How Long Are My Hydrophilic Toric Lenses Good For?

Discussion in 'Optometry Archives' started by Chris Pollard, Jun 16, 2005.

  1. 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
     
    Chris Pollard, Jun 16, 2005
    #1
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  2. 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.
     
    William Stacy, Jun 16, 2005
    #2
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  3. Chris Pollard

    Dr. Leukoma Guest

    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
     
    Dr. Leukoma, Jun 16, 2005
    #3
  4. Chris Pollard

    kemccx Guest

    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?
     
    kemccx, Jun 16, 2005
    #4
  5. Chris Pollard

    Dr. Leukoma Guest

    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
     
    Dr. Leukoma, Jun 16, 2005
    #5
  6. Chris Pollard

    Dr. Leukoma Guest

    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, Jun 16, 2005
    #6
  7. 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.
     
    William Stacy, Jun 16, 2005
    #7
  8. Chris Pollard

    Dr. Leukoma Guest

    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
     
    Dr. Leukoma, Jun 16, 2005
    #8
  9.  
    William Stacy, Jun 16, 2005
    #9
  10. 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.
     
    William Stacy, Jun 16, 2005
    #10
  11. William Stacy, Jun 16, 2005
    #11
  12. Chris Pollard

    Dr. Leukoma Guest

    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
     
    Dr. Leukoma, Jun 16, 2005
    #12
  13. Chris Pollard

    LarryDoc Guest

    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.
     
    LarryDoc, Jun 17, 2005
    #13
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