Detección de Acanthamoeba por reacción en cadena de la polimerasa en tiempo real en líquidos de conservación de lentes de contacto / Detection of Acanthamoeba sp. by real-time polymerase chain reaction in contact lens solutions

RESUMEN Objetivo: Estandarizar una técnica de reacción en cadena de la polimerasa en tiempo real para la detección del parásito e identificar Acanthamoeba en líquidos conservantes de lentes de contacto. Métodos: Se realizó un estudio descriptivo observacional de corte transversal sobre la técnica de reacción en cadena de la polimerasa en tiempo real para la detección de Acanthamoeba, en el Instituto de Investigaciones en Ciencias de la Salud de la ciudad de Asunción, en Paraguay. Se analizaron 110 líquidos conservantes aportados por usuarios sanos de lentes de contacto, mediante reacción en cadena de la polimerasa en tiempo real y cultivo en medio PAGE - SDS. Resultados: Se estandarizó con éxito la técnica de reacción en cadena de la polimerasa en tiempo real con límite de sensibilidad de 1 pg/µL. Se aisló Acanthamoeba a partir de una muestra (1 por ciento) por método de cultivo, mientras que la carga parasitaria en el líquido conservante fue inferior al límite de detección de la reacción en cadena de la polimerasa en tiempo real. El ADN obtenido del cultivo de dicha muestra fue positivo para Acanthamoeba por este método. Conclusión: El sistema estandarizado presenta buena sensibilidad y podrá ser incorporado en los laboratorios que cuentan con acceso a equipos de reacción en cadena de la polimerasa en tiempo real para un diagnóstico rápido y más eficiente en casos de sospechas de queratitis amebiana. Recomendamos el uso combinado de métodos moleculares y cultivo para aumentar la potencia del diagnóstico, sobre todo en muestras donde la carga parasitaria es muy baja(AU)

ABSTRACT Objective: Standardize a real-time polymerase chain reaction technique for detection of the parasite and identify Acanthamoeba in contact lens solutions. Methods: A cross-sectional observational descriptive study was conducted about a real-time polymerase chain reaction technique for detection of Acanthamoeba at the Institute of Health Sciences Research in the city of Asunción, Paraguay. A total 110 solutions were analyzed, which were provided by healthy contact lens users, by real-time polymerase chain reaction and culture in SDS-PAGE medium. Results: Successful standardization was achieved of the real-time polymerase chain reaction technique with a sensitivity limit of 1 pg/µl. Acanthamoeba was isolated from one sample (1 percent) by culture, whereas the parasite load in the contact lens solution was below the detection limit of the real-time polymerase chain reaction technique. The DNA obtained from the culture of that sample was positive for Acanthamoeba by the real-time polymerase chain reaction technique method. Conclusion: The system standardized exhibits good sensitivity and may be incorporated into laboratories with real-time polymerase chain reaction technique equipment for a rapid and more efficient diagnosis of suspected amoebic keratitis. We recommend the combined use of molecular methods and culture to enhance diagnostic power, mainly in samples where the parasite load is very low(AU)

Radial Keratoneuritis in Aeromonas Keratitis

PURPOSE: We report a case of Aeromonas keratitis presenting as radial keratoneuritis. CASE SUMMARY: A 33-year-old woman with a history of cleaning her contact lenses with tap water presented with decreased visual acuity for 1 day in the left eye. The patient showed diffuse corneal edema, stromal infiltration, and radial keratoneuritis, which were thought to be pathognomonic for Aeromonas keratitis. Based on the patient's clinical findings and past history, a diagnosis of Aeromonas keratitis was made and she was prescribed topical fortified cefazolin (50 mg/mL, 5%), tobramycin (3 mg/mL), and 0.02% chlorhexidine per hour. Culture results from the contact lens and contact lens solution confirmed infection by Aeromonas hydrophilia. Polymerase chain reaction results for Aeromonas were negative. After 8 days of treatment, the uncorrected visual acuity was 0.7/0.3 with improvement in her corneal findings. CONCLUSIONS: Radial keratoneuritis is not always pathognomic for Aeromonas keratitis and can be present in Aeromonas keratitis. Therefore, ophthalmologists should be cautious when interpreting this clinical sign.

Perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato / Demographic and behavioral profile of patients with optic medical indication of contact lenses

RESUMO Objetivos: Avaliar o perfil demográfico e comportamental de pacientes com indicação médica óptica de lentes de contato (LC) em um hospital público de Curitiba. Métodos: Estudo transversal realizado através de questionário em pacientes atendidos no serviço de lentes de contato do ambulatório do SUS do Hospital de Olhos do Paraná, no período de 02 de setembro de 2014 a 04 de agosto de 2015. Resultados: Dos 69 entrevistados, 56,52% fizeram LC. Destes, 55,07% têm entre 20-49 anos, 69,56% são mulheres, 40,58% com ensino médio completo e 36,23% com 2 a 6 salários mínimos. Predominaram a lente rígida com 66,67%, com menos de 8 horas de uso em 41,02% e desconforto durante o uso em 59%. A limpeza das LC é feita ao colocar e ao retirar em 87,18% dos casos, com 71,8% utilizando solução própria para LC. Alto custo da compra foi o principal motivo do não uso de LC, com 70% dos pacientes que não fizeram uso desse recurso. Conclusões: Dos entrevistados, 56,52% iniciaram o uso de LC, sendo o ceratocone a doença mais indicada. Foi demonstrado nesse estudo que os pacientes em questão têm boa orientação quanto a manuseio e manutenção das LC. Apesar dos inquestionáveis avanços da tecnologia médica, continuam ocorrendo a desistência do uso desse recurso principalmente pelo custo e medo do manuseio. É responsabilidade do especialista esclarecer os benefícios que os pacientes com indicação médica terão com o uso de LC, assim como motivar o seu uso.

ABSTRACT Objectives: To assess the demographic and behavioral profile of patients with optic medical indication of contact lenses (CL) in a public hospital in Curitiba. Methods: Cross-sectional questionnaire study of patients who attended the contact lens service of the national health system (SUS) outpatient clinic from the "Hospital de Olhos do Paraná" between September 2nd, 2014 and August 4th, 2015. Results: Of the 69 people interviewed, 56.52% acquired CL. Of these, 55.07% are between 20-49 years old, 69.56% are women, 40.58% had finished high school and 36.23% earned a salary of 2 to 6 times the minimum wage. Rigid lenses prevailed, representing 66.67% of the total, with less than 8 hours of usage in 41.02% of the cases and discomfort during usage was assessed in 59%. The cleaning of CL was done at the moment of insertion and removal in 87.18% of cases, and 71.8% used contact solution. High purchase cost was the main reason for not using CL for 70% of patients who did not use this resource. Conclusions: Of the patients interviewed, 56.52 % started using LC. Keratoconus was the main disease for which CL were indicated. It was demonstrated in this study that patients in question have good guidance on handling and maintenance of LC. Despite the unquestionable advances in medical technology continue to occur the abandonment of the use of this feature mainly the cost and fear of handling. It is the responsibility of the expert clarify the benefits that patients with medical indication will have with the use of LC, as well as encourage their use.

Allergic Contact Dermatitis on the Periorbital Area: Report of Three Cases / 대한피부과학회지

The use of ophthalmic drugs and contact lens solutions has increased and allergic contact dermatitis due to these agents has also recently increased. The first case was a 67-year-old female patient who developed allergic contact dermatitis after application of Latano(R): The patch test with the ingredients in Latano(R) showed positive reaction to latanoprost and benzalkonium chloride. The second case was a 63-year-old female patient who developed allergic contact dermatitis after application of Ecolicin(R), Tolon(R), Forus(R) and Uniten-F(R): The patch test showed a positive reaction to Tolon(R). She didn't want further evaluation. The third case was a 51-year-old female patient who developed allergic contact dermatitis after application of Terramycin(R) eye ointment: the patch test with the ingredients of Terramycin(R) eye ointment showed a positive reaction to polymyxin B. When contact dermatitis occurs in periorbital areas, topical ophthalmic ointment or lens cleanser needs to be considered as a causative agent.

