contact lens cleaner. “MiraFlow loosens and removes deposits and
debris to help maintain comfort and vision."
Specific surfactant cleaners are particularly useful if
lenses are replaced relatively infrequently i.e. less than
monthly. Patients who tend to deposit lipid and other
debris also benefit.
These cleaners need to be thoroughly rinsed from the lens
surface prior to disinfection as they will irritate the ocular
surface.
Disinfecting Solutions
Product Types
Care products can be considered by the function that they
have within the care regimen.
Cleaner/Surfactant
Surfactants work in the same way as detergents used in
washing up liquids and washing powders to clean kitchen
utensils and clothes. Debris is dissolved and the surfactant
forms a monolayer around lipid droplets. Recombination
of lipid is prevented so fats are emulsified. Common
surfactants
include
poloxamine
and
amphoteric
These complete the cleaning cycle and include peroxide
systems and multipurpose solutions.
Multipurpose
solutions may include surfactant ingredients them
Disinfecting solutions designed for use with soft lenses
increasingly use additional ingredients that attempt to
enhance moisture retention properties of lens materials
e.g. Focus Aqua, Ciba Vision and Opti-Free Replenish,
Alcon.
Disinfecting solutions designed for use with rigid lenses
will include agents that wet and condition the lens
surface.
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Figure 11 (Left) Single dose preservative free sterile saline from Abatron Ltd. And (Right) Steripod (Molnlyke Healthcase)
The tubes are also convenient to practitioners for rinsing eyes after the instillation of Bengal Rose and Fluorescein dyes into the eyes.
Saline
Used for rinsing lenses e.g. after cleaning and prior to
soaking. Currently available saline products in the UK
come in plastic squeezy bottles and contain
preservatives If a preservative free product is
required then saline Minims® or a unit dose product
such as Steripods (Figure 11 Left) should be used.
Patients should be made aware that these products
are not suitable for disinfecting lenses.
Sodium Hypochlorite is found in products used for
cleaning baby bottles and other baby feeding
equipment, such as Milton cleaning fluid. For advice
on the re-use and cleaning of trial RGP lenses The
College of Optometrists website4 is recommended.
Functions of Contact Lens Solution
Components
Protein Removers
Preservatives
Protein removers (Figure 11 Right) are used to
remove bound protein from lens surfaces. To be
effective they need to be used before protein
denatures so where use is indicated it needs to be
regular e.g. weekly. Lens wearers who will probably
need to use protein removers are those that replace
their lenses less frequently than monthly, rigid lens
wearers would be an example. It is fairly unusual to
see patients who replace their lenses at least
monthly having problems with protein deposition.
The author would actually suspect that monthly
wearers who do have such problems might well be
making their lenses last rather longer than a month
particularly if the patient pays cash for their lenses
or purchases from the internet. Those patients on
planned replacement schemes are less likely to
“make their lenses last”.
These are substances or preparations added to a
product to destroy or inhibit the multiplication of
micro organisms.
Subtilisin-A found in Ultrazyme Universal Intensive
Cleaner (AMO) can be dropped into either Hydrogen
Peroxide or Multipurpose disinfecting solutions as
part of the disinfecting cycle. This eliminates the
need for a separate protein removal process.
Menicon Co. Ltd market a product called Menilab for
practice use only. This product contains Sodium
Hypochlorite which is effective against prions and
viruses and is intended for RGP trial lens disinfection.
PolyQuaternium 1 based systems (Polyquad®) act as
antibacterials which is used By Alcon in OptiFree
Express and OptiFree Replenish. These solutions also
contain myristamidopropyl dimethalamine MAPD
(Aldox®) which has anti-acanthamoebal and antifungal properties.
Polyhexamethaline biguanide PHMB is known by
including
polyhexanide,
several
names5
polyaminopropyl biguanide, Dymed and Trischem.
PHMB is present in many currently available
multipurpose solutions.
Chlorhexadine an effective preservative historically
used in soft lens solutions caused many solution
sensitivity problems due to its small molecular size
and has been replaced by chemicals with much larger
molecules such as PMBH and Polyquad. There is a
reduced uptake of large molecule preservatives into
soft lens matrix6 and reduced levels of allergic
reactions. Chlorhexadine is still found in Boston RGP
lens cleaning products.
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Active Agent / Ingredient:
These are the surfactant / cleaning ingredients within
the solution.
film is maintained the optical quality and
performance of the lens will be enhanced. These
include the viscosity agents mentioned above.
