Despite their established disinfection and safety benefits, the use of hydrogen peroxide (H2O2) lens care systems among today's wearers of reusable contact lenses remains low in comparison with multipurpose solution (MPS) use. Multipurpose solution systems, however, present several potential drawbacks that may impact patient outcomes, including the use of chemical preservatives for disinfection, biocompatibility issues, and challenges with respect to lens care compliance. Given their unique composition and mechanism of action, one-step H2O2 systems offer the opportunity to avoid many of the challenges associated with MPS use. This article reviews the evolution of H2O2 lens care systems and examines the current scientific and clinical evidence regarding the relative ease of use, lens and tissue compatibility, disinfection efficacy, and ocular surface safety of H2O2 systems. Evaluation of the available data indicates that in comparison with MPS, one-step H2O2 systems tend to promote more favorable compliance, efficacy, comfort, and ocular surface outcomes for a wide range of contact lens–wearing patients. Based on the current published evidence, the authors recommend that eye care practitioners consider making one-step H2O2 systems their first-line contact lens care recommendation for most wearers of reusable lenses.
Office of the Vice President for Research (J.J.N.), The University of Alabama at Birmingham, Birmingham, AL; School of Optometry (J.J.N.), The University of Alabama at Birmingham, Birmingham, AL; Clinical Trial Consultant (R.L.C.), Atlanta, GA; School of Optometry (K.D.) University of California Berkeley, Berkeley, CA; Clinical Research Scientist and Consultant (K.D.), Berkeley, CA; School of Optometry and Vision Science (L.J.), University of Waterloo, Waterloo, ON, Canada; Centre for Ocular Research & Education (L.J.), University of Waterloo, Waterloo, ON, Canada; Internal Clinics (C.W.L.), The Eye Center, Southern College of Optometry, Memphis, TN; Clinical Development & Medical Affairs, North America (M.M.M.), Alcon, a Novartis Company, Fort Worth, TX; Department of Ophthalmology and Visual Sciences (L.S.-F.), Case Western Reserve University, Cleveland, OH; and Contact Lens Service (L.S.-F.), University Hospitals Eye Institute, Cleveland, OH.
Address correspondence to Jason J. Nichols, O.D., M.P.H., Ph.D., F.A.A.O., The University of Alabama at Birmingham, AB 714A, 1720 2nd Avenue South, Birmingham, AL 35294-0107; e-mail: email@example.com
J. J. Nichols has received compensation for consulting and research from Alcon, a Novartis company, research from Johnson & Johnson Vision Care, Inc., research from Bruder Healthcare, consulting and research from Shire Plc, research from Oculus, Inc., and research from TearScience. R. L. Chalmers has received compensation for consulting from Alcon, a Novartis company and AcuFocus, Inc., and research support from CooperVision, Inc., and Johnson & Johnson Vision Care, Inc. K. Dumbleton has received compensation for consulting from Alcon, a Novartis company. L. Jones (or his research group) has received research support or lectureship honoraria from the following companies: Advanced Vision Research, Alcon, a Novartis company, Allergan, Inc., Contamac, CooperVision, Inc., Essilor International S.A., GL Chemtec International, Ltd., Inflamax Research, Johnson & Johnson Vision Care, Inc., Nature's Way, Novartis International A.G., Ocular Dynamics, LLC, Oculus, Inc., Safilens S.R.L., Santen Pharmaceutical Co., Ltd., Shire Plc, TearLab Corporation, and TearScience. He has also received compensation for serving as a consultant and/or on an advisory board from Alcon, a Novartis company, CooperVision, Inc., Johnson & Johnson Vision Care, Inc., and Novartis International A.G. C. W. Lievens has received compensation for consulting from Alcon, a Novartis company, and Transitions Optical, Ltd. M. M. Merchea is an employee of Alcon, a Novartis company. L. Szczotka-Flynn has received compensation for consulting and research from Alcon, a Novartis company, Johnson & Johnson Vision Care, Inc., and Coopervision, Inc.
Editorial and administrative support was provided by BioScience Communications (New York, NY) through funding provided by Alcon, a Novartis company (Fort Worth, TX).
Accepted July 01, 2018