Contact lenses contamination by Acanthamoeba spp. in Upper Egypt.

BACKGROUND: Acanthamoeba spp. are one of the free-living amoeba that spread worldwide causing keratitis. Owing to the increase in the use of lenses, whether for medical or cosmetic purposes, the incidence of disease increases every year. Contamination of the lenses with the Acanthamoeba trophozoites or cysts may lead to eye infection and cause sight-threatening keratitis in human. We isolated Acanthamoeba spp. from new lenses, used lenses, and contact lens disinfecting solutions and identified them based on morphological characteristics and molecular test. METHODS: New and used lenses and contact lens disinfecting solutions were cultured on monogenic media. Light and scanning electron microscope was used to identify Acanthamoeba spp. morphological features. Genotype identification was also evaluated using PCR sequencing of 18S rRNA gene specific primer pair JDP1 and JDP2. RESULTS: A hundred samples were examined, 29 (29%) were infected with Acanthamoeba spp. That belonged to two strains of Acanthamoeba (Acanthamoeba 41 and Acanthamoeba 68). 18S rRNA of the Acanthamoeba 41 had 99.69% sequence identity to Acanthamoeba castellanii clone HDU-JUMS-2, whereas Acanthamoeba 68 had 99.74% similar pattern to that of Acanthamoeba sp. isolate T4 clone ac2t4 that are morphologically identified as Acanthamoeba polyphaga. The obtained data revealed that the isolated strains belong to T4 genotype that was evolutionarily similar to strains isolated in Iran. CONCLUSIONS: Cosmetic lenses and disinfectant solutions are a major transmissible mode for infection. This genotype is common as the cause of Acanthamoeba keratitis. To avoid infection, care must be taken to clean the lenses and their preservative solutions and prevent contamination with the parasite.

Microbiome analysis of contact lens care solutions and tear fluids of contact lens wearers: Possible involvement of streptococcal antigens in allergic symptoms related to contact lens wear.

The present study elucidated the pathogenesis of allergic symptoms (AS) related to contact lens (CL) wear by assaying CL care solutions in lens storage cases and tears from subjects with AS using molecular biology techniques. A total of 15 CL storage cases were collected from subjects with AS (n=9) and healthy, asymptomatic control CL wearers (n=6). Bacterial populations in CL care solutions and tears were assayed by culture and 16S rDNA sequencing. Histamine levels in tears were measured by high­performance liquid chromatography. Western blot analysis was performed to identify the bacteria recognized by tear IgE from subjects with AS. No significant differences were found in the culture results between the subjects with AS and asymptomatic subjects. Histamine was detected in 2 subjects with AS. Meta­16S rDNA sequencing identified a cluster of 4 subjects with AS that were distinguished from others by principal coordinate analysis. Detailed population analysis revealed that the abundance of Gram­positive bacteria in the microbiomes of CL care solutions used by the subjects with AS were higher than those of asymptomatic subjects (42.24±9.47 vs. 16.85±22.76% abundance). Among these, Streptococcus was the dominant genus (12.1­18.3% abundance). Tear microbiome analysis revealed that the abundance of Streptococcus in the subjects with AS was significantly higher than that in other subjects (19.02±5.50 vs. 3.08±3.35%, P<0.01). Western blot analysis demonstrated that the tear IgE in all subjects with AS reacted with Streptococcus (100%), but not with Staphylococcus. On the whole, these results provide novel insight into the pathogenesis of AS and identify Streptococcus as an important factor in AS associated with CL wear.

Physicochemical stability of contact lenses materials for biomedical applications / Estabilidad fisicoquímica de los materiales de las lentes de contacto, para aplicaciones biomédicas

