Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Canada.
Cont Lens Anterior Eye. 2021 Oct;44(5):101432. doi: 10.1016/j.clae.2021.02.018. Epub 2021 Mar 5.
Reusable soft daily wear contact lenses (CLs) remain popular and were fit to just over half of all wearers in the most recent international CL prescribing survey. Unlike daily disposable CLs, reusables require cleaning and disinfecting after every use, along with storage in a CL case. These additional requirements add a number of steps to the daily wear and care routine, increasing the opportunities for CL wearers to exhibit non-compliant behaviour. The impact of non-compliance ranges from poor lens comfort through to potentially sight-threatening infective keratitis. The coronavirus pandemic has refocused the profession on the importance of hand hygiene in particular, and the need for promoting safe CL wear in general. This review summarises typical non-compliant behaviour related to reusable CLs, and examines strategies and opportunities to better support wearers. Patient education has a central role in encouraging compliant behaviour, although patient recall of information is low, and personal belief systems may result in continuation of non-compliant behaviour despite awareness of the risks. CL care solutions are required for the daily disinfection of lenses, however misuse of multipurpose solutions (MPS) and hydrogen peroxide (HO)-based care systems can challenge their ability to be fully efficacious. Standard efficacy testing is reviewed, with consideration of how well current protocols model real-world use of CL solutions. Although some recommendations are in place for the inclusion of additional variables such as lens cases, CL materials, organic soil and efficacy against Acanthamoeba, opportunity still exists to reevaluate global standards to ensure consistency of testing in all markets. Finally, potential future innovations are discussed which may further support increased safety in reusable lens wear through novel antimicrobial additions to both CL materials and cases.
可重复使用的软性日常佩戴隐形眼镜（CL）仍然很受欢迎，在最近的一项国际隐形眼镜处方调查中，超过一半的佩戴者选择了可重复使用的隐形眼镜。与日抛型隐形眼镜不同，可重复使用的隐形眼镜在每次使用后需要清洁和消毒，并储存在隐形眼镜盒中。这些额外的要求增加了日常佩戴和护理的步骤，增加了隐形眼镜佩戴者不遵守规定的行为的机会。不遵守规定的影响范围从镜片舒适度差到潜在的威胁视力的感染性角膜炎不等。冠状病毒大流行使整个行业重新关注手部卫生的重要性，以及普遍推广安全隐形眼镜佩戴的必要性。这篇综述总结了与可重复使用的隐形眼镜相关的典型不遵守规定的行为，并探讨了改善支持佩戴者的策略和机会。患者教育在鼓励遵守规定的行为方面起着核心作用，尽管患者对信息的记忆能力较低，而且个人信仰系统可能导致尽管意识到风险，但仍会继续不遵守规定的行为。隐形眼镜护理解决方案是每天对镜片进行消毒的必要条件，但是多用途溶液（MPS）和基于过氧化氢（HO）的护理系统的错误使用可能会影响其完全有效的能力。本文回顾了标准的功效测试，并考虑了当前的协议如何很好地模拟隐形眼镜护理解决方案的实际使用情况。尽管已经提出了一些建议，包括将镜片盒、隐形眼镜材料、有机污垢和针对棘阿米巴的功效等附加变量纳入其中，但仍有机会重新评估全球标准，以确保所有市场的测试一致性。最后，讨论了潜在的未来创新，这些创新可能通过在隐形眼镜材料和镜片盒中添加新型抗菌剂，进一步提高可重复使用隐形眼镜佩戴的安全性。
