![]() Hydrogen-peroxide (H 2O 2) solutions are effective against all common ocular microbes, including Acanthamoeba, and they have been proven safe with proper compliance. Some CL MPS contain both PQ-1 and PHMB, but no increased risk of adverse events has been reported when combining the two. PQ-1 and PHMB are likely safe when used with CLs, but they may cause ocular adverse events, with roughly equal risk between the two preservatives. ![]() Modern, high-molecular-weight preservatives, including polyquaternium-1 (PQ-1) and biguanides (PHMB), are generally effective against bacteria, minimally effective against fungi, and not effective against Acanthamoeba. Results: This review found that first-generation preservatives are no longer used in CL multipurpose solutions (MPS) due to their high levels of ocular toxicity. Methods: Manuscripts written in English were obtained by searching with the term contact lens plus antimicrobial, benzalkonium chloride, biguanide, Aldox, polyquaternium, preservative, thimerosal, EDTA (ethylenediaminetetraacetic acid), chlorhexidine, or blister pack. The purpose of this review is to summarize the current knowledge related to the use of common ophthalmic preservatives in CL care products with respect to both safety and efficacy. Purpose: Preservatives are essential for preventing contact lens (CL)-related microbial keratitis (MK). Chelsea S Bradley, 1 Lindsay A Sicks, 1 Andrew D Pucker 2ġIllinois College of Optometry, Chicago, IL, USA 2School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USAĬorrespondence: Andrew D Pucker Email ![]()
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