PURPOSE: The physicochemical stability, thermal and water plasticizing effect on transport properties of contact lenses (CL) were analyzed to verify its capacity to maintain the original properties after being dehydrated and rehydrated. METHODS: Two daily disposable (nesofilcon A and delefilcon A) and two monthly CL (comfilcon A and lotrafilcon B) were used. Measurements of refractive index (RI), water content (WC), chemical structure and thermal properties were taken: new (N), after dehydration (D) and rehydrated (R). RI and WC were accessed using a digital automated refractometer (CLR-12-70). Chemical structure was evaluated by a Fourier Transformed Infrared Spectroscopy (FTIR-ATR) and Differential Scanning Calorimetry (DSC) with a calorimeter (Mettler Toledo DSC-821). RESULTS: The FTIR spectrum of N, D and R was quite similar for all CL, with higher differences observed in the transmission between 3500-3000cm−1 due to the hydroxyl group (OH). After dehydration and rehydration, there were no significant changes in the chemical structure. RI and WC of the CL rehydrated did not vary significantly from the initial CL (p > 0.05) and thermal properties also confirm that the behavior did not change. It was observed that the glass-transition temperature decrease with increased WC. CONCLUSIÓN: No significant alterations were observed in the physicochemical structure of the materials after dehydration and rehydration showing a good stability of their components. The strong water plasticizing effect in the silicone hydrogel lens materials improves flexibility and chain mobility and may should be considered for other biomedical applications

OBJETIVO: Se analizaron la estabilidad fisicoquímica, las propiedades térmicas y el efecto plastificante en las propiedades de transporte de las lentes de contacto (LC), para verificar su capacidad de mantener sus propiedades originales tras la deshidratación y rehidratación. MÉTODOS: Se utilizaron dos lentes de contacto desechables diarias (nesofilcon A y delefilcon A) y dos mensuales (comfilcon A y lotrafilcon B). Se realizaron medidas del índice de refracción (IR), contenido de agua (CA), estructura química y propiedades térmicas: nuevas (N), tras la deshidratación (D) y tras la rehidratación (R). Se accedió a IR y CA utilizando un refractómetro digital automatizado (CLR-12-70). La estructura química se evaluó mediante Espectroscopía de infrarrojos con transformada de Fourier (FTIR-ATR) y Calorimetría diferencial de barrido (DSC) con un calorímetro (Mettler Toledo DSC-821). RESULTADOS: El espectro FTIR de N, D y R fue bastante similar para todas las LC, observándose mayores diferencias en la transmisión entre 3500-3000cm−1 debido al grupo hidroxilo (OH). Tras la deshidratación y rehidratación no se produjeron cambios significativos en la estructura química. Los valores IR y CA de las LC rehidratadas no variaron significativamente con respecto a la LC inicial (p > 0,05), y las propiedades térmicas confirmaron también que el comportamiento no experimentó cambio alguno. Se observó que la temperatura vidrio-transición disminuía al incrementarse WC. CONCLUSIÓN: No se observaron alteraciones significativas en la estructura fisicoquímica de los materiales tras la deshidratación y rehidratación, reflejando una buena estabilidad de sus componentes. El fuerte efecto plastificante del agua en los materiales de las lentes de hidrogel de silicona mejora la flexibilidad y la movilidad de la cadena, debiendo considerarse esta circunstancia para otras aplicaciones biomédicas

A novel 3D-printed solid phase microextraction device equipped with silver-polyaniline coated pencil lead for the extraction of phthalate esters in cosmeceutical products.

A screw-based portable and simple solid phase microextraction device was fabricated by a 3D printer and used in combination with the developed silver-incorporated porous polyaniline film pencil lead solid-phase microextraction fiber (Ag/PANI SPME). Scanning electron microscopy revealed a porous structure of the electrodeposited Ag/PANI film. The spectrum from energy dispersive x-ray spectroscopy (EDS) and the elemental map confirmed the presence of silver in the porous polymer film. It was used under stirring for the extraction of five phthalate esters: dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), benzyl butyl phthalate (BBP) and di-2-ethylhexyl phthalate (DEHP). The extracted solution was identified and quantified by gas chromatography using a flame ionization detector (GC-FID). Under the optimum conditions of the developed method, a good linearity was obtained in a concentration range of 5.0-1000 µg L-1 for all five phthalate esters with limits of detection (LODs) of 4.41 ±â€¯0.91 µg L-1, 3.98 ±â€¯0.92 µg L-1, 3.65 ±â€¯0.74 µg L-1, 4.91 ±â€¯0.52 µg L-1 and 4.25 ±â€¯0.66 µg L-1 for DMP, DEP, DBP, BBP and DEHP, respectively. The developed method provided good precision when tested with standard solutions (RSD < 5.5%, n = 6) and real samples (RSD < 3.4%, n = 6). Good fiber-to-fiber reproducibility was also confirmed by extraction with six newly prepared fibers; recoveries ranged from 81.09 ±â€¯0.54% to 92.92 ±â€¯0.46% with RSD <6.6%. The developed method was used to determine phthalate esters in 14 cosmeceutical samples. In rubbing alcohol samples, DEP and DEHP were detected at 7.03 ±â€¯0.76 µg L-1 and 5.89 ±â€¯0.53 µg L-1, respectively, while in contact lens cleaners, DEHP was found in a concentration range from 5.3 ±â€¯1.1 µg L-1 to 6.8 ±â€¯1.2 µg L-1. No phthalate esters contamination was detectable in saline solutions, eye cleaners and antibacterial disinfectant liquids. Recoveries in the range of 81.92 ±â€¯0.99% to 102.4 ±â€¯1.1% indicated the good accuracy of the developed method.

