Contact lens cleaning solution incompatibilities

 
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Contact Lens Solution Incompatibilities

Solutions for contact lenses are considered incompatible if the use irritates the eyes or discolors the lenses. Also when solutions that are to be used together, if not used in that same manner may harm lenses or eyes. Different types of solutions are required for different types of contact lenses and it is vitally important to use only those solutions recommended for your specific type of lens. Gas permeable lenses require special cleaners, soaking and wetting solutions. Soft lenses also require many solutions like daily cleaners, disinfecting solutions like hydrogen peroxide, enzyme cleaners, rinsing and storing solutions. Generally soft contact lenses are more prone to damage due to incompatibilities but problems can also occur with gas permeable contacts.

Multipurpose solutions

Multipurpose solutions and MPD’s contain all ingredients necessary for cleaning, disinfecting and storing in a single bottle. They also enhance wetting and protein removal. They are designed to promote better patient compliance but some people shortcut the directions and also do not rinse their cases properly and change the solutions nightly.

The solution becomes less effective after the first use, therefore patients who fail to change their solutions or who merely top off the solution remaining in the case may not achieve adequate disinfection. Also, while topping off, some patients immerse the tip of the solution bottle into the old solution that remains in the lens case. This can contaminate the solution in the bottle. As they squeeze additional solution into the case and then release the tension, old solution is suctioned back into the container. This can transfer bacteria and other material into the bottle of cleaning solution.

Some patients do not understand the difference between saline solution and multipurpose solution and purchase saline solution as it is cheaper. Saline solution supports microbial growth and no disinfection occurs. In addition, many patients stop using solutions that were recommended by their practitioners and buy generic solutions or whatever is on sale. Switching care systems, mixing multipurpose solutions can lead to lens discoloration, clouding and more adverse reactions like toxic red eye. Frequent replacement lenses have less adverse reactions caused by improper use of multipurpose solutions.

Solution Incompatibilities in Soft Lenses

Products from different manufacturers with different preservatives and active ingredients interact with one another and many contact lens solution incompatibilities are found to occur. All eye specialists are familiar with the scope for damage to the lenses or the eyes and the symptoms when contact lens care solutions are used inappropriately. Since the manufacturer of one company does not test how their product reacts when mixed with products of other manufacturers, it is difficult to document which solutions are incompatible. However, there are some reactions that are documented. In case of soft lenses, if the user changes from one cold disinfecting solution to another without changing the lenses then precipitates can form on the lens matrix. If a tablet neutralizer with catalase is used in a case containing a catalytic disc, then the disc will become gummy and there will be incomplete neutralization. If the contents of the neutralizer or case becomes foamy and overflows, the surfactant cleaner then has not been thoroughly rinsed from the lenses before disinfection.

If hydrogen peroxide system containing Ultracare is used for disinfecting any sandwich technology lens, then bubbles will form on the inner layers of the laminates. When silicone hydrogel lenses are disinfected with Ultracare, “sag depth” may occur. If ReNu Multiplus is used with Pure Vision hydrogel lenses there may be complications. When soft lenses are soaked overnight in a surfactant cleaner in an attempt to remove heavy deposits, it will be difficult to completely rinse out the cleaner and sometimes some cleaners distort the shape of the lens due to the presence of isopropyl alcohol in the solution.

Rigid Gas Permeable Solution Incompatibilities

In rigid gas permeable lenses, solution incompatibilities occur when patients mix solutions from various manufacturers or if non appropriate cleaning agents like dishwashing liquids, baby shampoo or toothpaste are used to clean lenses. In these cases there is drying of lenses, itching, burning, hazy vision, heightened lens awareness and surface deposits and some patients experience injection in the conjunctiva, mild epithelial edema, SPK, hydrophopic surface spotting.

There are few incompatibilities which are felt with RGP solutions like when borate buffered solutions are used in conjunction with those containing polyvinyl alcohol then a sticky gel forms on the lenses. When generic peroxide is used then lens surface becomes soft and there is resultant scratching, scoring and scuffing. If chlorhexide preserved solutions are used with lenses that contain styrene then there will be clouding on the surface of the lens.

Maintaining a successful contact lens care system is largely dependent on patient compliance. The users of contact lenses can avoid problems by purchasing only those solutions that have been prescribed by the practitioner. Mixing or transferring solutions, contaminating them, skipping nightly care routine will result in complications. So patients should first be educated regarding contact lens care system.