Cytotoxicity and antimicrobial activity of six multipurpose soft contact lens disinfecting solutions.

OBJECTIVES: To assess and compare the cytotoxicity and antimicrobial activity of six multipurpose disinfecting contact lens solutions (MPDS). METHOD: Six MPDS were assessed and compared: MeniCare Soft, Complete Moisture Plus, Solo-Care Aqua, Opti-Free Express, ReNu MultiPlus and ReNuMoistureLoc. Cytotoxicity was evaluated by means of the colony-forming assay (ISO 10993-5) using one cell line. One hundred Chinese hamster's fibroblast V79 cells in 2 mL of medium were inoculated into 6-well plates and cultured for 24 h. After incubation, the medium was removed and 2 mL of each MPDS was diluted with physiological saline and medium and added individually into wells at 1.25, 2.5, 5 and 10% concentrations. After an additional 6 days of incubation, cells were fixed and stained with Giemsa solution. Subsequently, the number of colonies was counted. Cytotoxicity was expressed in terms of the concentration of the MPDS that suppresses colony formation. Antimicrobial activity was evaluated by means of the stand-alone contact lens disinfection test (ISO 14729). RESULTS: Cytotoxicity--MeniCare Soft and Complete Moisture Plus were not cytotoxic at any of the concentrations tested. The cytotoxicity ranking of the other MPDS was as follows: Solo-Care Aqua approximately equal to Opti-Free Express < ReNu MultiPlus < ReNu MoistureLoc. Antimicrobial activity--All MPDS met the primary criteria of the stand-alone test for bacterial species. ReNu MoistureLoc showed borderline values for Serratia marcescens and Staphylococcus aureus. Complete Moisture Plus failed to meet the stand-alone test criteria for Fusarium solani. CONCLUSIONS: Large differences in cytotoxicity and antimicrobial activity were found among the MPDS under investigation. Multipurpose disinfecting contact lens solutions with identical concentrations of polyhexamethylene biguanide can behave differently depending on solution formulation. The new MeniCare Soft showed effective antimicrobial activity and minimal cytotoxicity.     

Staphylococcus aureus causes acute inflammatory episodes in the cornea during contact lens wear

The aim of this investigation was to determine the ability of Staphylococcus aureus to cause keratitis during contact lens wear in the rabbit. Rabbits were fitted with hydrogel lenses and wore them on an extended wear schedule for 7 weeks. At the end of each week of wear, one drop of S. aureus was added to the eyes, and the eyes were monitored using slit lamp bio-microscopy, with subsequent microbial and histological studies of the cornea. In the presence of S. aureus, keratitis occurred after 3 weeks of lens wear, a condition that was characterized by diffuse infiltration of the peripheral cornea and limbal redness. In the absence of bacteria, there was no infiltration until week 6. Contact lens wear also prolonged the retention of bacteria in the eye. Extended contact lens wear and S. aureus caused non-ulcerative keratitis in a rabbit model, and disturbances in the ability of the eye to remove bacteria.     

Comparative efficacies of contact lens disinfecting solutions against Pseudomonas aeruginosa

Purpose: The aim of the present study was to evaluate the disinfection properties of multipurpose contact lens disinfection solutions, based on the International Organization for Standardization (ISO) 14729 guidelines. Methods: Three lots of each of six multi‐purpose solutions were tested as follows: Renu MultiPlus, Solo Care Aqua, All‐Clean Soft, Contact All‐in one Advanced, Hippia, Ginza multi‐purpose solution and 0.9% normal saline solution were inoculated with the standard strain of Pseudomonas aeruginosa (ATCC 9027). The surviving bacteria were quantified at specified times. An average logarithm reduction in bacterial numbers at the manufacturer's minimum recommended disinfection time was determined and compared with the criteria for stand‐alone disinfection products for each multi‐purpose disinfection solution against each bacterial strain. Results: Renu MultiPlus, Solo Care, All‐Clean Soft and Contact All‐in one Advanced were effective in achieving a four logarithmic units reduction in the bacterial count; however, Renu MultiPlus and Solo Care Aqua resulted in the greatest reduction in bacterial numbers. The other solutions were not effective against Pseudomonas aeruginosa after specified times. Conclusions: Generally, Renu MultiPlus, Solo Care Aqua, All‐Clean Soft and Contact All‐in one Advanced meet the ISO 14729 guidelines for stand‐alone contact lens solutions.     

