Thomas G. Quinn
Practitioners say these new products are improving wearing time and
creating patient loyalty.
To keep up with advancing technology in contact lenses, manufacturers
have scrambled to develop matching multipurpose disinfecting solutions for
enhanced efficacy and patient comfort that translate into better compliance.
Outbreaks of Fusarium keratitis in 2006 and Acanthamoeba shortly
thereafter were eventually linked to noncompliance with contact lens solutions.
As a result of these industry scares, certain manufacturers have reformulated
some of their solutions, according to Thomas G. Quinn, OD, a practitioner from
AMO: RevitaLens OcuTec
As these companies have undertaken the reformulations, they have
tested them under more real-world conditions, he said. Prior to
these outbreaks, the testing requirements for U.S. Food and Drug Administration
approval were fairly artificial, such as in a laboratory setting.
Dr. Quinn points to RevitaLens OcuTec (Abbott Medical Optics) as a
contact lens solution that has undergone rigorous testing. Any soft lens
patient is a candidate for the product, assuming they have no sensitivities to
the ingredients, he told Primary Care Optometry News.
It works with the new silicone hydrogel material as well as the
old hydrogel material, he said. In addition, the solution has been shown
to be comfortable and is very effective in killing bugs, even if the patient
does not care for the contact lenses or the storage case as he or she should.
I have seen no adverse events with the solution, said Dr.
Quinn, who has been prescribing RevitaLens for about 6 months.
Patients who choose to top-off the solution in their contact
lens case to save money in todays trying economy causes a change in
the chemical characteristics of the disinfectant a partial evaporation
which was one of the reasons for the Fusarium keratitis crisis,
Dr. Quinn said.
However, when test conditions subjected lenses to a partial evaporation
process with RevitaLens, the solution still maintained a high level of
disinfection, he said.
One of the disinfecting agents, polyquaternium-1 (PQ-1) is not
taken up by the contact lens itself, so it is more available and stays active
when the lens is stored in the case, Dr. Quinn said.
RevitaLens became commercially available last October, according to
Thomas M. Arens, an associate marketing director at Abbott.
Our solution allows contact lens wearers to have greater
satisfaction with their contact lenses, he told PCON.
The overall formula was developed for silicone hydrogel lenses, and we
consulted with more than 600 eye care professionals to bring the newest
technology to the market.
Within a few years, this new type of lens material is expected to be
recommended by 80% to 90% of eye care professionals, Mr. Arens said.
The unique next-generation formula contains only ingredients that
really work hard synergistically to clean lenses and disinfect, he
continued. There was a need to develop a more efficacious solution that
would overcompensate for noncompliance.
Additionally, he said that RevitaLens provides patients with up to 16
hours of end-of-day lens wearing comfort.
Alcon: Opti-Free PureMoist
Opti-Free PureMoist (Alcon) multipurpose solution also has the
ability to enhance the patients wearing experience with their contact
lenses, Mile Brujic, OD, a partner at Premier Vision Group, a
four-location optometric practice in northwest Ohio, told PCON.
Although the solution did not debut in the U.S. until June, Dr. Brujic
was involved in clinical trials.
One of the ingredients that is certainly different than anything
else weve ever seen in a solution is the molecule HydraGlyde (compound
name polyoxyethylene-polyoxybutylene), he said.
The HydraGlyde moisture matrix has a strong affinity to the lens
surface. It allows the contact lens to remain wet for up to 16 hours.
This is truly a new surfactant that seems to be showing a lot of
promise, Dr. Brujic said.
A double-masked trial of symptomatic patients who were uncomfortable
wearing contact lenses consisted of randomizing subjects in a double-masked
fashion to either PureMoist or a controlled solution for 1 month.
A number of patients in the PureMoist group experienced
significant improvement in comfort that we didnt see in the control
group, said Dr. Brujic, one of the investigators, who will likely
position the product as first line for all soft contact lens wearers. He said
he expects comfort to typically last up to 16 hours.
A separate study of PureMoist, in which Dr. Brujic did not participate,
recruited patients who were not symptomatic for dry eye symptoms with their
contact lens wear. The randomized trial found a statistically significant
difference favoring the group using PureMoist.
Products that work more efficaciously are ideally positioned to
keep patients more compliant and to minimize switching solutions, Dr.
