Do you re-use daily disposable contact lenses? I used to do this a lot, but now I’m not sure if it is safe. There is a belief that cheaper daily disposable contact lens (DDCL) are medically suitable and in fact identical to the regular lenses, which could be used for up to two weeks at a time. Is this true today, and what’s happened so far? Let's take a look at what you should know about disposable contact lenses and if it is safe to re-use them.
The Issue
The controversy started way back in the 1990s, actually. Back then, Bausch & Lomb were accused of repackaging their "OptimaFW"daily disposable contact lens (DDCL) as an extended-wear lens called "Medalist", and later as "SeeQuence2" disposable model, the latter two having cheaper prices than the original branding. Eventually, this repackaging, the price differences and the way contact lens practitioners were trained, resulted in a lawsuit. Bausch & Lomb were basically sued for selling the same product under three different names, and at three different prices. By February 1995, Bausch & Lomb were in settlement talks. They settled in August 1996, agreeing to provide up to US$68 million to their customers, half of this in cash and half of it in products.
Not long later in 2001, Vistakon – a division of Johnson & Johnson – settled a consumer rights lawsuit concerning contact lenses. The class-action lawsuit bore accusations that the marketing methods for Acuvue lenses was misleading. Mind you, it wasn't a lawsuit about quality or safety – it was about marketing methods. Johnson & Johnson eventually went into a settlement with the many plaintiffs, including the State of California. The amount of money allegedly scammed went into hundreds of millions of dollars.
At the end of the day, these two cases were settled, so there was no court ruling that the manufacturers committed any wrongdoing, and there is no admission from the manufacturers about this either. However, apart from anecdotal evidence of the purely spoken word of contact lens practitioners, there is some evidence out there that DDCLs in the early 2000s are probably no different from two-week lenses. Take for example, this 1999 submission for FDA approval for Vistakon's DDCL:
The statements from Vistakon and the Center for Devices and Radiological Health both say quite explicitly:
"Eye care practitioners may prescribe the lens either for single-use disposable wear or frequent/planned replacement wear with cleaning, disinfection and scheduled replacement. When prescribed for frequent/planned replacement wear, the lens may be disinfected using a chemical disinfection system only."
Even today, the downloadable inserts for Acuvue continue the marketing of saying their DDCLs should only be single use but they do not actually say that they cannot be re-used. Ultimately, they leave it to the Eye Care Professionals to prescribe the duration of use, and say “never wear lenses beyond the period recommended by the Eye Care Professional”.
Unsurprisingly, therefore, there are still people today who continue to re-use DDCLs by storing them in lens cases using fresh injections of saline, usually those marketed as being able to clean or disinfect the lens.
Well, I have to admit that I myself used to re-use my lenses for up to five continuous days, and sometimes I would use them for one day, keep them, and use them again only 10 days later.
Is this safe?
The Considerations
The Johnson & Johnson case was not about the DDCLs having different inherent quality or safety issues from longer-use lenses. Instead, Johnson & Johnson were accused of creating a false impression that the two types of lenses were different, in order to charge more for one label than the other. Underlying this, was the accusation that both types of lenses were chemically, physically and medically identical - but that was never proven in court.
First of all, re-using lenses is inherently dangerous, regardless of what type of lens you use. This is the reason longer-wear lenses used to have to be disinfected from time to time. People need to be taught – and even reminded – of basic lens hygiene. These are not irrelevant side issues, because if people ignore such basics, it doesn’t matter whether they re-use their DDCLs - the danger level is already so high as to make no difference. So, are you already practicing good contact lens hygiene? Do you wash your hands with soap and water and dry them with a clean, lint-free cloth before removing contact lenses? Do you take care to prevent tap water from coming into contact with your soft lenses? Do you make sure your lens solution is always fresh and never re-used? Do you wash your lens case with solution instead of water, and use it for no more than three months? If you're not carefully following all these steps, you're already putting yourself in danger! If you are not, there is no point thinking if it is safe to re-use DDCLs, or whether you can afford the risk - you are already at-risk of eye infections or other injury from lens misuse.
Secondly, available technology changes over time. The lawsuits are more than 10 years old. Technology could move with the times. Here's an example, concerning lens-wetting materials (humectants).
"In the early 2000s, lens-wetting technology started with DDCLs. DDCLs such as Acuvue used additives (e.g., polyvinylpyrrolidone, aka "PVP") embedded into the lens material. These are slowly squeezed out by blinking, and help in end-of-day comfort. Within a few short years, hyaluronic acid was used as an additive for two-week lenses and eventually a 1% copolymer 845 was used for silicone hydrogel lenses. PVP was added to Acuvue Advance and Acuvue Oasys."
What does all this technical mumbo-jumbo mean? It means that when some technology is invented that makes one type of lens better, it can develop to apply to other types of lens.
Thirdly, just because technology can become available, doesn’t mean it necessarily will be applied everywhere. Anti-protein surface treatments, lens thicknesses and materials, cleaning/disinfection solutions, humectant technology, are all not guaranteed to be applied equally across lenses of all types of duration.
The Conclusion
At the end of the day, the first question should be “what difference does it make considering my current state of contact lens hygiene”? If my lens hygiene is already seriously bad, I should be worrying about other things.
If my lens hygiene is good, I might consider re-using DDCLs, but even so, I would be very careful not to use them for more than a week. The idea that DDCLs can be safely re-sued stems partly from possible outdated or inapplicable models of lens technology, so be very careful at all times, and always, always clean the lens cases. The word of the contact lens manufacturers is one thing. The fact that they lay ultimate responsibility on your eye care professional, however, means that the manufacturers simply cannot accept any responsibility should you be injured by re-using DDCLs.
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