Analysis of polyhexamethylene biguanide and alexidine in contact lens solutions using capillary electrophoresis, ultra-performance liquid chromatography and quadrupole time of flight mass spectrometry.

Polymeric biguanides, as well as quaternary ammonium compounds, are ubiquitous antimicrobial agents in healthcare. Due to the highly cationic and polymeric nature of these compounds and the complex matrices in which they are found, the analytical characterization of products containing them remains challenging. In this work an efficient, sensitive, and high-resolution separation protocol was developed to perform quantitative measurements (sub-mg L-1) of alexidine dihydrochloride (ADH) and polyhexamethylene biguanide (PHMB) in commercial multipurpose contact lens solutions (MPS). Initially, contactless conductivity (C4D) detection was explored, but lacked adequate selectivity and sensitivity to quantify PHMB or ADH in commercial MPS. To overcome these limitations, an alternative approach using solid phase extraction (SPE) followed by separation with reversed phase ultra-performance liquid chromatography (RP-UPLC) was developed for both ADH and PHMB separation and detection. The most sensitive and reliable method investigated utilized standard additions to compensate for matrix effects. For ADH, concentration values measured with the presented method were consistent with data provided by the MPS manufacturer (1.6 mg L-1) within 0.10 mg L-1. PHMB quantification in MPS products was successful at concentrations <1 mg L-1 with quantitative reproducibility better than 2% RSD. Comparison of blind sample testing using the RP-UPLC method showed strong correlation (R2 = 0.939) of PHMB concentrations with results obtained by the United States Food and Drug Administration using a published HPLC-Evaporative light scattering detection (ELSD) assay. A significant advantage of this method is the ability to partially resolve PHMB polydispersity, which to date has been minimally studied and explained. By coupling with electrospray mass spectrometry (MS), a general trend was observed for increased retention as a function of PHMB chain length. The improved robustness and reproducibility of UV detection versus ELSD coupled with the superior resolving power of UPLC is an asset to the detection and characterization of PHMB and ADH. In addition to quality control of MPS, this method has potential application to the analyses skin wipes, wound dressings and other medical products where understanding how manufacturing processes lead to differences in polydispersity is important to maximize the antimicrobial properties while minimizing toxicologic effects.

Hydrogel Contact Lens Water Content is Dependent on Tearfilm pH.

Introduction: Based on clinical inferences, investigators theorized in situ soft lens hydration was linked to the precorneal tearfilm pH. Methods: Forty-one myopic subjects at Fort Rucker, AL, USA were fitted with one of two types of extended-wear soft contact lenses, and were followed quarterly for a period of 33 mo. The anterior soft contact lens surface pH was measured in situ, while the in vitro lens water content was measured immediately after lens removal, using a hand-held refractometer on one lens, and a gravimetric means of hydration measurement on the other lens. Results: The in situ pH increased logarithmically across extended wearing time, reaching an asymptote at approximately 5 d' wearing time at a pH of 7.45 ± 0.03. Lens water content was shown to similarly decrease at an inversely logarithmic rate, leveling off at 4-5 d' extended wearing time. Both means of hydration assessment correlated well with each other across days' extended wearing time (R = 0.98; p < 0.0001). Discussion: A log-log dual conversion yielded significantly different linear slopes (p < 0.001), based on a multifactorial analysis of both lens types, by the pH, and by their water content. The differing ionic status of each material accentuated their varied polar attraction characteristics. Two soft lenses, identical in all patient-based parameters, could provide differing oxygen availability, as well as differing physical fits in patients of identical physical characteristics, as a result of their unique tearfilm pH differences. Conclusion: The in situ hydrogel lens water content is directly dependent on the precorneal tearfilm pH.

