Lysozyme sorption in hydrogel contact lenses.
(1/217)
PURPOSE: To examine the processes involved in formation of protein deposits on hydrogel contact lenses. METHODS: The adsorption and/or penetration of lysozyme on or into three types of contact lenses, etafilcon A, vifilcon A, and tefilcon, were investigated in vitro using a radiolabel-tracer technique, x-ray photoelectron spectroscopy, and laser scanning confocal microscopy. RESULTS: Binding of lysozyme to high-water-content, ionic contact lenses (etafilcon A and vifilcon A) was dominated by a penetration process. The extent of this penetration was a function of charge density of the lenses, so that there was a higher degree of penetration of lysozyme in etafilcon A than in vifilcon A lenses. In contrast, the binding of lysozyme to tefilcon lenses was a surface adsorption process. The adsorption and desorption kinetics showed similar trends to those found in human serum albumin (HSA) adsorption on lens surfaces. However, the extent of lysozyme adsorption on tefilcon is much higher than HSA adsorption, probably because of the self-association of lysozyme on the tefilcon lens surface. Furthermore, either penetration or adsorption of lysozyme involved reversible and irreversible processes and were both time dependent. CONCLUSIONS: Binding of lysozyme to hydrogel lenses involves surface adsorption or matrix penetration. These processes may be reversible or irreversible. The properties of the lens materials, such as charge density (ionicity) and porosity (water content) of the lenses, determine the type and rates of these processes. (+info)
Measurement of post-lens tear thickness.
(2/217)
PURPOSE: A method to measure the tear film beneath a soft contact lens, referred to as post-lens tear thickness (PLTT), would have many applications to contact lens research. In this study a noninvasive technique for measuring the PLTT is presented. METHODS: The feasibility of measuring the tear layer by optical pachometry was first assessed using a model eye. The baseline corneal thickness (B) of both eyes of 21 subjects was measured, etafilcon-A ionic disposable soft contact lenses (58% water) were inserted, and the total thickness (T) of the cornea, contact lens, and PLTT were measured. After the pachometry readings the lenses were removed and their center thickness (C) determined. The PLTT was calculated using the equation: PLTT = T-(B+C). Two sets of measurements of T were performed at 15 and 25 minutes after lens insertion. The entire procedure was repeated at a second visit. RESULTS: The pachometry measurements of the small aqueous reservoir between the model eye and the lens closely matched those obtained by direct microscopic measurement. For human PLTT, the mean values (and 95% confidence intervals) for right eyes on visits 1 and 2 were 11 (8, 13) and 12 (10, 15) microm, respectively, and for left eyes were 12 (10, 15) and 11 microm (8, 14) microm, respectively. CONCLUSIONS: It is possible to measure the post-lens tear thickness using optical pachometry. The variability between repeated measurements suggests that with careful sample size planning, the technique is sufficiently precise to be useful in group assessments of PLTT. (+info)
Sympathetic swelling response of the control eye to soft lenses in the other eye.
(3/217)
PURPOSE: To compare central corneal swelling and light scatter after 8 hours of sleep in eyes wearing high- and low-Dk hydrogel lenses and to the contralateral control eyes. METHODS: Twenty neophyte subjects wore a Lotrafilcon A (Dk, 140; Ciba Vision, Duluth GA) silicone hydrogel lens and an Etafilcon A (Dk, 18; Acuvue; Vistakon, Jacksonville, FL) 58% water content hydrogel lens of similar center thickness in random order in the right eye only, for overnight 8-hour periods. The contralateral nonwearing left eyes served as controls. Central corneal thickness was measured using an optical pachometer and light scatter using a Van den Berg stray-light meter before lens insertion, after lens removal on waking, and every 20 minutes for the next 3 hours. RESULTS: Central corneal swelling induced by the Etafilcon A lens on eye opening was significantly higher than with the Lotrafilcon A lens (8.66%+/-2.84% versus 2.71%+/-1.91%; P<0.00001). Light scatter induced by the Etafilcon A lens on eye opening was significantly higher than with the Lotrafilcon A lens (46.09+/-5.62 versus 42.78+/-6.07 Van den Berg units, P = 0.0078). The swelling of the control eyes paired with the Etafilcon A lens-wearing eyes was also slightly but significantly higher than that of the control eyes paired with the Lotrafilcon A lens-wearing eyes (2.34%+/-1.26% versus 1.44%+/-0.91%; P = 0.0002). Light-scatter measurements were not significantly different between control sets of eyes but showed the same trend. CONCLUSIONS: In neophyte subjects, corneal swelling of the contralateral control eyes appears to be influenced by the swelling of the fellow lens-wearing eyes-that is, the swelling of the contralateral control eye was significantly lower when there was less swelling of the fellow eye wearing the high-Dk lens. Although there was no statistically significant difference in light-scatter measurements between the control sets of eyes, a trend similar to the corneal swelling results was observed, which could be used to support the suggestion that this may be a sympathetic physiological response rather than an unusual sampling coincidence. (+info)
Observation of soft contact lens disinfection with fluorescent metabolic stains.
(4/217)
A rapid fluorescent staining method using a tetrazolium dye and propidium iodide for the in-use assessment of disinfection of Pseudomonas aeruginosa biofilms on soft contact lenses showed that 11 to 13% of cells on lenses remained actively respiring and recoverable by culture methods after 30 min of exposure to 3% hydrogen peroxide. (+info)
Unusual case of Acanthamoeba polyphaga and Pseudomonas aeruginosa keratitis in a contact lens wearer from Gauteng, South Africa.