Avaliação da ação antimicrobiana de soluções multiuso para desinfecção de lentes de contato hidrofílicas, in vitro / Antimicrobial efficacy assessment of multi-use solution to disinfect hydrophilic contact lens, in vitro

OBJETIVO: Avaliar a influência da ação antimicrobiana das soluções multiuso para desinfecção de lentes de contato hidrofílicas. MÉTODOS: Duas soluções multiuso denominadas solução A (poliquaternário-1 a 0,001 por cento e miristamidopropil dimetilamina a 0,0005 por cento) e solução B (poliaminopropil biguanida a 0,0001 por cento) foram testadas em lentes de contato hidrofílicas contaminadas com Pseudomonas aeruginosa (ATCC27583), Staphylococcus epidermidis (ATCC1226), Klebsiella pneumoniae (ATCC13883), Staphylococcus aureus (ATCC25923) e Candida albicans (ATCC 10231) para verificar a quantidade de redução do crescimento dos microrganismos após o enxágue com as soluções. Foram seguidas as instruções preconizadas pelos fabricantes. RESULTADOS: Houve redução de 90 por cento do crescimento de Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus aureus e Candida albicans. Não houve crescimento de Klebsiella pneumoniae. CONCLUSÃO: As soluções testadas neste trabalho mostraram redução do número de microrganismos testados.

PURPOSE: To evaluate the efficacy of disinfecting solutions in hydrophilic contact lenses (CL). METHODS: Two multi-use solutions denominated solution A (0.001 percent polyquaternium-1 and 0.0005 percent myristamidopropyl dimethylamine) and solution B (0.0001 percent polyaminopropyl biguanide) were used. The solutions were tested in hydrophilic contact lenses infected with Pseudomonas aeruginosa (ATCC27583), Staphylococcus epidermidis (ATCC1226), Klebsiella pneumoniae (ATCC13883), Staphylococcus aureus (ATCC25923) and Candida albicans (ATCC 10231) and the decrease in microorganisms growth after the hydrophilic contact lenses were cleaned with the respective solutions was verified. The manufacture's instructions were followed. RESULTS: A decrease of 90 percent of Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus aureus, Candida albicans and a decrease 100 percent of Klebsiella pneumoniae was observed. CONCLUSION: The solutions decreased the amount of microorganisms tested.

Sistemas atuais de cuidados e manutenção de lentes de contato: [revisão] / Current care and maintenance systems for contact lenses: [review]

A correta manutenção das lentes de contato é fundamental para se obter sucesso e manter a continuidade de seu uso. É grande o número de pacientes que abandonam o uso de suas lentes por problemas que poderiam ser solucionados com tratamentos relativamente simples ou com uma orientação mais adequada. O mau uso das lentes, associado à má adaptação, contaminação, doenças oculares prévias e fatores ambientais, podem aumentar o número de infecções corneanas através da proliferação de microorganismos. O presente artigo visa apresentar as atualizações em relação aos cuidados e manutenção com as lentes de contato.

The proper maintenance of contact lenses is crucial for their success and to maintain the continuity of their use. Many patients abandon the use of their lenses due to problems that could be solved with relatively simple treatments. The misuse of lenses, coupled with poor adjustment, contamination, eye disease and environmental factors may increase the number of corneal infections through the proliferation of microorganisms. This article aims to provide contact lens care and maintenance updates.

Bacteriological evaluation of conjunctiva, contact lens storage cases and solutions during contact lens wear.

A total of 90 subjects were investigated in this study, out of which 51 constituted the contact lens wearing group and 39 constituted the control group who had never worn contact lenses. Out of 51 contact lens wearing group, 41 were asymptomatic lens wearer subjects and 10 were symptomatic lens wearer subjects having some complications. All the subjects of contact lens wearing group had worn soft contact lenses on daily wear basis for a duration of 7 days to one year. In total 33 subjects were culture positive and remaining 57 culture negative. Staphylococcus epidermidis was isolated equally from asymptomatic and control group, however, significantly more gram negative organisms such as Pseudomonas aeruginosa and Serratia marcescens were isolated from the symptomatic lens wearers. P. aeruginosa and S. marcescens could also be isolated from lens storage cases. S. marcescens was the organism most commonly isolated from the contact lens solutions. Further, the results showed that both P. aeruginosa and S. marcescens adhere to injured cornea only and not to normal cornea when microscopic study of adherence of bacteria to uninjured and injured ex vivo mouse corneas was done.