Hygiene
Neutralising agents
Hydrogen Peroxide is an extremely effective
disinfecting agent, will cause a great deal of
discomfort if introduced onto the surface of the eye
so needs to be neutralised. Currently this is achieved
either by the use of platinum introduced into the
case as a disc e.g. AOSept PLUS Ciba Vision and
EasySEPT Bausch and Lomb, or by use of the enzyme
catalase e.g. Oxysept 1-step AMO. By products of the
neutralisation process are oxygen and water. Cases
have to be vented to allow the oxygen to escape and
prevent the case from exploding so patients need to
understand that they need to use only the case
provided with the solution.
Clean hands are an essential starting point to contact
lens wear. Patients (and practitioners) need to be
taught how to wash hands thoroughly using hand
wash. A five second “rinse” with cold water is not
enough. Hands will always potentially be a sources of
many contaminants which may range from something
that causes minor ocular irritation to full blown MK
caused by bacterial contamination
It is worth remembering that acanthamoeba find
limescale a very cosy habitat and that the average
face flannel provides a wonderful environment for
pseudomonas to breed in.
Case Cleaning
Chelating Agents
EDTA (ethylyne diamine tetra-acetic acid) or its salts
acts as a synergist in aiding preservative action and
may help to improve product stability through
chelating and sequestering metal ions and mineral
ions such as calcium and magnesium.
Buffers
Buffers are elements in solutions that resist pH
changes. Currently Borate, Phosphate and Citrate
buffer systems are used in contact lens solutions.
Change in pH can alter solution properties including
biocidal activity of preservatives or disinfectants.
Lubricating Agents
These constituents are intended to help reduce or
eliminate symptoms of ocular dryness and or
discomfort.
These
include
hypromellose,
Dexpanthanol in Focus Aqua Ciba Vision
It seems to be generally agreed that contact lens
cases should be replaced frequently, consensus would
suggest monthly is the way to go. Cases also need to
be cleaned regularly. Various methods of cleaning
cases have been suggested: rinsing on a daily basis
with cooled boiled water and allowing the case to air
dry, cleaning on a weekly basis either using contact
lens disinfecting solution or sodium hypochlorite
(available as proprietary baby bottle cleaning
products) solution then rinsing with cooled boiled
water and allowing to air dry. Any sticky debris can
be removed by gently brushing with a soft baby
toothbrush, one that has been bought for the purpose
rather than one previously used by baby.
Ciba Vision provide a case containing silver, which
has antimicrobial properties, with Focus Aqua
solution (Figure 12).
Viscosity Agents
Increasing the viscosity of a solution will help to
improve in-eye contact time and also soothe, help
reduce irritation and make surfaces slippery.
Polyvinylpyrrolodine PVP, Polyvinyl alcohol PVA and
polyethylene glycol PEG are examples of viscosity
agents.
Conditioning Agents
These ingredients are constituent parts of solutions
for use with RGP lenses. The solution needs to
increase the surface tension of the RGP lens to
enable tears to “wet” the lens. The lens will be
cushioned and foreign body sensation should be
reduced on lens insertion. If a regular pre-lens tear
Figure 12 The MicroBlock lens case from Ciba Vision contains the
inorganic antimicrobial agent silver to reduce contamination and
prevent biofilm formation. The silver is injection moulded into the
plastic so efficacy is not affected by surface abrasion. Silver ions
are enclosed in a carrier and released only when the case comes
into contact with moisture.
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Product Information Tables 1-6
The following tables following include many solutions
currently available in the UK.
Many retailers sell these solutions including
supermarkets and large pharmacy chains as well as
many optical outlets so it should not be difficult for
patients to purchase lens care products.
The list is not exhaustive and cannot take into
account any recent introductions, discontinuations or
reformatting of products.
Ngaire Franklin BSC FCOptom DipCL is currently
Professional Practice Manager with Boots Opticians.
Previously a Boots Tutor Practitioner and Visiting
Lecturer at both Cardiff and Aston Universities, her
specialist areas include contact lens practice and
legal & professional studies. Ngaire is co-author of
two Eye Essential Text books, Soft Lens Fitting and
Rigid Gas-Permeable Fitting by Elsevier Health.
