Reviews Supplements The CL Infiltrate Thing : Page 1

OF EW VI RE OPTOM ET R Y The CL Infi ltrate Thing By Milton M. Hom, OD, FAAO, FACAAI(Sc) D uring late spring of 2010, I stood with Tom Kislan, OD, on the poster fl oor of the sacred neutral ground at The Association for Research in Vision and Ophthalmology (ARVO) annual meeting, as we were bombarded with ques-tions about our poster. At the time, I wondered how I got into such a fi restorm. When we presented our data, I had no idea that this issue would remain such a hot topic in con-tact lenses for years to come. Yes, it was controversial, but I did not think I would still be writing about it almost three years later. So, what am I talking about? I call it “the infi ltrate thing,” and much has been written on the subject. In the following pages, I would like to review the literature and hopefully help you, the clini-cian, make sense of it. First Things First The underlying question here is, “Is there an association between corneal infi ltrates and specifi c contact lens care prod-ucts?” In 2009, Diec et al. re-ported on a prospective study of 765 patients using peroxide, polyhexamethylene biguanide (PHMB) and polyquaternium (PQ)-Aldox (myristamidopro-pyl dimethylamine)-based lens care solutions. 1 They found that PQ-Aldox solutions had a higher rate (10.2%) of signifi -cant corneal infi ltrative events (CIEs) than peroxide (0.7%) or PHMB (4.6%), but they did not fi nd that lens type made a sig-nifi cant diff erence. 1 That same year, Carnt and colleagues found a higher incidence of symptomatic CIEs in a meta-analysis of 558 patients for OPTI-FREE RepleniSH Contact Solution (Alcon) over Clear Care Cleaning and Disinfecting Solution (Alcon) ( p =0.01) and OPTI-FREE EXPRESS MPDS Lasting Comfort Formula (Alcon) ( p =0.01). 2 The highest incidence of symptomatic CIEs Release Date: April 2013 Expiration Date: March 31, 2014 Goal Statement: Complications with contact lens wear is not a new issue for optometrists. Soft lens complications have decreased over the years, but eye-care practitioners and their patients can take simple measures to prevent them as well as minimize the risk of their recurring. This continuing education activity will examine the incidence of corneal infiltrates with con-tact lenses and lens care systems and discuss the importance of recommending appropriate contact lens and lens case cleaning regimens. Faculty/Editorial Board: Milton M. Hom, OD, FAAO, FACAAI(Sc) Credit Statement: This course is COPE approved for 2 hours of CE credit. COPE ID is 37221-CL. Please check your state licens-ing board to see if this approval counts toward your CE require-ment for relicensure. Joint-sponsorship Statement: This continuing education course is joint sponsored by the University of Alabama School of Optometry and Bausch + Lomb. Disclosure Statement: Dr. Hom has disclosed having direct financial and/or proprietary interests in Bausch + Lomb, Allergan, AMO, SARcode and TearScience. REVIEW OF OPTOMETRY APRIL 15, 2013 1

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