Ulcerative keratitis associated with contact lens wear.

To review the microbiological profile of ulcerative keratitis associated with contact lens (CL)-wear, 35 patients with culture-proven CL-associated microbial keratitis were studied between September 1999 and September 2002. Corneal scrapes and CL-care products were collected and were subjected to microbiological evaluation. Gram-negative bacilli alone were recovered from the corneal scrapes of all 35 (100%) patients, all 70 (100%) CL storage case wells and also from CL-care solution of six (17.14%) of the 35 patients. There was a significantly higher number of Pseudomonas aeruginosa (71.43%) isolated from eyes with CL-related keratitis than other bacterial isolates (28.57%) (P<0.001). Microbial contamination of CL storage cases was a great risk for gram-negative bacterial infection among soft CL-wearers.

Natural occurrence of Mycobacterium as an endosymbiont of Acanthamoeba isolated from a contact lens storage case

Recent in vitro studies have revealed that a certain Mycobacterium can survive and multiply within freeliving amoebae. It is believed that protozoans function as host cells for the intracellular replication and evasion of Mycobacterium spp. under harmful conditions. In this study, we describe the isolation and characterization of a bacterium naturally observed within an amoeba isolate acquired from a contact lens storage case. The bacterium multiplied within Acanthamoeba, but exerted no cytopathic effects on the amoeba during a 6-year amoebic culture. Trasnmission electron microscopy showed that the bacteria were randomly distributed within the cytoplasm of trophozoites and cysts of Acanthamoeba. On the basis of the results of 18S rRNA gene analysis, the amoeba was identified as A. lugdunensis. A 16S rRNA gene analysis placed this bacterium within the genus Mycobacterium. The bacterium evidenced positive reactivity for acid-fast and fluorescent acid-fast stains. The bacterium was capable of growth on the Middlebrook 7H11-Mycobacterium-specific agar. The identification and characterization of bacterial endosymbionts of free-living protozoa bears significant implications for our understanding of the ecology and the identification of other atypical mycobacterial pathogens.

Evaluation of Cysticidal Effects of Contact Lens Disinfectant on Acanthamoeba Isolates

PURPOSE: To evaluate the cysticidal effect of 5 kinds of commercially available contact lens disinfectants against 2 clinical isolates of Acanthamoeba. METHODS: Five kinds of commercially available contact lens disinfectants were soaked with cysts of Acanthamoeba ludgdunesis and castellanii at the concentration of 10(3), 10(4), and 10(5) cells/ml for 1 and 4 or 6 hours. Cysts which were not excysted in 7 days after treatment were recognized to be killed. Morphologic changes were evaluated by electron microscopic observation. RESULTS: Contact lens disinfectants which contain myristamidopropyl dimethylamine (MAPD) showed the best cysticidal effect. These disinfectants demonstrated a cysticidal effect on both Acanthamoeba species of all concentrations in 6-hour treatment. Contact lens disinfectants which contain polyhexamethylene biguanide (PHMB) did not demonstrate cysticidal effect, except for Acanthamoeba castellanii at the concentration of 10(3) cells/ml, in either 4- or 6-hour treatment. Separation of plasma membrane from endocyst and damage of organelles were prominent in cases showing a cysticidal effect. CONCLUSIONS: Contact lens disinfectant which contains MAPD may be helpful in preventing the Acanthamoeba keratitis. A higher concentration of PHMB is required to be effective in preventing Acanthamoeba keratitis.

A testing method of assessing the protein-removing effect of the contact lenses' protein -removing care solution / 中国医疗器械杂志

<p><b>OBJECTIVE</b>Testing the protein-removing effect of the protein-removing care solution on the protein precipitation of the soft contact lenses.</p><p><b>METHOD</b>Soak the lenses into the artificial-tears to simulate the protein absorption, test the absorbency of cleaned protein at the wavelength of 280 nm by UV spectrophotometer, and compute the percentage of protein.</p><p><b>RESULT</b>Testing results of the percentage of the cleaned protein are repeatable.</p><p><b>CONCLUSION</b>This experimental method can be used to evaluate the cleaning effect of the protein- removing care solution, but still needs much improvements.</p>