A polypyrrole-chitosan cryogel stir-bead micro-solid phase extractor for the determination of phthalate esters in contact lenses storage solutions and in artificial saliva in contact with baby teethers.

Phthalate esters (PAEs), especially dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), di-2-ethylhexyl phthalate (DEHP) are widely used as plasticizers in plastics and polymers. They are not chemically bound and can easily migrate into food and human tissue that comes into contact with these materials. The method developed in this work was applied for the preconcentration and determination of these four phthalate esters that might leach from contact lenses and baby teethers. A novel stir-bead micro-solid phase extractor of chitosan cryogel composited with polypyrrole with a steel wire core was evaluated for the extraction of DMP, DEP, DBP and DEHP before analysis by high performance liquid chromatography (HPLC). Scanning electron micrographs of the polypyrrole-chitosan cryogel beads revealed a high porosity with large surface area. Under the optimum conditions, the developed method provided a good linearity in a concentration range from 10 to 750 ng mL-1 for DMP and from 5.0 to 750 ng mL-1 for DEP, DBP and DEHP. The limits of detection (LOD) were 6.07 ± 0.22 ng mL-1, 4.358 ± 0.097 ng mL-1, 4.408 ± 0.099 ng mL-1 and 3.916 ± 0.053 ng mL-1 for DMP, DEP, DBP and DEHP, respectively, and the method reproducibility was good (n = 6, % RSD < 6.0). DBP and DEHP were detected in two original storage solutions of contact lenses from 13.2 ± 1.1 ng mL-1 to 15.4 ± 1.9 ng mL-1 and from 21.3 ± 1.6 ng mL-1 to 23.5 ± 1.5 ng mL-1, respectively. In the artificial saliva in contact with baby teether samples only DEHP was found, from 4.91 ± 0.31 ng mL-1 to 6.78 ± 0.23 ng mL-1, with good recoveries ranging from 81.3 ± 8.4% to 106.3 ± 5.2%.

Repertoire of free-living protozoa in contact lens solutions.

BACKGROUND: The repertoire of free-living protozoa in contact lens solutions is poorly known despite the fact that such protozoa may act as direct pathogens and may harbor intra-cellular pathogens. METHODS: Between 2009 and 2014, the contact lens solutions collected from patients presenting at our Ophthalmology Department for clinically suspected keratitis, were cultured on non-nutrient agar examined by microscope for the presence of free-living protozoa. All protozoa were identified by 18S rRNA gene sequencing. RESULTS: A total of 20 of 233 (8.6 %) contact lens solution specimens collected from 16 patients were cultured. Acanthamoeba amoeba in 16 solutions (80 %) collected from 12 patients and Colpoda steini, Cercozoa sp., Protostelium sp. and a eukaryotic more closely related to Vermamoeba sp., were each isolated in one solution. Cercozoa sp., Colpoda sp., Protostelium sp. and Vermamoeba sp. are reported for the first time as contaminating contact lens solutions. CONCLUSION: The repertoire of protozoa in contact lens solutions is larger than previously known.

Acanthamoeba spp. in Contact Lenses from Healthy Individuals from Madrid, Spain.

