I was just wondering what the consensus is on the new Optifree No Rub contact lens solution. From what I can remember from my schooling days, the proper ways to regularly clean a lens were (and still are) digital rubbing or ultrasonic units. I still prefer and recommend the former. Let me know your views. And yes I have heard the; our product is better than everyone else's because blah, blah, blah .....from the reps already. Mullo
Well I for one still tell my pts that I am training to use cls to digital rub even though it says you don't have to. For me they will never be quite clean unless you do. I find it hard to believe.
Just my thoughts,
Steph
Don't have any personal experience with Alcon's new product, but I will relay this with for what it's worth. When I was originally taught, I was taught to digitally rub lenses for one full minute, and rinse them in tap water (don't let me hear from any of you anti~tap water folks on this) before insertion in the eye. It is and was my habit to have rigid lenses shipped to me dry, I inspect them and keep them dry until delivery to the patient. When Boston first brought out a solution for RGP's they hired Jerry Feldman, PhD. To go around and tell us that lenses had to be soaked in this stuff for 4+ hours before they would wet. Since I knew Jerry I decided that there might be something to this and started soaking lenses after inspection until I delivered them to the patient. It was still my habit to digitalize them before insertion onto the eye. Then I got one lens in a patient's eye and had a phone call, I told myself: "This lens has been soaking in solution for a week", so I just rinsed and placed the second lens on the eye. When I got off of the telephone, I looked at both of the lenses with floureciene in the slit~lamp. The digitalized lens was well wetted, the other quite oily. I repeated this test many times same result. Also note I had no problem wetting un~soaked lenses if they were digitally wetted. My conclusion: "The manual wetting of a lens is much more important than soaking.
Do not misunderstand me , I do not believe in dry storage of lenses in patient use. I do think that rigid lenses that are going to be stored for long periods of time should be cleaned, blotted dry of all moisture and stored dry. This includes spare pairs and trial lenses.
Ole Chip (With old ideas) Anderson
I use it as no rub and feel it gives the same comfort as a hydrogen peroxide. That is the truth! I encourage all of my lazier patients to spend the extra few bucks and get it. It is only good for monthly or 2-week lenses, however.
If you are using the solution for only 2wk or monthly disposables, why would you not just soak the lens in any multipurpose solution(or saline for that matter). If your patients are going to be lazy and don't want to properly clean their lenses, fine. However, I am concerned that there is a misconceived notion that this works as well as a 3 step peroxide system. Mullo
I have tried many different cleaners, including peroxides. I know that peroxides do a better job, but this one comes the closest. I speak from both personal experience and professional opinion, if that means anything.
My point is that digital rubbing or something rubbing/moving against the lens is (I believe) required to do a "proper" lens cleaning. If you were to fill your sink with
dish detergent and only soak the dishes, but not rub them, would they come out as clean??? Your other alternative is using a dishwasher (ultrasonic cleaning unit to us optiminds or the like). To actually clean the dishes better than dish soap and rubbing would require a very highly potent solvent. If a no rub contact lens solution were to clean as well as a digital rub would you want this in your eye??? Mullo
OK, now we have products that we can just spray on our showers, and never have to clean them. Right....
We can also just dump soap on ourselves (liquid, mind you), stand under the shower and we will have clean bodies and clean hair. No extra toil.
I do believe that the no-rub products are good for non-compliant patients, but where do we stop re-inforcing good hygiene habits to you patients. I still that educating them is important and that includes digitally rubbing the lens, even if they choose to use a no-rub multipurpose product.
I had a patient come in yesterday, wearing a non-disposable, non-frequent replacement soft lens, that she had been fit with by another practitioner. She was originally fit years ago, and was aware of the multi levels of lens care that was SOOOOOO much trouble in the past and just changed on her own accord a couple years ago to a multipurpose solution. That also meant that she stopped using an enzyme product as well, because the bottle stated "ALL IN ONE". She stated that she was concerned that her lenses weren't as comfortable as they used to be, and certainly didn't last as long. I inspected them, and they were awful...calcium deposits, discoloration, and protein deposits. Upon flipping her lids, you can imagine what I saw as well.
The lens wasn't the problem, and her former practitioner wasn't the problem. The problem was the solution, which is marketed to the consumer everywhere. They read the instructions, and feel that they are doing a great thing by changing to an "ALL IN ONE" product, that is SOOOO much simpler.
Do I believe that Non-rubbing products are good or bad. Bad in the wrong hands. Let's look at our patients in a year that have been using the products with absolutely no rubbing and check any changes in their lids and the condition of their lenses.
Just my thoughts.
Diane
My sentiments exactly.....Gimme a G...Gimme a P...Gimme a C....what do they have??Originally posted by Diane:
Do I believe that Non-rubbing products are good or bad. Bad in the wrong hands. Let's look at our patients in a year that have been using the products with absolutely no rubbing and check any changes in their lids and the condition of their lenses.