Serotype and adhesion of Pseudomonas aeruginosa isolated from contact lens wearers

The purpose of the present study was to correlate the serotypes of Pseudomonas aeruginosa to the bacterial adhesion to contact lenses and human corneal epithelial cells. Twenty‐three strains isolated from contact lens wearers were used for the study. The bacterial serotypes were examined with a P. aeruginosa antisera kit. The attachment of bacteria on contact lenses or human corneal epithelial cells was determined by counting the number of adhered bacteria after incubation of the bacteria with contact lenses or corneal epithelial cells. The 23 ocular isolates belonged to seven serotypes. Strains of serotypes I, G and E were the three dominant serogroups and were more adhesive to contact lenses compared with other groups of the bacteria. The bacterial serotypes and the clinical sequelae were not strongly related. These results indicate that the surface characteristics of bacterial serotypes are related to the bacterial adhesion to the surface, but the pathogenesis of the bacteria may result from multiple factors.     

Cytotoxicity and effects on metabolism of contact lens care solutions on human corneal epithelium cells

Purpose: The aim was to determine the cytotoxic effects of three multipurpose solutions (MPS) on human corneal epithelial cells (HCEC) and to assess the metabolic rates of recovering cells at different levels of cell membrane damage. Method: The effects of one to 15 minutes exposure to multipurpose solutions containing polyquaternium‐1 (MPS‐A), polyaminopropyl biguanide (MPS‐B) and polyhexanide (MPS‐C) on HCEC were determined. Recovery rates at different levels of cell membrane damage were assessed after re‐culture for two hours at 37°C. Cell viability and membrane integrity were assessed using Annexin V‐FITC/7‐AAD staining and flow cytometry. Effects of concentrations of 10 to 40 per cent multipurpose solutions on the metabolic rate of recovering HCEC were assessed using a Vybrant MTT cell proliferation assay kit. Results: The highest percentage of late necrotic cells resulted after exposure to MPS‐A compared with other solutions and the control (p < 0.001). The percentages of early necrotic cells after 10 and 15 minutes of soaking in MPS‐B were significantly higher than the control and other multipurpose solutions (p < 0.001). Although MPS‐C exposure also resulted in statistically significant higher percentages of early necrotic cells than the control (p < 0.005), these differences were small. No recovery was noted when HCEC treated with multipurpose solutions were re‐cultured, with numbers of dead cells in MPS‐B‐treated cultures increasing fourfold. The MTT assay showed significant dose‐response decreases of 500 nm absorbance for all MPS‐treated cells. In 40 per cent MPS‐A‐treated HCEC, lack of activity indicated the cells were non‐viable. Conclusions: Multipurpose solutions induced varying levels of irreversible tissue sensitivity reactions, with MPS‐A showing the greatest effects. The solutions damaged cell integrity and reduced metabolic rates suggesting delayed healing ability. The formulations of multipurpose solutions need to balance antimicrobial effectiveness with low cytotoxicity, which might not be currently possible to achieve. In light of our results, we suggest that contact lens wearers should be advised to rinse the soaked lenses with saline before lens insertion.     

Antifungal efficacy of soft contact lens disinfecting solutions against Fusarium solani and Candida albicans

Purpose: The aim was to evaluate the disinfection properties of six multi‐purpose contact lens disinfection solutions (MPDS) available in Iran against Fusarium solani and Candida albicans, based on the International Organization for Standardization (ISO) 14729 guidelines. Methods: Three lots each of six multi‐purpose solutions, namely, Renu MultiPlus, Solo Care Aqua, All‐Clean soft, Contact All In One Advanced, Hippia, Ginza Multi‐Purpose Solution and 0.9% normal saline solution were inoculated with standard strains of Fusarium solani (ATCC 36031) and Candida albicans (ATCC 10231). Surviving fungi were determined by counting colony‐forming units on recovery plates at specified times. The mean log reduction in fungal numbers at the manufacturer's minimum recommended disinfection time was determined and compared with the criteria for stand‐alone disinfection products for each MPDS against each fungal strain. Results: Renu MultiPlus, Contact All In One Advanced and All‐Clean Soft were effective in achieving the mean 1.0 log reduction in fungal numbers, based on ISO 14729 stand‐alone primary acceptance criteria. Solo Care Aqua failed to achieve the ISO 14729 stand‐alone primary acceptance criteria for Candida albicans. The other solutions were not effective against test microorganisms after the specified times. Conclusions: There were differences in the rates of disinfection efficacy. Generally, Renu MultiPlus, Contact All In One Advanced and All‐Clean Soft exceeded the primary acceptance criteria of the ISO 14729 guidelines for stand‐alone contact lens solutions.     

Compatibility of two new silicone hydrogel contact lenses with three soft contact lens multipurpose solutions*.

