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Medical Forum / General / Vision / June 2005How Long Are My Hydrophilic Toric Lenses Good For?
Greetings! I recently transitioned from wearing RGP lenses (30 years) to Soft Lenses. I am wearing "Softmed Toric Weeklies" by Ocular Sciences. I wear the lenses 16 hours a day and they soak in Opti-free Express Solution during the evening. My doctor said that I should throw away the lenses after two weeks. If the lenses are not torn or cloudy, and I am not experiencing any issues with my eyes, do I still need to dispose of the lenses on a periodic basis? Thanks! -Chris You'll get diffent opinions, but the concensus seems to be for most 1-2 week lenses (as categorized by the manufacturers) can safely be used for a month of full time daily wear. There is no timer in those lenses, but you don't want to push it too far or you can start collecting things on your lenses. Things you shouldn't be saving. w.stacy, o.d. > Greetings! > [quoted text clipped - 13 lines] > > -Chris Sorry, but I am not aware of any consensus about wearing lenses longer than their intended use. It has been demonstrated that protein and lipid deposition on soft contacts begins very quickly. This "biofilm" is also impossible to remove completely. Therefore, in order to realize the full benefits of disposable lens wear, you should be changing your lenses as often as you can afford to change them, with respect to your individual requirements, as recommended by your eye doctor. Soft daily disposable lenses, i.e. lenses that are thrown away every day, have the lowest rate of eye infection. DrG I like the idea of daily disposables. Are there many brands out there? Are they similar to the 2 week brands as far as vision and comfort are concerned? There are several brands in spherical prescriptions. We carry the Focus Dailies, 1-Day Acuvue, and the B&L version -- have I missed any? Ciba makes a toric version, I do believe, but I haven't used it. The daily lenses are the cheapest to manufacture, using the cheapest materials. Vision and comfort are similar to other lenses made from the same or similar materials, i.e. mid-water content hydrogel. I tend to use them in applications requiring frequent replacement such as allergic conjunctivitis, heavy deposits, or for patients who only wear lenses occasionally. The annual costs run higher than for non-daily disposables. They occupy a small niche in my practice, which is heavily skewed toward silicone-hydrogels and Proclear. DrG Sure. Ideally all lenses would be disposed of daily. But in the real world, talking to CL reps, I stand by what is commonly done by most patients in the USA. w.stacy, o.d. > Sorry, but I am not aware of any consensus about wearing lenses longer > than their intended use. [quoted text clipped - 9 lines] > > DrG Well, I don't know that disposing of lenses daily is the ideal situation, either. It seems awfully wasteful. To me, the ideal situation is safer continuous wear for months. I agree that most patients will try to extend the wearing time on their lenses, and that most will not clean them properly when they take them out. So, why not then cut to the chase and teach our patients bad habits in the beginning to shorten the learning curve? DrG To me, the ideal > situation is safer continuous wear for months. That would be true if it weren't for that little problem of the bandage effect, which will mask an infectious keratitis just long enough to give a vision threatening ulcer a head start. w.stacy, o.d. There is that little problem of infectious keratitis that seems to occur at the rate of 1/3500 per year or less, and that's with the first generation of silicone-hydrogel lenses. DrG > There is that little problem of infectious keratitis that seems to > occur at the rate of 1/3500 per year or less, and that's with the first > generation of silicone-hydrogel lenses. > > DrG > There is that little problem of infectious keratitis that seems to > occur at the rate of 1/3500 per year or less, and that's with the first > generation of silicone-hydrogel lenses. > > DrG What's that, about 10 or 20 times the non-extended wear incidence? Whatever it is, I don't like it. w.stacy, o.d. According to Chang, et. al., Lancet, 1999, the rate is about 1/5000 for daily wear soft lenses and 1/500 for EW soft lenses. The latest information suggests that the rate for silicone-hydrogel lenses worn continuously is about 1/3500 or thereabouts. Whatever it is, it is greater than zero, which can be achieved by not wearing contacts and sticking with eyeglasses. Rather than quibbling over CW vs. DW, we should be arguing over CW vs. LASIK, just in case you were wondering where your contact lens patients were going to eliminate the hassle of contact lenses. DrG > According to Chang, et. al., Lancet, 1999, the rate is about 1/5000 for > daily wear soft lenses and 1/500 for EW soft lenses. The latest > information suggests that the rate for silicone-hydrogel lenses worn > continuously is about 1/3500 or thereabouts. Which also make the difference between old generation daily wear and current generation silicone hydrogel continuous wear statistically insignificant. > Whatever it is, it is greater than zero, which can be achieved by not > wearing contacts and sticking with eyeglasses. > > Rather than quibbling over CW vs. DW, we should be arguing over CW vs. > LASIK, just in case you were wondering where your contact lens patients > were going to eliminate the hassle of contact lenses. And let's see: 1/100 serious outcomes compromising eye health and vision, 1/8 significant outcomes affecting quality of vision permanently or requiring remediation. And the winner is................ --LB, O.D. I still pretty much follow the recommendations of: http://www.aao.org/education/library/information/contact_lenses.cfm |
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