Diane [/I]
Mullo
[This message has been edited by mullo (edited 03-10-2001).]
GPC is unlikely with a 2 week replacement. I have seen it, but in cases where the previous practioner was negligent in teaching care or the patient was abusing the lenses and wearing them EW or for extended periods of time.
Alcon's study of 2 week wearers showed zero patients that came down with GPC (No, I get nothing from Alcon or have any affiliation with them). I recently had a kid come in with moderate GPC that the MD had just put in CL's and had not even said anything about it. Just goes to prove that MD's know dick about fitting CL's.
Back to the topic, Alcon does a great job for 2 week or even 1 month.
Am I missing something here, peroxide disinfectants I know about, peroxide cleaners, I am unaware of.
Chip
Peroxide "systems", no one said anything about peroxide cleaners....MulloOriginally posted by chip anderson:
Am I missing something here, peroxide disinfectants I know about, peroxide cleaners, I am unaware of.
Chip
All our solutions are own-branded, so you'll have to excuse my ignorance here. Is this the one where the case fizzes, because it has a widgety thing in the bottom?
No, that is Aosept by Cibavision. The "no rub" solution is a multipurpose/one step non-peroxide system. It is supposed to clean your lenses without any actual digital rubbbing. Everyone loves a little rub now and then. Even old codgers....Mullo
[This message has been edited by mullo (edited 03-10-2001).]
Mullo: You didn't read all the posts, UtahOD, mentioned peroxide cleaners.
I must have had my eyes closed during that one....I stand corrected. My regards, Mullo
I just read an article stating that not all "No-Rubs" are the same. No-Rub implies to cleaning only. If lenses are not digitally rubbed, disinfection is not efficient with all solutions. AOSept, not a no-rub, was rated the highest for disinfection with Alcon Opti-Free No-Rub second right behind them. The other no-rubs were rated pretty far behind. Additionally, some multi-purpose brands, not Opti-Free, had some type of negative chemical reaction when the formulas switched to multi-purpose, requiring additional preservatives be added which may affect sensitive patients who never had a problem before.
Have been told that the instructions on No-Rub say:
"Rinse for 20 seconds." Patient is going to use a lot of solution and just as much time as rubbing if this is true.
Now: " As to why not store the lenses in saline for that matter?" Saliene Grows fungus. Just open a new bottle product lens, take the cap off, put the cap back on without removing the lens, or putting anything into the bottle. Re-cap the bottle and look at it in 3 days, you will find black fungus spots growing in the bottom of the bottle. Never store lenses in unpreserved saline unless the container is autoclaved after sealing.
Chip
Some of the bottles also say "Rinse twice." This will also use a lot of solution if the patient bothers to read the directions or the dispenser takes the time to tell them.Have been told that the instructions on No-Rub say:
"Rinse for 20 seconds." Patient is going to use a lot of solution and just as much time as rubbing if this is true.
NO rub solution is like a power wash to your car. Lots of water and extra cost to power wash.
But a quick rub with a rag will get the car cleaner quicker and cheaper.
Harry
no rub
:hammer: If no one has figure it out by now, the no rub is just another gimmick manufactured by some one to take care of basic laziness, which seems to be more inherent with the younger crowd, as there too busy with their active lifestyles, or so the buzz word goes.
.....Anyone seen that commercial on tv with the young lady who has herpes. She is just too damm busy in her active lifestyle(which i presume is spreading herpes) to have to take a pill 4 times a day. So, what happens, someone gets smart and develops one that only has to be taken twice a day. Now little miss active lifestyle has more time to philander around, because society certainly would not want to waste any of her precious time eridicating a social disease.
......So there you have it my friends, dont mess with them people with the active lifestyles, they aint got the time and they sure don,t care.
Great Topic, but know matter how much we explain the "proper" procedure to our patients.... they only "hear" what they "what" to hear "it says NO Rub!!
We have to remember that most patients don't use solutions the way they were marketed to used. They will "extend" the life span of a bottle as long as they can; rather than spending 5-10$ per month on a new bottle.
I still recommend digital cleaning; and explain that NO Rub is like a "fire hose" method, 5 seconds per side per lens before storing and then again before insertion. As if the patients going to do this. Probably quicker just to RUB!!!
My best advice is always followed up by explaining and pointing out pictures on the posters that they've been looking at around my office.
Still get a kick out of the patients that want daily wear and keep them for 2 years and when I ask what solutions they use they say @#$% (MPS); I ask if they do protien removal and they say NO its in the bottle. As if the bottle has enough powerful protein removal to take care of lenses that are that old; I explain how powerful tablets in the little case with solution is more powerful. But sometimes I'm just wasting my breath (but at least they can't say I didn't tell them) People look for the easiest route.
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