Make Happier Custom Contact Lens Patients

Tangible Hydra-PEG, a coating for specialty (gas permeable/GP/scleral) lenses, was introduced in 2017, and now, virtually every GP lens lab offers it and virtually any GP lens material can be ordered with it. Tangible Hydra-PEG is a biocompatible polymer that is applied as a final step in the specialty lens manufacturing process to address the issues of surface wettability, friction, deposits and scleral lens fogging. The coating smooths over the roughness inherent in contact lens material and creates a lubricious, wettable layer that encapsulates the lenses. It is permanently bonded to the lens surface and effectively shields the tear film from the hydrophobic lens material.

To ensure the longevity of the coating and its benefits, coated lenses require a care regimen that is different from uncoated lenses. As a way to optimize the care and durability of coated lenses, the company recently introduced Tangible Clean, an FDA-cleared multi-purpose contact lens solution, that is ideal for coated lenses and can also be used with uncoated lenses. It has the ideal properties to protect coated contact lenses and ensure the coating’s benefits last as long as possible.

Used together, the two products can not only enhance the contact lens experience but also ensure that the coating’s benefits last as long as possible. We recently spoke with Dr. Tiffany Chen, OD, FAAO, with Rosemore Eye Care in Plano, Texas about how she is using Tangible Hydra-PEG and Tangible Clean multi-purpose solution together.

What are the biggest problems you see in your practice?

I would say dryness is the number one patient problem, especially in Texas where severe allergies and a windy environment can contribute to increased dry eye complaints. Patients with poor wetting of the contact lens and any patient with overall dry eyes make up a large part of my practice. A lot of my patients are middle-aged females who have moderate to severe dry eye because of hormonal changes, or who suffer from rheumatoid arthritis, Sjogren’s syndrome, or other autoimmune conditions that cause more dryness. The contact lens itself can cause dryness in certain patients, especially for heavy makeup wearers or scleral lens patients. These patients also frequently experience fogging of the contact lenses as a result. I give these patients instructions for a proper contact lens care regimen to help decrease fogging, but roughly 50% actually follow through with my recommended care. Generally, patients are compliant only to what is convenient for them, and adding extra steps to help with dryness and fogging is often forgotten or ignored. I’ve found that Tangible Hydra-PEG has helped a lot, both with decreasing fogging and reducing steps in lens care, thus increasing patient compliance.

How do you select patients for Tangible Hydra-PEG coated lenses?

I prescribe the coating to almost all gas permeable lens wearers with dry eyes. I almost always prescribe it if the patient is a middle-aged female or older, or if I see someone with eyelid disease. For any new patients, especially those adapting to corneal GPs for the first time, I automatically add Tangible Hydra-PEG. It makes lenses a lot easier and more comfortable to adapt to. I also use coated lenses for anyone with fogging issues, especially scleral lens wearers. This totals about 70% of my practice who get coated lenses.

I generally won’t add Tangible Hydra-PEG to lenses for a previous patient who doesn’t have coated lenses, isn’t complaining of anything with their current lenses, or whose contact lens surfaces look clean and clear. Younger patients are debatable – I probably won’t use with younger patients in corneal GPs, who have already adapted to the contact lens, or have really set ways of cleaning their contacts. Occasionally, I’ll encounter a patient who has had the same contact lens solution routine for years, using a two-step cleaning system with an abrasive cleaner, and prefers to keep it that way - I would not add the coating when ordering their new lenses.

What are the benefits of Tangible Hydra-PEG?

Comfort and fogging would be my top two benefits. With the coating, patients are no longer having a constant wetting problem on the front surface, and that helps with comfort. The coating is slippery, so it enables the eyelid to glide over the lenses a lot easier. The fact that it coats the entire contact lens solves a lot of problems. By reducing fogging, it can actually improve visual quality and increase wear time.

The patients who have coated lenses have fewer complaints when they come in. This makes for a quicker follow-up and finalization process with the lenses, and reduces chair time. Ultimately, it makes me really happy to hear patients excitedly tell me that they can wear their coated lenses for 12 hours a day without complaint – about 80% of whom have the Tangible Hydra-PEG coated lenses. This is compared to previously wearing the lenses for only six to eight hours at work and taking them off the second they get home.

You have been recommending Tangible Clean for your coated lens patients for a few months now – tell us about your experience.

I have been recommending the new Tangible Clean multi-purpose contact lens solution for most of my coated lens wearers, with positive overall feedback - a good amount of these patients have switched over their solution to Tangible Clean. A lot of my patients actually say that it makes a big difference; one of them even said it was a day and night difference.

That patient has really bad dry eyes and uses a variety of topical glaucoma medications, which cause more dryness. And because of all the ocular surface issues as a result of the glaucoma medications, he has really bad fogging, where his lenses fog up every 3 or 4 hours.  Where before he was cleaning and reinserting his lenses 2 or 3 times a day, after getting coated lenses and using the new cleaner, he’s now only cleaning his lenses once a day, if at all.

Being in Texas, the new cleaner has worked wonders for my patients who get fogging from the heat and humidity, even with coated lenses. It’s almost like the cleaner adds an additional layer to prevent or reduce fogging. The ease of use has also increased patient compliance with their lens care, since fewer solutions are needed to still provide a good and comfortable lens wearing experience.

Of all the patients I’ve started Tangible Clean on, only one or two patients didn’t notice a difference with Tangible Clean compared to another gas permeable cleaner.

We want to thank Dr. Chen for her dedication to the field of optometry, and for her support of coated lenses as part of her patient care regimen. Dr. Chen does not receive any financial support or honoraria from Tangible Science.

About Tiffany Chen, OD, FAAO

 Dr. Chen joined Rosemore Eye Care in Plano, Texas in 2017. She is licensed as both a therapeutic optometrist and an optometric glaucoma specialist in the state of Texas. She received a Bachelor’s degree in Psychology from the University of California, San Diego and a Doctorate of Optometry from the Southern California College of Optometry. She completed a rigorous optometric residency in Cornea and Contact Lenses at the University of Houston College of Optometry, which included a rotation through Baylor College of Medicine, Soper Brothers and Associates, Eye Excellence of Houston, and Slade and Baker Vision Center in Houston. She has been trained in managing ocular diseases during her time at Indian Health Services in Lawton, OK, San Diego Naval Hospital, and at the Veteran’s Affair CBOC in Sierra Vista, AZ.

Dr. Chen is a fellow of the American Academy of Optometry (FAAO) and a current member of the Northeast Texas Optometric Society (NETOS). She actively participates in InfantSEE, a program that gives eye exams free of charge for any infant younger than one year old.