How 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.

 

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

 

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

 

Dr. Leukoma wrote:

To me, the ideal

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

 

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.

 

I still pretty much follow the recommendations of:

http://www.aao.org/education/library/information/contact_lenses.cfm

 

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

 

Which also make the difference between old generation daily wear and
current generation silicone hydrogel continuous wear statistically
insignificant.

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.