Validación del método analítico para el control de la calidad y el estudio de estabilidad del neolimpilen / Validation of the analytical method for the quality control and the stability study of neolimpilem

Se validó el método analítico desarrollado para el control de la calidad y el estudio de estabilidad en la cuantificación de hidroxipropilmetilcelulosa y laurilsulfato de sodio por espectrofotometría con detección ultravioleta a 635 y 650 nm respectivamente. Además, se presentan los resultados analíticos del estudio de estabilidad realizado a la solución para la limpieza y conservación de lentes de contacto rígidos (neolimpilen), con el empleo de 3 lotes envasados en 2 frascos diferentes realizando el estudio por estabilidad acelerada y vida de estante; se comprueba la estabilidad física y química de la solución por espacio de 24 meses a temperatura ambiente. En la validación de la hidroxipropilmetilcelulosa, la curva de calibración en el rango de 0,06 a 0,18 mg/mL se comportó de forma lineal con un coeficiente de correlación igual a 0,99581; la prueba estadística para el intercepto y la pendiente resultó no significativa. Se obtuvo un recobrado del 99,8 por ciento en el rango de concentración estudiado y las pruebas de Cochran´(G) y Student´s (t) resultaron no significativas. El coeficiente de variación en la repetibilidad se comportó igual a 0,9 por ciento para 10 réplicas ensayadas, mientras que en la reproducibilidad las pruebas de Fischer y Student fueron no significativas. El método resultó específico, lineal, preciso y exacto. Mientras que en la validación del laurilsulfato de sodio la curva de calibración en el rango de 1,44 a 3,0 mg/mL se comportó de forma lineal con un coeficiente de correlación igual a 0,99036; la prueba estadística para el intercepto y la pendiente fue no significativa. Se obtuvo un recobrado del 99,9 por ciento en el rango de concentración estudiado y las pruebas de Cochran´(G) y Student´s (t) resultaron no significativas. El coeficiente de variación en la repetibilidad se comportó igual a 0,8 por ciento para 8 réplicas ensayadas, mientras que en la reproducibilidad las pruebas de Fischer y Student fueron no significativas. El método resultó específico, lineal, preciso y exacto

A Comparison of Anti-Pseudomonal effects by Multi-purpose Contact Lens Solutions

PURPOSE: To compare the antimicrobial effects of various kinds of multi-purpose solutions, study effective ways of washing contact lens (CLs), and suggest the most effective lens care system using P. aeruginosa-contaminated CLs. METHODS: Each disposable soft CL was incubated in 0.1 ml of diluted solution of P. aeruginosa standardstrain (10(8)CFU / mm(3)) and 0.9 ml tryptic soy broth in cell culture wells for 24 hours. In the first experimental group, to find the most antimicrobial solution, 40 CLs contaminated by P. aeruginosa were divided into four subgroups washed with four different kinds of multi-purpose solutions. Ten CLs were used in each subgroup and in the control group; Ten CLs contaminated by P. aeruginosa were washed with phosphate buffered saline (PBS) instead of cleaning solution. In the second experiment groups to find the most effective way of washing, using only Renu Multiplus multi-purpose solutionR we compared the antimicrobial effect of four different ways of washing including 30 seconds rubbing, 30 minutes soaking, 4 hours soaking, 30 seconds rubbing and 4 hours soaking. RESULTS: There was no significant difference of antimicrobial effect between four kinds of multi-purpose solutions. All methods have a significant antimicrobial effect over control group (P<0.001) and the most effective method of washing CLs was 4 hours soaking. CONCLUSIONS: we should advise all the soft CL users that they should have their CLs soaked over 4 hours everyday after wearing it.

