Hydrogen Peroxide – the Forgotten Cleaning System
Hydrogen peroxide was introduced as a contact lens maintenance system in the mid 1980s. At this time, it was seen as a major breakthrough in contact lens cleaning and disinfection, as previously patients had been required to use heat disinfection (which usually led to signification contact lens degradation and deposition) or chemical systems that incorporated preservatives such as thiomersal or chlorhexidine (which often led to adverse reactions from the eyes). Hydrogen peroxide eliminated the problems of both the thermal systems (due to better lens cleaning) and the chemical systems (due to being preservative free).
Just as hydrogen peroxide was about to become the first choice for contact lens maintenance, disposable contact lenses were launched onto the market in the late 1980s. In conjunction with this, there were new multipurpose chemical systems developed which incorporated preservatives with a higher molecular weight such that they would not be retained in the contact lens and so they would be less likely to cause any problem to the eyes. Consequently, the use of hydrogen peroxide decreased significantly to the point that for the next 20 years or so less than 10% of contact lens wearers were using hydrogen peroxide to look after their lenses.
Over the last 5 years, there has been resurgence in the use of hydrogen peroxide for contact lens maintenance, especially with the increased use of silicone hydrogel contact lenses which do tend to deposit more due to the incorporation of silicone into the lens material. Hydrogen peroxide is a great problem solver and we are using it more and more in our practice. It has excellent disinfection properties and it is very effective in helping to minimize the degree of protein and lipid deposition on the contact lens surface.
Even though a hydrogen peroxide system involves a little bit more work for contact lens wearers, it is interesting to note that a recent paper in Contact Lens Spectrum by Sarah Guthrie, Kathy Dumbleton and Lyndon Jones showed that hydrogen peroxide users – when compared to contact lens patients who used multipurpose solutions – were more compliant with respect to returning to their contact lens practitioner at shorter intervals, not switching from the lens care brand recommended by their practitioner, not “topping-up” their cleaning solution and replacing their contact lens case within the recommended three months.