Please note that the comments below are representative of remarks made in the chat room, and do not necessarily reflect the views of the moderators, the guest expert, or the GPLI.

• One-step regimens do not clean adequately and may cause irritation.
   
• Supraclens works well with GP lenses.
   
• The concept of a one-bottle system was to improve compliance, and it has, except because they don't work the results are a lot of compliant patients with dirty lenses.
   
• One step regimens have also encouraged patients to give up the rub step.
   
• Rubbing the lens is important even if the patient is using liquid enzyme.
   
• To match the patient to the correct regimen: first, have a few to choose from. "One size does NOT fit all." A good variety includes a one step with enzyme, a two step with Miraflow, aggressive enzyme and non aggressive. When you have a patient in front of you, it's important to give them an opportunity to have a voice in the decision. Studies have shown that patients are most compliant when they have a say in the care that is chosen for them.
   
• Most of the participants have GP patients enzyme their lenses.
   
• In-office polish -- every six months.
   
• Papain enzymes are preferred, some reactions noted with subtillisin.
   
• Miraflow is an excellent cleaner, some restrict use to in-office only. It must be rinsed thoroughly and quickly.
   
• Care systems must be discussed at every visit -- patients often 'drift away' from the fitter's instructions and must be re-educated.
   
• Regimen for a dry-eyed patient: clean with Boston..soak in Barnes/Hind or Novaclens, insert with non-preserved artificial tears.
   
• Always start the dry-eyed patient on lid scrubs.
   
• The wrong make up (slight allergy) or remover (oily) can mess up a fit.
   
• Punctal occlusion should be considered for dry-eyed GP wearers.
   
• Less problem with warpage these days: stiffer new materials and stressing cleaning in the palm of the hand.
   
• For teens & young patients keep the regimen simple and talk looks, not health, and put everything in writing!

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