A comparison of one-step peroxide systems

The challenges surrounding contact lenses and lens care have been longstanding. Lately, our attention has been drawn toward the astonishing number of patients who drop out of contact lens wear each year. The consistent challenge is that these patients typically do not complain during their exam, yet they end up dropping out due to discomfort. Unfortunately, we may not find out until years down the road, when they return to renew their glasses prescription.

In light of this, it is important that we use our influence during the exam to recommend lens care products that will positively influence their wearing experience. Peroxide systems have long been credited with superior cleaning capabilities, leading to better overall patient satisfaction.

H2O2: What's behind the bubble?

Brand loyalty is another challenge with established wearers, but according to a 2013 survey, Alcon Clear Care users were more loyal than those using any other lens care brand.¹ Clinically, it is certainly rare to have a peroxide user return to a multi-purpose solution. Another major challenge in lens care is compliance, but one report from Kathy Dumbleton showed that 100 percent of peroxide users (Clear Care) were compliant with overall lens care practices, while only 37 percent of multi-purpose solution users were compliant.²

Peroxide users buy nearly two times more solution throughout the year, substantiating this vast difference in compliance.³ Presumably, patients would be similarly compliant with other one-step peroxide systems, partly, because we, as eye care providers, spend more time educating patients on compliance when a peroxide system is recommended. We inherently know the value of a peroxide system, but now with new systems on the market, what are the differences and similarities among them?

Disinfection

Though hydrogen peroxide breaks down into simple water and oxygen, it is a powerful disinfectant with oxidizing capabilities. Hydrogen peroxide is lipid soluble. It enters the cell easily and delivers rapid destruction via hydroxyl free-radicals.^4-6 While biofilms are a growing concern, research has shown that peroxide is more effective against these encapsulated microorganisms than multi-purpose solutions.⁷ Hydrogen peroxide (3%) continues to have a broad spectrum of antimicrobial activity with a quick kill time and limited resistance.

Bausch + Lomb PeroxiClear uses carbamide as a platinum-modulating compound (PMC). A PMC occupies sites on the platinum disc, temporarily blocking it from interacting with and neutralizing the peroxide for approximately 60 minutes. Data shows this technology to expose microbes to higher levels of peroxide, despite the shorter neutralization time. Ultimately though, the microbes are typically destroyed within the first few minutes, and the overall kill rate (of the microbes tested) is virtually the same between both PeroxiClear and Clear Care.⁸