Purpose: The purpose of this study is to assess corneal staining and subjective symptom ratings with six different silicone hydrogel contact lens/multipurpose solution combinations, including the recently launched Menicon PremiO silicone hydrogel contact lens, after the first night of soaking the lenses in solution. Methods: This study is a prospective, single-centre, subject-masked, contralateral, crossover, daily wear clinical trial in which subjects were randomly fitted in the morning with a different lens/solution combination in each eye, asked to wear the lenses for the whole day (at least 12 h), soak each of the lenses overnight in one of the test solutions and insert the lenses on the following morning. Subjects were asked to come on that morning for assessment of corneal staining and subjective ratings. All subjects repeated this procedure on another two occasions in order to collect the results of the six different lens/solution combinations: Menicon PremiO/MeniCare Soft; Menicon PremiO/Complete 10; Menicon PremiO/OptiFree Express; Acuvue Oasys/MeniCare Soft; Acuvue Oasys/Complete 10; Acuvue Oasys/OptiFree Express. Results: Menicon PremiO lenses were associated with a lower level of corneal staining overall, and in the nasal and temporal locations, compared with Acuvue Oasys lenses (p < 0.05). No significant differences were found in corneal staining between solutions (p > 0.05). An overall rate of solution-induced corneal staining per eye of 12% was found. Symptoms were very similar among the six different lens/solution combinations (p > 0.05). Discussion: The lower level of corneal staining found with Menicon PremiO lenses compared with Acuvue Oasys lenses might be attributed to material, surface and design differences between lens types. The overall rate of solution-induced corneal staining and symptomatology found between the different lens/solutions combinations is consistent with previous studies.     

Effect of storage temperatures and time on the efficacy of multipurpose solutions for contact lenses

PURPOSE: To determine the effect of storage time and temperature on the efficacy of four multipurpose solutions for soft contact lenses. METHOD: Aliquots of multipurpose solutions (OPTI-FREE Express, ReNu MultiPlus, COMPLETE and SOLO-care) stored at different temperatures over a 3-month period, were challenged with contact lens-related ocular pathogens, Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. RESULTS: The results showed that OPTI-FREE Express had the best activity against Ps. aeruginosa at all temperatures; ReNu MultiPlus performed well at 25 degrees C; COMPLETE barely achieved activity requirements at all temperatures, and lost efficacy after 2 months. SOLO-care maintained its activity best against Ps. aeruginosa at 30 degrees C. Storage at fridge temperature reduced activity of all solutions. Regardless of storage temperature, activities of all solutions against S. aureus markedly decreased by 2 months. Only OPTI-FREE Express met FDA requirements against C. albicans. CONCLUSION: Performance of multipurpose solutions is affected by time and temperature of storage. Contact lens users should be aware that the efficacy of opened solutions may not be sustained for as long as 3 months. Manufacturers should reconsider their recommendations to further safeguard the ocular health of contact lens wearers.     

Detection of virulence factors in Serratia strains isolated from contact lens‐associated corneal ulcers

Purpose: This paper reports on the microbiological findings pertaining to three Serratia isolates from soft contact lens‐related corneal ulcers, which represent a complication of contact lens wear reported with increasing frequency. Methods: Bacterial identification and antibiotic susceptibility testing were performed using the Vitek system. Serratia’s ability to form biofilm, produce gelatinase, elastase and alkaline protease, and invade human corneal epithelial (HCE) cells was investigated. The isolates’ susceptibility to the following disinfectants was tested: (a) ReNu MultiPlus^®, containing polyaminopropyl biguanide 0.0001%; (b) Opti‐Free Express^®, containing polyquaternium‐1 0.001% and myristamidopropyldimethylamine 0.0005%; (c) Opti‐Free Replenish^®, containing polyquaternium‐1 0.001% and myristamidopropyldimethylamine 0.0005%, and (d) Oxysept Comfort^®, a one‐step 3% hydrogen peroxide‐catalase system. Results: Two Serratia marcescens and one Serratia liquefaciens were identified. All the strains were susceptible to aminoglycosides and fluoroquinolones. No isolate formed biofilm or significantly invaded HCE cells; all produced alkaline protease and gelatinase, but not elastase. Opti‐Free Express^® and Opti‐Free Replenish^® were active against S. liquefaciens, but failed to kill the S. marcescens isolates within the minimum recommended time (6 hours). ReNu MultiPlus^® needed 6 hours to kill one strain of S. marcescens, which is 2 hours more than recommended. Conversely, Oxysept Comfort^® was always effective within the minimum recommended time (6 hours). Conclusions: The ability to produce alkaline protease and gelatinase may play a major role in the pathogenesis of contact lens‐related Serratia keratitis. Several types of contact lens solutions may be ineffective in eradicating Serratia from contaminated contact lens cases within the minimum recommended time. Only exposure to Oxysept Comfort^® was always effective against Serratia in this study.     