PURPOSE: Acanthamoeba keratitis (AK) is a painful and potentially blinding corneal infection caused by Acanthamoeba spp. In Madrid, environmental studies have demonstrated a high presence of these free-living amoebae in tap water. Since most of AK cases occur in contact lenses (CL) wearers with inadequate hygiene habits, the presence of Acanthamoeba in discarded CL has been studied and compared with other common etiological agents of keratitis, such as Pseudomonas aeruginosa and Staphylococcus aureus. METHODS: One hundred and seventy-seven healthy individuals from Madrid contributed their discarded CL and answered a questionnaire on hygiene habits. DNA was extracted from the CL solution and analyzed by real-time PCR for Acanthamoeba, Pseudomonas aeruginosa and Staphylococcus aureus. These CL and their solutions were also cultured on non-nutrient agar to isolate Acanthamoeba. RESULTS: Among the 177 samples, Acanthamoeba DNA was detected in 87 (49.2%), P. aeruginosa DNA in 14 (7.9%) and S. aureus DNA in 19 (10.7%). Cultivable amoebae, however, were observed in only one sample (0.6%). This isolate was genotyped as T4. The habits reported by this CL owner included some recognized risk factors for AK, but in this study only the practice of "not cleaning the CL case" presented some statistical significant association with Acanthamoeba DNA presence. Detection of the investigated bacterial DNA did not demonstrate statistical significant association with the studied practices, but the presence of P. aeruginosa revealed a possible inhibition of Acanthamoeba in these samples. CONCLUSIONS: The PCR results suggest a high presence of Acanthamoeba spp. in healthy CL wearers from Madrid, but we can assume that CL solutions are properly disinfecting the CL since only 1.1% of the positive PCR samples correspond to viable amoebae and, after four years, only one participant reported stronger ocular problems. Nevertheless, more studies are necessary to corroborate this hypothesis.

Effect of the osmolarity change in multipurpose solutions induced by an improper contact lens case cleaning procedure.

PURPOSE: To determine whether variations in multipurpose disinfecting solution (MPDS) storage osmolarity from inappropriate contact lens (CL) case cleaning affect ocular surface integrity and wearer comfort. METHODS: There were twenty contact lens cases (study CLCs) in the study group. Ten were filled with ReNu Multiplus(®) and 10 with SoloCare Aqua™ (MPDS-1 and -2, respectively) and kept closed for 8h; the cases were then emptied and kept open for air-drying for 16h. This procedure was carried out every day for two months. Storage solution osmolarity was measured on days 0, 15, 30, 45 and 60. Ten subjects were then fitted with both month-old lenses stored in the study CLCs and with new lenses stored in new cases with fresh solution for 24h (control CLCs). Symptoms, tear osmolarity and percentage of subjects whose conjunctival hyperaemia and ocular surface staining scores changed were determined after 1h of wear. RESULTS: Study CLC osmolarity increased in both solutions after two months (p<0.05). For MPDS-1 there were differences in stinging between study CLCs and control CLCs after 10min of CL wear (p=0.04), and in comfort after 10 (p=0.035) and 60min wear (p=0.042). Significant (p<0.05) differences between study CLC and control CLC groups were also found for MPDS-2 in limbal hyperaemia (study: 50% change; control: 0% change) and bulbar and corneal staining (study: 80% change; control: 20% change). CONCLUSION: The stored-MPDS osmolarity increase caused by air-drying the CLCs could affect the ocular surface. This increase might reduce lens wear comfort.

Near-infrared spectroscopy for the detection and quantification of bacterial contaminations in pharmaceutical products.

Accurate detection and quantification of microbiological contaminations remains an issue mainly due the lack of rapid and precise analytical techniques. Standard methods are expensive and time-consuming being associated to high economic losses and public health threats. In the context of pharmaceutical industry, the development of fast analytical techniques able to overcome these limitations is crucial and spectroscopic techniques might constitute a reliable alternative. In this work we proved the ability of Fourier transform near infrared spectroscopy (FT-NIRS) to detect and quantify bacteria (Bacillus subtilis, Escherichia coli, Pseudomonas fluorescens, Salmonella enterica, Staphylococcus epidermidis) from 10 to 10(8) CFUs/mL in sterile saline solutions (NaCl 0.9%). Partial least squares discriminant analysis (PLSDA) models showed that FT-NIRS was able to discriminate between sterile and contaminated solutions for all bacteria as well as to identify the contaminant bacteria. Partial least squares (PLS) models allowed bacterial quantification with limits of detection ranging from 5.1 to 9 CFU/mL for E. coli and B. subtilis, respectively. This methodology was successfully validated in three pharmaceutical preparations (contact lens solution, cough syrup and topic anti-inflammatory solution) proving that this technique possess a high potential to be routinely used for the detection and quantification of bacterial contaminations.

