Introduction

1. Impact of Mechanical Rubbing on the Effectiveness of No-Rub Contact Lens Solution Protein Removal: Part One of a Two-Armed In Vivo Study William Park, M.D.1, Matthew Welch, B.S.2, Peter Russo, O.D.1 1 Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 2 Stritch School of Medicine, Loyola University Medical Center, Maywood, IL Discussion References Introduction Methods Results • This is a two-armed, randomized, prospective study. • Study components include: Arm 1: Completion of a survey of lens use/patient education history. Arm 2: Protein quantification following use of no-rub solution for a 2- or 4-week duration of wear. • Subjects were randomized to daily lens cleaning with mechanical rubbing with one lens; the contralateral served as a control. • Total protein extraction and analysis using bicinchoninic acid analysis is ongoing. • To date: • 24 subjects • 7 males and 18 females • Aged 23-56 years (mean 26.8) • Ophthalmologist/optometrist provided lens care education: Verbally (15 patients) With demonstration (10) Written instructions (4) Direct observation (8) No education given (5) Read solution instructions (6) • Frequency of mechanical lens rubbing (patient reported) Daily (2 patients) 4 times weekly (2) 3 times weekly (1) Twice weekly (2) Once weekly (2) None (15) • This study suggests lens care education is variably provided by eye care professionals. • This likely contributes to sub-optimal soft contact lens hygiene and increased tear protein deposition. • The second arm of this study will add protein quantification data (by bicinchoninic acid assay) to adjunct survey results. • Comparison of protein accumulation with and without mechanical rubbing will allow for improved patient education, providing optimum comfort and lens hygiene. Baines MG, Cai F, Backman HA. Adsorption and removal of protein bound to hydrogel contact lenses. Optom Vis Sci 1990;67:807-10. Bohnert JL, Horbett TA, Ratner BD, Royce FH. Adsorption of proteins from artificial tear solutions to contact lens materials. Invest Ophthalmol Vis Sci 1988;29:362-73. Bontempo AR, Rapp J. Protein and lipid deposition onto hydrophilic contact lenses in vivo. CLAO J 2001;27:75-80. Borazjani R, Kilvington S. Effect of multipurpose contact lens solution on the survival and binding of acanthamoeba species in contact lenses examined with a no-rub regimen. Eye Contact Lens 2005;31:39-45. Gellatly KW, Brennan NA, Efron N. Visual decrement with deposit accumulation of HEMA contact lenses. Am J Optom Physiol Opt 1988;65:937-41. Gower LA, Stein JM, Turner FD. Compliance: a comparison of three lens care systems. Optom Vis Sci 1994;71:629-34. Grant T, Holden BA, Rechberger J, Chong MS. Contact lens related papillary conjunctivitis (CLPC): influence of protein accumulation and replacement frequency. Invest Ophthalmol Vis Sci 1989;30(Suppl):166. Guillon M, Maissa C. Clinical acceptance of two multipurpose solutions: MPS containing HPMC versus citrate-based MPS without rubbing. CLAO J 2002;28:186-91. Ichijima H, Kawai T, Yamamoto K, Cavanagh HD. Determination of protein deposits on RGP lenses by x-ray photoelectron spectroscopy. CLAO J 2000;26:18-20. Jung J, Rapp J. The efficacy of hydrophilic contact lens cleaning systems in removing protein deposits. CLAO J 1993;19:47-9. Keil JS. Protein removal from soft contact lens using disinfection/neutralization with hydrogen peroxide/catalytic disc. Clin Ther 1993;15:30-5. Keith D, Hong B, Christensen M. A novel procedure for the extraction of protein deposits from soft hydrophilic contact lenses for analysis. Curr Eye Res 1997;16:503-510. Leahy CD, Mandell RB, Lin ST. Initial in vivo tear protein deposition on individual hydrogel contact lenses. Optom Vis Sci 1990;67:504-11. Li S, Ladage P, Yamamoto T, Petroll W, Jester J, Cavanagh H. Effect of contact lens care solutions on surface exfoliation and bacterial binding to corneal epithelial cells. Eye Contact Lens 2003;29:27-30. McGrath D, Costanzo S, Manchester R, Kaiser J, Norton McC. Comparative antimicrobial activity of no-rub multipurpose lens care solutions in the presence of organic soil. Eye Contact Lens 2003;29:245-9. Miller MJ, Callahan DE, McGrath D, Manchester R, Norton SE. Disinfection efficacy of contact lens care solutions against ocular pathogens. CLAO J 2001;27:16-22. Mok KH, Wong BW, Lee V. Effectiveness of no-rub contact lens cleaning on protein removal: a pilot study. Optom Vis Sci 2004;81:468-70. Raali E, Vaahtoranta-Lehtonen HH, Lehtonen OP. Detachment of trophozoites of acanthamoeba species from soft contact lenses with BEN22 detergent, BioSoak, and Renu multi-purpose solutions. CLAO J 2001;27:155-8. Sweeney DF, Willcox MD, Sansey N, Leitch C, Harmis N, Wong R. Incidence of contamination of preserved saline solutions during normal use. CLAO J 1999;25:167-75. • Introduced in 2000 • Marketed as a new safeguard against soft contact lens contamination and protein accumulation. • To date, limited in vivo data is available about no-rub solution use and efficacy. • This study looks to evaluate the impact of patient education on cleaning habits as well as no-rub solution efficacy following in vivo lens use. Duration of Lens Wear (wks) Compared to Frequency of Mechanical Rubbing (wkly) Frequency of Mechanical Rubbing Compared to Lens Care Education 4 wks 2 wks Acknowledgements: Research supported by the Richard A. Perritt Charitable Foundation