Which Contact Solution Is the Best?
There are two types of contact lens care systems: multipurpose contact lens solutions and hydrogen peroxide-based care systems. Each system has advantages and potential disadvantages.
Multipurpose Contact Lens Solutions
Multipurpose contact lens solutions are dual-purpose liquids that both clean and disinfect contacts.
Multipurpose solutions also are called "no-rub" solutions, because they are designed to adequately clean and disinfect lenses with a simple rinse-and-store method, eliminating the need to mechanically rub the lenses to remove lens deposits.
Recent research, however, suggests that rubbing the lenses after moistening them with a stream of multipurpose solution provides greater cleaning effectiveness. For this reason, many eye care professionals recommend adding a short, 10-second period of mechanical rubbing as part of the cleaning regimen with multipurpose solutions.
Proponents of multipurpose contact lens solutions say they are less expensive and easier to use than hydrogen peroxide-based solutions, and therefore contact lens wearers are more likely to use multipurpose solutions properly.
But in recent years there has been a global recall of at least one brand of a multipurpose contact lens solution because of an outbreak of fungal eye infections associated with the product.
Still, multipurpose solutions are the most popular method of contact lens care in the United States. Advocates of multipurpose solutions say the recall of a single solution was an isolated incident and that no-rub solutions are proven safe, effective and economical for lens cleaning and disinfection.
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Hydrogen Peroxide-Based Lens Care Systems
Hydrogen peroxide-based (HPB) contact lens care systems also are popular in the United States.
While HPB systems provide effective lens disinfection, and no product recalls have occurred due to outbreaks of eye infections associated with their use, these systems tend to be more cumbersome than no-rub multipurpose contact lens solutions.
Eye care professionals who recommend hydrogen peroxide-based care systems often advise that you first clean your contacts with a separate surfactant cleaning solution and/or rinse them with saline solution. So already an additional step is required.
Lens disinfection with HPB lens care systems can be a one-step or two-step process, depending on the product.
Both one-step and two-step HPB lens care systems require neutralization of the hydrogen peroxide solution after lens disinfection and prior to wearing the lenses. This is because hydrogen peroxide is an effective disinfecting agent, but it is toxic to the cornea and must be converted to saline with a neutralizing agent to avoid eye injury.
In one-step HPB systems, the lenses are placed in a holder within a cylindrical contact lens case, and the case is filled with a 3 percent solution of hydrogen peroxide. The bottom of the case contains a solid disk of a material that immediately begins neutralizing the hydrogen peroxide.
In two-step systems, the contacts are placed in a lens case filled with only the hydrogen peroxide for a specified period of time. A neutralizer is then added to the case to convert the disinfectant to harmless saline.
Hydrogen peroxide care systems are preservative-free and therefore are often recommended for contact lens wearers who may be sensitive to preservatives found in multipurpose contact lens solutions.
Hydrogen peroxide-based lens care systems are not free from controversy, however.
Eye care professionals who prefer multipurpose contact lens solutions say one-step HPB systems may not expose contacts to full-strength hydrogen peroxide for an adequate period of time for effective disinfection of resistant microbes, including those that cause a serious eye infection called Acanthamoeba keratitis.
They also say two-step HPB systems pose the risk that users will forget the neutralizing step and incur a painful eye injury from exposing their eyes to unneutralized hydrogen peroxide.
Another potential problem with HPB systems is that after the hydrogen peroxide has been neutralized, the solution remaining in the lens case has no disinfecting ability. It's possible the case and your contacts can become contaminated if you open the case and then use it to store your lenses without adding fresh disinfecting solution.
Ask Your Eye Doctor
Choosing the best contact lens solution for you is not a decision you should make yourself. During your contact lens fitting, your eye doctor will tell you which solution he or she feels is best for you.
Also, do not change lens care systems before first discussing it with your eye doctor.
About the Author: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 25 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include contact lenses, nutrition and preventive vision care. Connect with Dr. Heiting via Google+.
[Page updated February 2014]
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