Microbial contamination of soft contact lenses & accessories in asymptomatic contact lens users.

BACKGROUND & OBJECTIVES: With increasing use of soft contact lenses the incidence of contact lens induced infections is also increasing. This study was aimed to assess the knowledge of new and existing contact lens users about the risk of microbial contamination associated with improper use and maintenance of contact lenses, type of microbial flora involved and their potential to cause ophthalmic infections. METHODS: Four samples each from 50 participants (n=200) were collected from the lenses, lens care solutions, lens care solution bottles and lens cases along with a questionnaire regarding their lens use. The samples were inoculated onto sheep blood agar, Mac Conkey's agar and Sabouraud's dextrose agar. Organisms were identified using standard laboratory protocols. RESULTS: Overall rate of microbial contamination among the total samples was 52 per cent. The most and the least contaminated samples were found to be lens cases (62%) and lens care solution (42%), respectively. The most frequently isolated contaminant was Staphylococcus aureus (21%) followed by Pseudomonas species (19.5%). Majority (64%) of the participants showed medium grade of compliance to lens cleaning practices. Rate of contamination was 100 and 93.75 per cent respectively in those participants who showed low and medium compliance to lens care practices as compared to those who had high level of compliance (43.75%) (P<0.05). INTERPRETATION & CONCLUSIONS: Lens care practices amongst the participants were not optimum which resulted into high level contamination. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required.

The role of multi-purpose solutions in prevention and removal of lipid depositions on contact lenses.

The sorption and desorption of radiolabeled dipalmitoylphosphatidylcholine (DPPC) and cholesterol (CH) were measured on 5 types of commercial contact lenses. The lenses were soaked in vitro in an artificial tear fluid for 16h. The effects of borate buffered saline and two commercial multi-purpose lens-care solutions (MPSs) on reducing the lipid (DPPC and CH) sorption and increasing the lipid removal were examined. The results showed that silicone hydrogel (SiHy) lenses accumulated the most lipids, sorbing over an order of magnitude more than polymacon, a conventional hydrogel lens. Pre-soaking the SiHy lenses for 16h in MPSs reduced the DPPC sorption by up to 13% and the CH sorption by up to 11%, compared to controls that were not pre-soaked. However neither these reductions nor those on polymacon were statistically significant (p>0.05). In sorption experiments without presoaking, subsequent exposure to the MPSs removed some DPPC from the lenses (0-3.1% for SiHy lenses and 14-55% for polymacon), but CH removal was 0.0-0.8% for SiHy lenses and 0.6-28% for polymacon lenses. Some of these removals were statistically significant (p<0.05).

Drug resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolated from contact lenses in Karachi-Pakistan.

BACKGROUND: The contaminated contact lens provides Pseudomonas aeruginosa an ideal site for attachment and biofilm production. Continuous contact of the eye to the biofilm-infested lens can lead to serious ocular diseases, such as keratitis (corneal ulcers). The biofilms also prevent effective penetration of the antibiotics, which increase the chances of antibiotic resistance. METHODS: For this study, 22 Pseudomonas aeruginosa isolates were obtained from 36 contact lenses and 14 contact lens protective fluid samples. These isolates were tested against eight commonly used antibiotics using Kirby-Bauer disk diffusion method. The biofilm forming potential of these isolates was also evaluated using various qualitative and quantitative techniques. Finally, a relationship between biofilm formation and antibiotic resistance was also examined. RESULTS: The isolates of Pseudomonas aeruginosa tested were found resistant to most of the antibiotics tested. Qualitative and quantitative biofilm analysis revealed that most of the isolates exhibited strong biofilm production. The biofilm production was significantly higher in isolates that were multi-drug resistant (p < 0.0001). CONCLUSION: Our study indicates that multi-drug resistant, biofilm forming Pseudomonas aeruginosa isolates are mainly involved in contact lens associated infections. This appears to be the first report from Pakistan, which analyzes both antibiotic resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolates from contact lens of the patients with contact lens associated infections.