Estudantes de Medicina usuários de lentes de contato / Medical students and contact lens wear

Objetivo: O presente estudo tem por objetivo avaliar o conhecimento e atitude de estudantes de medicina, usuários de lentes de contato, quanto ao uso, manutenção, complicações e orientações recebidas quando das avaliações oftálmicas. Material e métodos: Foi realizado um "survey" exploratório em 101 alunos, selecionados aleatoriamente entre os matriculados no Curso de Graduação da Faculdade de Medicina de Petrópolis, na Cidade de Petrópolis, Estado do Rio de Janeiro. Resultados: A média de idade dos alunos foi de 21,9 anos (ñ2,85), sendo que 53 (52,48 por cento) eram do sexo masculino e 48 (47,52 por cento) do sexo feminino. O maior motivo para procura do uso de lentes de contato foi o estético (77,23 por cento). As lentes gelatinosas representaram a maior escolha (91,09 por cento) e, dentre estas, as descartáveis (40,60 por cento). Quanto à limpeza, 96,04 por cento utilizavam substâncias limpadoras e, quanto à desinfecção, 72,28 por cento usavam substâncias químicas, 14,85 por cento desinfecção térmica e 12,87 por cento não desinfectavam. Em relação à manutenção, 35,64 por cento responderam que era para melhorar a visão, 60,40 por cento para melhorar o conforto e 3,96 por cento não faziam manutenção das lentes. Dos selecionados, 52 (51,49 por cento) indivíduos que utilizavam lentes de contato responderam que tinham tido algum tipo de complicação. Nas consultas de controle, 39,60 por cento não eram questionados como usavam as lentes de contato, 67,33 por cento não recebiam orientações por escrito, 11,88 por cento não recebiam orientações verbais e 39,60 por cento não recebiam orientações sobre sinais de perigo de complicações. Conclusão: Nesta amostra de população jovem, da área de saúde, mais da metade referiu ter apresentado complicações pelo uso de lentes de contato. Impõe-se estabelecer ações educativas visando à manutenção da saúde ocular dos usuários de lentes de contato.

In Vitro Amoebicidal Efficacy of Hexamidine, Polyexamethylene Biguanide and Chlorhexidine on Acanthamoeba Ccular Isolates

To evaluate amoebicidal efficacy of various disinfectants, we treated ten ocular isolates of Acanthamoeba with polyhexamethylene biguanide(PHMB), chlorhexidine and hexamidine. Acanthamoeba cysts were collected from axenic nonnutrient agar plates from 4 week culture. Cyst suspension(100microliter) was inoculated on 96-well microplate with concentration of 105 cys/ml. Each well was treated with two-fold diluted hexamidine, PHMB and chlorhexidine(100microliter each, 8 and 48hrs). Each well was examined under the inverted microscope until 7 days after treatment. Minimal cysticidal concentration(MCC) of each disinfectant qas measured after five experiments. MCC of hexamidine, chlorhexidine and PHMB against ten ocular isolates ranged 6.07-500microgram/ml, 3.12-12.50microgram/ml, 1.17-4.68microgram/ml respectively in 48hr treatment. In 8hr treatment, MCC of PHMB and chlorhexidine ranged 4.42-12.50microgram/ml and 4.67-17.71microgram/ml, but hexamidine did not demonstrate cysticidal effect. For proper disinfection of contact lens, disinfectants having cysticidal efficacy should be included in the composition of contact lens solution. Among the currently used topical amoebicidal agents, PHMB showed the greatest cysticidal activity on ten ocular strains of Acanthamoeba in invitro study.

Role of contact lenses in acanthamoeba keratitis

The present work was planned to study the role of contact lenses in Acanthamoeba keratitis. The study included two groups, 100 subjects each [contact lens and non-contact lens users]; 50% of each group were suffering from keratitis, while the others were asymptomatic. Ocular samples [corneal scrapings or swabs], contact lenses and lens care systems [storage containers and solutions] were examined for the presence of acanthamoeba using cultureand staining techniques. The isolation of acanthamoeba was achieved by the cultivation of the previous samples on non-nutrient agar overlaid with E. coliat 37C. Acanthamoebae were identified according to their morphological characters and the negative flagellation test. Acanthamoeba was identified in cultures of different specimens obtained from 20 subjects out of 200. The majority of acanthamoeba positive cases [90%] were contact lens users. Acanthamoeba was isolated more frequently from patients with keratitis and was not isolated from any asymptomatic non-contact lens users. Cultivation of the contact lenses was associated with high rate of acanthamoeba detection compared with the other sources of samples. From the present study, it was concluded that acanthamoebae are expected to be found in the contact lenses, their storage containers and rinsing solutions, which may predispose tokeratitis in contact lens users. Precise disinfection of contact lenses, cleaning of lens storage containers and the use of sterile rinsing solutions have a primary importance to prevent acanthamoeba contamination of contact lens care system