Further Sources/ Recommended Reading
•
•
•
•
•
•
ACLM (Association of Contact lens Manufacturers) www.aclm.org.uk
BCLA (British Contact Lens Association) www.bcla.org.uk
College of Optometrists www.college-optometrists.org.uk
Contact Lenses Ed 5 Anthony J. Phillips, Lynne Speedwell Butterworth Heinemann Elsevier
www.staining-grid.com
www.ier.org.au
References
1. Bausch and Lomb in association with Eurolens Research University of Manchester. The Science of
Compliance A Guide for Eye Care Practitioners 2007
2. Brennan NA, Coles M.(1997) Extended Wear in Perspective. Optom Vis Sci74: 609-623
3. Ghormley N, Jones L. Managing lipid deposition on silicone hydrogel lenses. Contact lens Spectrum 2006.
21
4. www.College-optometrists.org.uk
5. Jones L, Christie C, Soft Contact lens Review:Part 2 modern Generation Care system. Optometry in
Practice 2008. 9
6. Schlitzer R. Preservative uptake by soft contact lenses. Spectrum 1992 7
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Table 1: Cleaner/Surfactant
Manufacturer
Advanced Medical
Optics (AMO)
Bausch and Lomb
(B&L)
Bausch and Lomb
(B&L)
Ciba Vision
Peach ethical
Product Name
Total Care Daily Cleaner
Boston Advance Cleaner
Daily Cleaner
MiraFlow
Daily Cleaner
Lens Type
Rigid
Rigid
Soft
Soft / Rigid
Soft / Rigid
Discard After
2/12
3/12
1/12
3/12
3/12
Preservative
None
EDTA
Sorbic Acid
None
None
Poloxamine 2%
Alcohol BP20% Isopropyl,
Poloxamer 407 15%
Miranol H2M 10%
PEG
Cleaning Agent
Own Branded by
Amphoteric Imidazoline
derivative5.1%,
Anionic Alkyl ether
sulphate 0.64%,
Nonionic fatty acid
amide2.2%
PHMB 0.0005%
Chlorhexadine 0.003%
Alkyl ether sulphate,
ethoxylated alkyl
phenol, sodium chloride,
silica suspension, sodium
phosphate dibasic,
triquaternary cocoa base
phospholipid
Asda Gas Permeable
Lens Cleaner
Boots Gas permeable
Advanced Cleaning
Solution
D&A GP Excel Precleaner
Asda Daily CL cleaner
Boots Daily Cleaner
D&A One Step Soft lens
Cleaner
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Tesco Daily Cleaner
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Table 2 Soaking/Wetting
Manufacturer
AMO
B&L
B&L
Lens Type
Rigid
Rigid
Rigid
Discard By
2/12
3/12
3/12
Total Care Disinfecting, Storing,
Wetting Solution
Boston AdvanceComfort Formula
Conditioning Solution
Boston Simplus
Polyhexanide 0.0005%
Chlorhexadine 0.003%
EDTA 0.05%
Chlorhexadine 0.003%
PHMB 0.0005%
Polyquaternium 10
Polyvinyl alcohol
Derivatised polyethylene glycol
Glucam 20
Cellulose Viscosfier
HPMC
Product Name
Preservative
Conditioning Agent
Viscosity Agent
Own Branded by
PHMB 0.0005%
Hydroxyethyl Cellulose 0.6%
Hydroxyethyl cellulose (HEC)
Asda RGP/Hard lens Conditioner
Boots Gas Permeable Advanced
Conditioning System
D&A GP Excel Conditioning Solution
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Table 3 Disinfection Peroxide (3% Hydrogen peroxide)
Manufacturer
Lens Type
Discard After
Product Name
Neutralizing Agent
Own Branded By
AMO
B&L
Ciba Vision
Peach Ethical
Sauflon
Soft
Soft
Soft / Rigid
Soft
Soft
2/12
3/12
3/12
3/12
3/12
Oxysept 1-Step
EasySEPT
AOSEPT PLUS
Catalase 0.1mg tablet
Platinum Coated
Catalytic Disc
Platinum Coated
Catalytic Disc
Asda One Step
Peroxide Soft
Boots Single Step
Solution
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Sauflon Multi
Polyphenol Oxide
covered by platinum
oxide
Superdrug One step
Contact Lens Solution