The refractive index of contact lens saline solutions.

PURPOSE: The aim of this study was to measure the refractive index of three readily available contact lens saline solutions in order that these values could be used in a calculation to convert back vertex power measured in saline to its corresponding power in air. METHOD: Using an automatic digital refractometer, measurements were made daily for 31 days at 20°C and at a wavelength of 589.3nm of the refractive index of fifteen bottles from different manufacturing batches of each of the three saline solutions. RESULTS: For AMO LENS PLUS™ OcuPure™, BAUSCH & LOMB Sensitive Eyes™ Plus Saline Solution and Sauflon saline, the mean values of refractive index were 1.33458, 1.33465 and 1.33470, respectively. The standard deviation for each solution was 0.00001 and the range of the measured values of refractive index of the three solutions over the test period did not exceed 0.00005. CONCLUSIONS: It is proposed that when calculating back vertex power in air from measurements made in a wet cell that refractive index values for AMO LENS PLUS™ OcuPure™, BAUSCH & LOMB Sensitive Eyes™ Plus Saline Solution and Sauflon saline of 1.3347, 1.3348 and 1.3348, respectively be used for focimeters operating at a wavelength of 587.56nm and values of 1.3361, 1.3362 and 1.3362, respectively when a wavelength of 546.07nm is used.

Silicone hydrogel lens-solution interaction and inflammation.

Daily wear of silicone hydrogel (SiHy) lenses using marketed lens care solutions results in varied levels of anterior eye inflammation. There are several pathways that may lead to corneal and conjunctival inflammation that include mechanical, allergic, and pathogen driven stimuli. The hypotheses and evidence for these various models of inflammation will be discussed in the context of SiHy lens designs and materials and lens care solution components.

The effect of contact lens materials on disinfection activity of polyquaternium-1 and myristamidopropyl dimethylamine multipurpose solution against Staphylococcus aureus.

OBJECTIVES: This study examined the interaction of seven different lens materials with a multipurpose solution (MPS) containing the disinfectants polyquaternium-1 (0.001%) and myristamidopropyl dimethylamine (0.0005%). The objective of this study was to determine whether the different lens materials affect the concentration of a disinfectant in this commercially available MPS and the efficacy of the disinfectant against Staphylococcus aureus. METHODS: Silicone hydrogel lenses (galyfilcon A, senofilcon A, comfilcon A, enfilcon A, balafilcon A, and lotrafilcon B) and a conventional hydrogel lens (etafilcon A) were soaked in polypropylene lens cases filled with commercially available MPS containing 0.001% polyquaternium-1 and 0.0005% myristamidopropyl dimethylamine for 6, 12, 24, 72, and 168 hours. Empty lens cases were also filled with MPS. After each time point, solutions from cases containing the seven types of lenses and controls were assayed for activity against S. aureus according to International Standards Organization 14729 standard with modifications. Test solutions were analyzed for polyquaternium-1 and myristamidopropyl dimethylamine concentration at each time point. RESULTS: The concentration of polyquaternium-1 and myristamidopropyl dimethylamine remaining in the lens cases was reduced only slightly over time. Storage with the lenses did not adversely affect biocidal efficacy of the solution, and in some cases, it was significantly better (P=0.0029). CONCLUSION: The efficacy of this polyquaternium-1 and myristamidopropyl dimethylamine MPS to kill S. aureus was not adversely affected by the presence of lens materials soaking in the cases. Thus, current methods for performing solution antimicrobial testing should be reevaluated.

The effects of contact lens materials on a multipurpose contact lens solution disinfection activity against Staphylococcus aureus.

