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    Patient perception vs. reality with compliance

    Make lens care compliance a part of your patients’ New Year’s resolutions

    Well, here we are, another year behind us, another new start ahead. And what made the cutoff for our list of resolutions? Lose 10 pounds, wake up earlier, save more money, make more family time?

    But wait—how can we possibly forget everyone’s list topper: To rub your contact lenses every day and replace the solution, to throw your lenses out on time? Adding this as a resolution sounds preposterous because it just doesn’t hold a place of priority for many patients. Unfortunately, they don’t see an immediate impact from lens care compliance—or the lack thereof. I’ve always believed that if we make it seem substantial to us, it will seem important to the patient.

    A comparison of one-step peroxide systems

    Bui found that while 86 percent of patients surveyed believed they were compliant with their lens care regimen, only 32 percent were compliant with even 90 percent of the recommended protocol.1 Another survey showed full compliance to be as low as 0.4 percent, and “good” compliance was confirmed in only two percent of those surveyed.2 Because total compliance seems to be an overwhelming goal for patients, let’s look at the impact of simply rubbing and rinsing the lens.

    Rub and rinse

    It is believed that lipid deposition is more common on silicone hydrogel (SiHy) lenses because the hydrophobic lipids in the tear film have an affinity for the hydrophobic silicone. And with the build up of lipid comes contact lens awareness, or worse yet, dryness, friction, intermittent blur, and inflammation. Luckily, with the decreased wear cycle compared to years past, the problem is somewhat limited, or is it? Nash recently compared the amount of lipid deposition on seven different sihy materials (140 lenses) via fluorometric enzymatic assay, each having been worn for two to four weeks. He found that the actual sorption was polymer dependent; enhanced-lotrafilcon B showed the least amount of sorption and enfilcon A showed the most (0.09±0.1microg/lens and 3.96±0.8microg/lens, respectively).3

    Recently, Tam conducted research to see how saline and multi-purpose solution (MPS) impact the sorption of radiolabeled dipalmitoylphosphatidylcholine (DPPC) and cholesterol (CH) on five different lens materials. As expected, SiHy absorbed more lipids than hydrogel material. Pre-soaking the SiHy materials in MPS for 16 hours reduced sorption by more than 10 percent compared to the controls; however, the reduction was not statistically significant.4

    The harsh reality of contact lens care compliance

    Crystal M. Brimer, OD, FAAO
    Dr. Brimer is a graduate of UNC-Chapel Hill and Southern College of Optometry. She is a fellow of the American Academy of Optometry and ...


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    Optometry Times A/V