软性角膜接触镜治疗角膜溃疡穿孔的临床观察

目的:观察软性角膜接触镜治疗角膜溃疡穿孔的临床疗效。方法:对24例24眼角膜溃疡穿孔的患者采用配戴软性角膜接触镜治疗。其中细菌性14例14眼,病毒性8例8眼,真菌性2例2眼。戴镜期间根据不同病因选择联合用药,角膜镜配戴1wk清洗,3wk更换,角膜愈合后摘镜,随诊复查。结果:角膜溃疡穿孔患者24例24眼戴镜后1～2d前房均形成,5～10d后角膜上皮覆盖,角膜基质层纤维网状支架形成,20～32d角膜溃疡愈合,穿孔区密闭良好。患者视力有不同程度提高。结论:软性角膜接触镜是一种安全有效的角膜溃疡穿孔的辅助治疗方法。     

In vitro and in vivo effects of a lubricant in a contact lens solution

PURPOSE: Physical properties and tear film function were investigated for a multipurpose contact lens solution containing the ocular lubricant hydroxypropyl methylcellulose (HPMC). METHODS: In the laboratory, wetting properties of multipurpose solutions with and without HPMC, and binding of HPMC to hydrogel lenses in vitro following an overnight soak, were measured. Tear physiology was evaluated in 35 hydrogel contact lens wearers using multipurpose solutions with and without HPMC. Pre-lens tear evaporation rate (TER), tear thinning time (TTT) and tear film structure (TFS) were recorded, and subjective responses were obtained. RESULTS: Laboratory measurements indicated improved wetting with the HPMC-containing solution, and continued release of HPMC from lenses after an overnight soak in the solution. Pre-lens TTT was longer (p < 0.001) and pre-lens TFS was improved (p = 0.034) with use of the HPMC-containing solution. Pre-lens TER and subjective comparisons did not demonstrate significant differences. CONCLUSIONS: In vitro and in vivo results are consistent with HPMC producing a thicker, longer-lasting layer of fluid on the hydrogel lens, leading to improvements in tear function in contact lens wearers.     

1g/L氟米龙滴眼液联合软性角膜接触镜治疗丝状角膜炎

目的：探讨1g/L氟米龙滴眼液联合软性角膜接触镜治疗丝状角膜炎的疗效。

方法：确诊丝状角膜炎患者30例45眼,随机分为治疗组16例23眼、对照组14例22眼。治疗组取出丝状物后配戴软性角膜接触镜,点糖皮质激素眼液(1g/L氟米龙滴眼液)和人工泪液(玻璃酸钠眼液); 对照组取出丝状物后仅使用人工泪液(玻璃酸钠眼液)点眼。随访3mo,比较两组疗效。

结果：治疗组患者临床治疗总有效率22眼(96%),明显高于对照组17眼(77%),差异有统计学意义(P=0.046),且发现未对眼压有明显影响。

结论：1g/L氟米龙联合软性角膜接触镜治疗丝状角膜炎有较好疗效。     

Effectiveness of mupirocin and polymyxin B in experimental Staphylococcus aureus,Pseudomonas aeruginosa,and Serratia marcescens keratitis

PURPOSE: The purpose of this study was to determine the effectiveness of mupirocin and polymyxin B, alone and in combination, in vitro and in vivo using rabbit models of, and keratitis. METHODS: Rabbit eyes were intrastromally injected with 1,000 colony-forming units (CFUs) of or or 100 CFUs of Rabbits were then treated with 2.7 mg/mL mupirocin, 10,000 U/mL polymyxin B, a mupirocin:polymyxin B combination, or 0.3% ciprofloxacin. Vehicle and untreated controls were also included. Treatment schedules depended on the strain injected. The number of CFUs was determined for all eyes after treatment. RESULTS: The mupirocin:polymyxin B combination was effective for all three genera both in vitro and in vivo. For keratitis, the mupirocin:polymyxin B combination was more effective than either drug alone and significantly reduced the log number of bacteria in the cornea by more than 3 logs compared with the vehicle or untreated controls (p 相似文献   

The Effect of Enzymatic Contact Lens Cleaning on Adherence of Pseudomonas aeruginosa to Soft Contact Lenses