Eficácia da associaçäo de soluçäo multi-açäo e de limpador enzimático líquido na manutençäo de lentes de contato hidrofílicas / Efficacy of Multi-Purpose Solution with Liquid Enzymatic Cleaner for cleaning of soft contact lenses

Objetivo: Avaliar a eficácia da soluçäo Opti-Free Supraclens (Alcon, Laboratório) na prevençäo e remoçäo de depósitos de lentes de contato hidrofílicas do grupo II e do grupo IV.Material e Métodos: Vinte pacientes, das clínicas particulares dos autores, tiveram suas lentes de contato encaminhadas para análise de presença e natureza de depósitos após 30 dias de uso. Inicialmente suas lentes foram cuidadas com soluçäo multi-açäo e, posteriormente, com soluçäo multi-açäo e limpador enzimático líquido. A análise dos depósitos foi feita por microscopia óptica. Os usuários foram solicitados a opinar quanto à simplicidade dol manuseio, conforto, comodidade, fidelidade e eficácia dos produtos. Resultados: Houve reduçäo significativa dos depósitos nas lentes com soluçäo multi-açäo e lim[pador enzimático líquido (p=0,0000001). Todos os usuários referiram simplicidade no manuseio e comodidade no uso dos produtos, 95 (por cento) consideram a associaçäo eficaz, 80 (por cento) referiram conforto e 85 (por cento) consideram associaçäo de produtos boa ou ótima. No período de realizaçäo do estudo, todos os usuários referiram fidelidade ao regime de uso dos produtos. Conclusäo: A simplificaçäo do sistema de cuidados das lentes hidrofílicas pode contribuir para aumentar a fidelidade dos usuários aos cuidados com as lentes

Sterility and the disinfection potential of Indian contact lens solutions.

Ocular infection associated with microbial contamination of contact lens care products is a major problem in contact lens wearers. The sterility and the antimicrobial activity of contact lens care systems reflect their suitability for disinfection of contact lenses. These factors remain to be evaluated for the various newer contact lens care products manufactured in India. In this study, 35 bottles of contact lens solutions marketed by different manufacturing units in India were tested for sterility. Seven solutions were tested for antimicrobial effectiveness employing the D value method of analysis. The D value is defined as the time required to reduce a population of organisms by 90% (one log unit). A standard inoculum of the ocular isolates of Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Aspergillus fumigatus, Fusarium solani, and Acanthamoeba castellanii were used as challenge organisms. Bacterial contamination was detected in 20 (57.1%) solution bottles and none yielded fungus or Acanthamoeba. Pseudomonas species were the most commonly encountered contaminant (11/20; 55%). Only sterile solutions were analyzed for antimicrobial activity. D values ranging between 12 and 20 minutes were demonstrated by six of the seven solutions against bacterial challenge. Good antifungal activity was noticed in five solutions against Fusarium solani though results varied with Aspergillus flavus and Candida albicans. All solutions were adequately effective against Acanthamoeba.

The Experimental Irritation Study Following the Instillation of Contact Lens Solution on the Rabbit Eyes

To determine the effects of contact lens-solution(Uni-cleaner, Uni-soak, Uni-rince on the ocular tissue following instillation for 21 consecutive days, the experimental irritation study was conducted on the rabbit eyes. Nine rabbits(18 eyes) were divided into three groups and each solution was instilled into the eyes four tims a day for 21 consecutive days. Ocular reactions including conjunctival injection, chemosis, sodium fluorescein stain, and erosion were observed and recorded. The reactions were noted using as a guide the scales for scoring from grade I to grade IV according to the severity through the slit lamp examination, and also measured was the corneal thickness change using the ultrasonic pachometer. The results were as follows; 1. No ocular abnormalitis were observed during the slit lamp examination through the test period except one minute after instillation of the solution. 2. The changes of the corneal thickness were not significant statistically(p>0.1). 3. Scanning electronic microscopy showed that epithelial cells formed a polygonal mosaic on surface of the cornea and microvilli and microplicae were present in adjacent cells.