(5/217)
Acanthamoeba species can cause a chronic, progressive ulcerative keratitis of the eye which is not responsive to the usual antimicrobial therapy and is frequently mistaken for stromal herpes keratitis. An unusual case of coinfection with Acanthamoeba polyphaga and Pseudomonas aeruginosa as causes of corneal keratitis in a contact lens wearer from Gauteng, South Africa, is reported. These two pathogens have previously been assumed to be selectively exclusive. Cysts of the isolated acanthameba tolerated an incubation temperature of 40 degrees C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen. The patient's history of careless contact lens-disinfecting habits emphasizes the need to adhere strictly to recommended methods of contact lens care. (+info)
Apoptosis in shed human corneal cells.
(6/217)
PURPOSE: To determine whether shear forces applied to the corneal epithelium by the repeated insertion and removal of a hydrogel contact lens alter the size and number of cells removed and to determine the contribution of apoptosis to this process. METHODS; Human corneal cells were collected from eight healthy subjects by sequential contact lens cytology (20 lens insertions and removals). Collected cells were stained with acridine orange for counting and measurement of cell size. In a separate experiment, collected cells were fixed and stained with TdT-mediated dUTP nick-end labeling (TUNEL) or labeled immediately after collection using annexin V. Hoechst stain and propidium iodide (PI) were used as nuclear counterstains. The proportion of cells labeled with acridine orange, TUNEL, and annexin V was quantified by fluorescence microscopy. RESULTS; The number of cells increased in later collections, and cells were smaller. The mean number of positively stained cells using TUNEL was 57%. Annexin V labeling on unfixed fresh samples showed a mean of 64%, with an increase in later collections. Apoptotic bodies were observed in very few cells. In most cells the nucleus and cytoplasmic membrane were intact. Structures were observed in which nuclei were missing (Hoechst negative) but in which cytoplasm had the size and appearance of whole, nucleated cells. These structures (cell ghosts) increased in number along with the increase in nucleated cells in later collections. CONCLUSIONS: The sequential removal of a soft contact lens caused a progressive increase in the number of cells collected from the surface and a progressive decrease in their size. The majority of nucleated cells removed by a contact lens were apoptotic in the sense of being positively labeled by TUNEL and annexin V. Morphologically they differed from classically apoptotic cells, in that cells showed an intact nuclear structure and no discernible apoptotic bodies. They could represent a last stage in a pathway of cell differentiation in which frictional forces induced by the removal of the contact lens activate the apoptotic program and cause the cell to be shed. There is also a pathway in which cells lose their nuclei before leaving the epithelial surface. (+info)
Optical and visual impact of tear break-up in human eyes.
(7/217)
PURPOSE: The purpose of this study was to examine the optical and visual impact of tear break-up. METHODS: Optical quality of the eye was assessed during periods of nonblinking by quantifying vessel contrast in the fundus image and by monitoring the psychophysical contrast sensitivity and the spatial distribution of tear thickness changes by retroillumination. All measures were obtained from three eyes either with or without a soft contact lens. RESULTS: A noticeable decrease in retinal vessel contrast and contrast sensitivity were observed soon after a blink. Both of these measures of optical quality of the eye showed a similar pattern of image degradation both with and without a soft contact lens. Although trial-to-trial variability was considerable, sample means show that image contrast in the low spatial frequency range can drop to between 20% and 40% of initial values after 60 seconds of nonblinking. Retroillumination of the tear film showed local intensity fluctuations that progressively spread across the pupil with increasing time after the blink. CONCLUSIONS: Optical aberrations created by tear break-up contribute to the decline in image quality observed objectively and psychophysically. The decline in image quality that accompanies tear break-up may be a direct cause of the blurry vision complaints commonly encountered in dry-eye patients. (+info)
Bacterial colonization of disposable soft contact lenses is greater during corneal infiltrative events than during asymptomatic extended lens wear.
(8/217)
Microorganisms, especially gram-negative bacteria, are considered to play a role in the etiology of certain corneal infiltrative events (CIEs) observed during soft contact lens wear. This study explored the possibility of microbial colonization of soft contact lenses as a risk factor leading to CIEs. In a clinical trial conducted from March 1993 to January 1996, 330 subjects wore disposable soft contact lenses on a 6-night extended-wear and disposal schedule. During this period, 4,321 lenses (118 during CIEs; 4,203 during asymptomatic lens wear) were recovered aseptically and analyzed for microbial colonization. A greater percentage of lenses were free from microbial colonization during asymptomatic wear than during CIEs (42 versus 23%; P < 0.0001). The incidence of gram-positive bacteria, gram-negative bacteria and fungi was greater during CIEs than during asymptomatic lens wear (P < 0.05). During asymptomatic lens wear, gram-positive bacteria were isolated most frequently and were usually normal external ocular microbiota. Of the gram-positive bacteria, the incidence of Streptococcus pneumoniae was greater during CIE than during asymptomatic wear (7.6 versus 0.6%; P < 0. 0001). While gram-negative bacteria were seen in few cases during asymptomatic wear, their incidence during CIE in comparison to asymptomatic wear was substantial and significant (23.7 versus 3.8%; P < 0.0001). Also, the level of colonization was high. Of CIEs, events of microbial keratitis, contact lens acute red eye, and asymptomatic infiltrative keratitis were associated with lens colonization with gram-negative bacteria or S. pneumoniae. Colonization of soft contact lenses with pathogenic bacteria, especially gram-negative bacteria and S. pneumoniae, appears to be a significant risk factor leading to CIE. (+info)