Platinum Coated
Catalytic Disc
D&A One Step
hydrogen Peroxide
System
SpecSavers Easyvision
1 Step+Multifunction
Peroxide Solution
VE Peroxide system
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Table 4 Disinfection Systems / Multipurpose Soft
Alcon
Alcon
AMO
B&L
B&L
Ciba Vision
Cooper
Vision
Menicon
Peach
Ethical
Sauflon
Sauflon
Sauflon
Lens Type
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Soft
Discard by
6/12
6/12
3/12
6/12
6/12
3/12
3/12
3/12
3/12
3/12
3/12
3/12
Opti-Free
Express
Opti-Free
Replenish
Complete MPS
Easy rub
Formula
Renu MPS
Renu
Multiplus
Focus Aqua
Options
Multi
Menicare
Soft
All-in –one
light
Comfort
Vue
CyClean
Poly
quaternium-1
0.001%
Poly
quaternium-1
0.001%
PHMB
0.0001%
PHMB
0.00005%
PHMB
0.0001%
PHMB
0.0001%
PHMB
0.0001%
PHMB
0.0001%
PHMB
0.00008%
PHMB
0.00008%
PHMB
0.0001%
Active
Ingredient
MAPD
0.0005%
MAPD
0.0005%
Poloxamer
0.05%
Poloxamine
EDTA/
Chelating agent
0.05% +
Citrate
Citrate
0.02%
0.01%
Yes
Yes
Yes
Boric Acid
Sorbitol
AMP-95
Borate
Phosphate
Tetronic
1304
Tetronic
1304 +
nonanoyl
EDTA
Poloxamer
237
Manufacturer
Product Name
Preservative
Buffer
Lubricating
agent
Own Branded
by
Boric Acid
Sodium Borate
Phosphate
Tetronic
1107
Asda
All in One
Solution
Soft
Boots
Multipurpose
Soft
Contact Lens
Solution
PHMB
0.0001%
Macrogol
Glycerol
Hydroxy
stearate
0.01%+
Hydranate
0.025%
Boric Acid
Sodium
borate
Sodium
Phosphate
Tromethamine
Tetronic
1107
Pluronic
F127
Dexpanthenol
Sorbitol
Boots
All in One
solution
www.ukoptometry.co.uk
Disodium
Hydrogen
Phospate
Dihydrate
Glycolic
Acid
Disodium
Edetate
0.00015%
Phosphate
Phosphate
Biopol
Propylene
Glycol
HPMC
Poloxamer
Poloxamer
HPMC
Biopol
Sainsbury
All in one
Contact
Lens
Solution
Specsavers
Easy
Vision
Multi
Active
Tesco
All in one
solution
SpecSaver
s
Easyvision
Multipurpo
se
Vision
Express
Multi
Purpose
M-Lite
Optometry Blog
Continuing Education and Training
Table 5 Saline Solutions
Manufacturer
AMO
B&L
Lens Type
Soft/Rigid
Soft/Rigid
Discard by
3/12
6/12
Product Name
Lens Plus OcuPure Non Aerosol Saline
Sensitive Eyes Plus
Sodium Chloride %
0.85
0.9
Preservative
Purite 0.005%
PHMB 0.00003%
EDTA 0.025%
Buffer
Boric Acid
Borate
PH
7.6 – 7.9
7.0 -.7.8
Own Branded By
-
-
www.ukoptometry.co.uk
Optometry Blog
Continuing Education and Training
Table 6 Protein Removers
Manufacturer
Abatron
AMO
Menicon
Menicon
Lens Type
Soft / Rigid
Soft / Rigid
Rigid
Rigid
Discard By
See packaging
See packaging
See packaging
See packaging
Ultrazyme Universal
Intensive
Protein cleaner
Menilab
(Practitioner use only)
Progent
Subtilisin- A
0.4 mg
Sodium Hypochlorite
Sodium Hypochlorite
Product name
Active Agent
Amiclair
Protease Pronase
Lipase Disodium
edetate
Other Ingredients
Form
Own Branded by
Peach Ethical
Soft / Rigid
See packaging
Trypsin Lipase Amylase
as 2 mg multi enzyme
complex
Potassium bromide
Tablet
Tablet
Liquid
Liquid
Tablet
Boots Protein Remover
Tablets
Tesco Effervescent
Protein Remover
Tablets
D&A Universal Protein
Remover Tablet
Disclaimer: the information contained within these tables was obtained from a variety of sources including product packaging, ACLM Yearbook 2008, BCLA website . 10 . The
author takes no responsibility for errors, omissions and changes to the table contents and would add that solutions may be subject to discontinuation or change at short notice.
www.ukoptometry.co.uk