Previous studies have demonstrated that Pseudomonas aeruginosa adheres more readily to soft contact lenses with a mucin coating than to unworn contact lenses. The mucin coatings that develop on soft contact lenses may, therefore, play a significant role in the pathogenesis of contact lens-associated Pseudomonas corneal ulceration. We tested the ability of a variety of enzymatic contact lens cleaners and other enzyme solutions to decrease the adherence of Pseudomonas to mucin-coated soft contact lenses. Of the commercially available solutions that were tested, cleaning with Optizyme® and Extenzyme® significantly reduced the adherence of Pseudomonas to the lenses, whereas cleaning with the Softmate Weekly Cleaning System® had no effect. Optizyme® and Extenzyme® were as effective as a 10% solution of acetylcysteine and more effective than a 0.25% trypsin solution. Neuraminidase at pH 5 was the most effective solution at reducing the adherence of Pseudomonas to the lenses, supporting the finding that sialic acid is a specific receptor for Pseudomonas aeruginosa. Soft contact lenses should be cleaned frequently with an effective enzymatic cleaner to reduce the likelihood of Pseudomonas adhering to the lens and thereby reduce the incidence of Pseudomonas corneal ulceration in soft contact lens wearers.     

配戴软性角膜接触镜对CCT和曲率的影响

目的：探讨配戴软性角膜接触镜(soft contact lens,SCL)对角膜中央厚度(central corneal thickness,CCT)、曲率的影响。方法：检测143例286眼配戴SCL患者的CCT、角膜地形图。154例308眼正常人为正常对照。比较连续配戴角膜接触镜不同年限患者和正常人的角膜厚度、角膜曲率的差异。结果：配戴SCL较短者(≤2a)的CCT与对照组相比并没有明显的变化;但戴镜时间超过2a的Ⅱ组和Ⅲ组与对照组及配戴SCL≤2a的Ⅰ组CCT相比时差异均有显著性(P<0.05);配戴SCL对角膜曲率无显著影响。结论：短期配戴SCL后角膜厚度尚无明显的变化,但随着戴镜时间的延长,角膜厚度逐渐变薄。而不论长期或者较短时间配戴SCL角膜曲率并无显著变化,但随着戴镜时间的延长角膜的不规则性有增加的趋势。     

治疗性软性角膜接触镜在翼状胬肉手术中的应用和评价

目的：评价翼状胬肉术后配戴治疗性软性角膜接触镜的术后反应和角膜创面的修复情况。

方法：将原发性单侧翼状胬肉患者88例100眼随机平均分成试验组和对照组(各50眼),两组均实施单纯翼状胬肉切除联合自体结膜移植术,试验组术后直接予以配戴治疗性软性角膜接触镜,对照组术后2d加压包扎术眼,两组术后均给予抗生素滴眼液和促进角膜创面修复眼药水点眼,观察术后患者角膜创面恢复情况及眼部刺激症状。

结果：试验组术后角膜创面愈合速度明显快于对照组,角膜刺激症状较对照组明显减轻且持续时间缩短。

结论：治疗性软性角膜接触镜能加速翼状胬肉术后角膜创面的修复,有效缓解患者的眼部刺激症状,并能提高医务人员工作效率,值得临床医师推广应用。     

Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus

Purpose

To evaluate the disinfectant properties of the three multipurpose contact lens disinfecting solutions available in Iran, against clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosaand Staphylococcus aureus, based on the international organization for standardization (ISO) 14729 guidelines.

Methods

Three multipurpose solutions that were tested were ReNu Multiplus, Solo Care Aqua and All-Clean Soft. The test solutions were challenged with clinical isolates and the standard strains of P. aeruginosa(ATCC 9027) and S. aureus(ATCC 6538), based on the ISO Stand-alone procedure for disinfecting products. Solutions were sampled for surviving microorganisms at manufacturer''s minimum recommended disinfection time. The number of viable organisms was determined and log reductions calculated.

Results

All of the three test solutions in this study provided a reduction greater than the required mean 3.0 logarithmic reduction against the recommended standard ATCC strains of P. aeruginosaand S. aureus. Antibacterial effectiveness of Solo Care Aqua and All-Clean Soft against clinical isolates of P. aeruginosaand S. aureuswere acceptable based on ISO 14729 Stand-alone test. ReNu MultiPlus showed a minimum acceptable efficacy against the clinical isolate of S. aureus, but did not reduce the clinical isolate by the same amount.

Conclusions

Although the contact lens disinfecting solutions meet/exceed the ISO 14729 Stand-alone primary acceptance criteria for standard strains of P. aeruginosaand S. aureus, their efficacy may be insufficient against clinical isolates of these organisms.