According to product information provided by Alcon, Opti-Free PureMoist
bolsters soft contact lens comfort via a new scientifically engineered block
copolymer platform. The product also causes minimal corneal staining
(correlated to comfort), reduces lipid deposition and has demonstrated
biocompatibility. Furthermore, the dual disinfection system provides
proven efficacy against a wide range of microorganisms.
According to the company, scientists began developing PureMoist 7 years
ago, before the Fusarium and Acanthamoeba outbreaks. More than 50 scientists
were involved in this work.
Bausch + Lomb: BioTrue
BioTrue (Bausch + Lomb) contact lens solution was launched June 2010.
The reception by eye care practitioners and patients to BioTrue
has been overwhelmingly positive, Chris Snyder, OD, FAAO, director of
Bausch + Lomb professional relations, North American Vision Care, said.
The unsurpassed disinfection efficacy from the dual-disinfectants
(polyhexamethylene biguanide [PHMB] and PQ-1) in the product is certainly
In addition to these two disinfectants being in very low
concentration compared to competitive products, Dr. Snyder told
PCON, BioTrue is a bio-inspired formulation, in that it matches
the pH of healthy tears and contains hyaluronan (HA), a natural lubricant of
the eye and the body.
This translates into incredible continuous comfort for up to 20
hours, he said.
BioTrue is also formulated with a component that helps manage the
proteins naturally found in tears. This part of the formulation will
actually protect the proteins in their native state, to keep them from
denaturing, Dr. Snyder said.
This component breaks down and clears the denatured proteins as well,
primarily while the lens is soaked in the solution.
Contact lens solutions typically dont have a lot of loyalty
by patients, or doctors for that matter, Ami A. Epstein, OD, a private
practitioner from Birmingham, Ala., said in an interview. But BioTrue has
so much patient and doctor loyalty and enthusiasm. Rarely do you hear about
someone having enthusiasm about a contact lens solution.
Dr. Epstein attributes this loyalty to the effectiveness of the product.
End-of-the-day comfort with the contact lens is improved, she said.
One patient was so impressed with the magic solution that
she referred her sister.
It made her contacts feel like they werent there that
they disappear. To have a contact lens in your eye that you are unaware of is
ultimately the goal of every patient who wears contacts, Dr. Epstein
By using BioTrue, Dr. Epsteins patients can now comfortably wear
their lenses all waking hours. When you first put the contact lens in it
is comfortable because the pH is pH-balanced to match your tears, Dr.
Epstein said. Likewise, HA brings moisture to the contact and stays with
it, whether it is a hydrogel or silicone hydrogel lens, for up to 20
Dr. Epstein, who has been dispensing BioTrue since June 2010, noted
this is not a me-too product. This is totally different than
anything else on the market.
In fact, some of Dr. Epsteins daily disposable contact lens
patients rinse their lenses with BioTrue before placing them into the eye for
easier insertion and longer comfortable wearing duration. Bob
- Ami A. Epstein, OD, can be reached at 2206 Cahaba Valley Dr., Suite
B, Birmingham, AL 35242; (205) 981-9441; firstname.lastname@example.org.
- Thomas M. Arens is an associate marketing director at Abbott Medical
Optics. He can be reached at 1700 E. St. Andrew Place, Santa Ana, CA 92705;
(714) 247-8459; email@example.com.
- Mile Brujic, OD, can be reached at Premier Vision Group, 1222
Ridgewood Dr., Bowling Green, OH 43402; (419) 352-2502;
- Thomas G. Quinn, OD, can be reached at 416 W. Union St., Athens, OH
45701; (740) 594-2271; firstname.lastname@example.org.
- Chris Snyder, OD, FAAO, is director of professional relations, North
American Vision Care, Bausch + Lomb. He can be reached at 2133 Partridge Berry
Road, Birmingham, AL 35244; (585) 451-6502;
- Disclosures: Dr. Epstein has no direct financial interest in any
products mentioned in this article. She is a paid consultant for Bausch + Lomb.
Dr. Brujic has no direct financial interest in any products mentioned in this
article, nor is he a paid consultant for any companies mentioned. Dr. Quinn has
no direct financial interest in any products mentioned in this article. He has
received support in the form of research funds, speaking honoraria and/or
advisory panel honoraria from AMO and Bausch + Lomb.
- RevitaLens OcuTec is available from Abbott Medical Optics,
- Opti-Free PureMoist is available from Alcon Laboratories,
- BioTrue is available from Bausch + Lomb,