OBJECTIVES: To determine the effect of 8 different lens materials on polyhexamethylene biguanide (PHMB) concentration in multipurpose solution (MPS) levels over time and to determine the effect of lenses on lens solution microbial efficacy over time. METHODS: Silicone hydrogel lenses and conventional hydrogel lenses were soaked in polypropylene lens cases filled with contact lens MPS containing 1 ppm PHMB for 6, 12, 24, 72, and 168 hours. Cases filled with the same solution without lenses were controls. After each time period, solutions from cases with the 8 types of lenses and controls were assayed for activity against Staphylococcus aureus according to International Organization for Standardization-14729 with modifications. Solutions were analyzed for PHMB concentration at each time point. RESULTS: Some of the different lens materials significantly affected the PHMB concentration (P<0.0001) and the biocidal efficacy. Etafilcon A lenses significantly decreased PHMB levels after only 6 hours of lens soak time. The product lot of MPS used was also significant (P<0.0001). Enfilcon A, senofilcon A, and lotrafilcon B lenses did not significantly decrease PHMB levels. CONCLUSIONS: The efficacy of MPS was affected by some lens materials and PHMB concentration. Lens materials differ in their effect on PHMB concentration and the subsequent efficacy of the MPS. Over time, some lens materials can significantly reduce the PHMB concentration and the MPS's microbial activity against S. aureus.

Impact of contact lens materials on multipurpose contact lens solution disinfection activity against Fusarium solani.

OBJECTIVE: To investigate the effects of eight different soft contact lenses on disinfection efficacy of a multipurpose solution (MPS) containing polyhexamethylene biguanide (PHMB) against Fusarium solani. METHODS: Six silicone hydrogel lenses (galyfilcon A, senofilcon A, comfilcon A, enfilcon A, balafilcon A, and lotrifilcon B) and two conventional hydrogel lenses (polymacon and etafilcon A) were placed in polypropylene lens cases filled with MPS containing 0.0001% PHMB and soaked for 6, 12, 24, 72, and 168 hours. After each interval, depleted MPS from lens cases were removed and assayed for activity against F. solani according to International Organization for Standardization (ISO) 14729 stand-alone procedure. A portion was aliquoted for chemical analysis. RESULTS: Soaking etafilcon A, balafilcon A, and polymacon lenses for 6 hours reduced the concentration of PHMB in MPS by more than half the stated labeled concentration, with concentrations below the limit of detection for etafilcon A-depleted and balafilcon A-depleted solutions after 12 and 72 hours of soaking, respectively. Except for comfilcon A-depleted solutions, all others failed to consistently obtain one log reduction of F. solani. The solutions soaked with etafilcon A, balafilcon A, and polymacon lenses for 24 hours or more lost all or almost all fungicidal activity against F. solani. CONCLUSIONS: Over time, the disinfectant uptake by some lenses can significantly reduce the PHMB concentration and the fungicidal activity of the MPS against F. solani. Current ISO methodology does not address the reduction in microbiocidal efficacy when lenses are soaked in MPS. The ISO committee should consider adding "soaking experiments" to quantify the effect that contact lens materials have on the performance of MPSs.

Microbial contamination of contact lens storage cases and domestic tap water of contact lens wearers.

Contact lenses have been widely used as an alternative to spectacles both in developed and developing countries. However, under certain circumstances, adverse responses can occur during contact lens wear and several microorganisms--including bacteria, fungi, and free living amoebae--can cause several eye infections in wearers. Extended wear of contact lenses is the major risk factor of eye infections such as microbial keratitis, besides contaminated contact lens storage case, contaminated lens care solutions, and inaccurate contact lens handling. In this study, we collected contact lens storage case and domestic tap water samples from 50 asymptomatic contact lens wearers. We determined that total aerobic mesophilic bacteria were isolated in 45 (90 %), Gram negative rod bacteria were isolated in 20 (40 %), Pseudomonas spp. were isolated in 2 (4 %) and fungi were isolated in 18 (36 %) out of 50 contact lens storage cases. Free living amoebae were not detected in investigated contact lens storage cases. At the same time, out of 50, total aerobic mesophilic bacteria were isolated in 34 (68 %), fungi were isolated in 15 (30 %) and free living amoebae were isolated in 15 (30 %) domestic tap water samples. No Gram-negative rod bacteria and Pseudomonas spp. were detected in investigated water samples. Two contact lens case samples and two tap water samples were excluded from the analysis for Pseudomonas spp. for technical reasons. According to our findings, inadequate contact lens maintenance during lens wear may result in the contamination of contact lens storage cases. This situation can lead to severe eye infections in contact lens wearers over time.