Microbial adherence to cosmetic contact lenses

AimTo investigate whether cosmetic contact lenses (CCL) with surface pigments affect microbial adherence.MethodFifteen brands of CCL were purchased from optical, non-optical retail outlets, and via the Internet. A standardized rub-off test was performed on each CCL (five lenses per brand) to confirm the location of the pigments. The rub-off test comprised gentle rubbing on the surfaces of each CCL with wetted cotton buds for a maximum of 20 rubs per surface. A new set of CCL (five lenses per brand) were incubated in Pseudomonas aeruginosa overnight. Viable counts of adhered bacteria were determined by the number of colony-forming units (CFU) on agar media on each lens. The adherence of P. aeruginosa as well as Staphylococcus aureus and Serratia marcescens to three brands of CCL (A–C) (five lenses per brand) were also compared to their adherences on their clear counterparts.ResultsOnly two of the 15 brands of CCL tested (brands B and C) had pigments that did not detach with the rub-off test. The remaining 13 brands of CCL all failed the rub-off test and these lenses showed higher P. aeruginosa adherence (8.7 × 10⁵–1.9 × 10⁶ CFU/lens). Brands B and C lenses showed at least six times less bacterial adhesion than the other 13 brands. Compared to their clear counterparts, bacterial adherence to brands B and C lenses did not differ significantly, whereas brand A lenses showed significantly higher adherence.ConclusionSurface pigments on CCL resulted in significantly higher bacterial adherence.     

Childhood and lifetime risk comparison of myopia control with contact lenses

PurposeThe relative risks of ocular pathology with increasing myopia have been described; the absolute lifetime risk of vision impairment from myopia is yet to be compared to the childhood and lifetime risks of contact lens wear for myopia control.MethodsUsing peer-reviewed data, the absolute risks of microbial keratitis (MK) in daily disposable soft, reusable soft and orthokeratology contact lens (CL) wear were calculated over both a childhood (age 8–18) and a lifetime (age 8–65) of CL wear. This was compared to the previously published cumulative risk of vision impairment by age 75 based on increasing myopia and axial length. Data were converted utilizing the Council of International Organizations of Medical Sciences (CIOMS) classification system for frequency of adverse events, with 95 % confidence intervals included.ResultsThe lifetime risk of vision impairment in axial lengths over 26 mm and more than 6D of myopia is greater than the lifetime risk of MK in any CL modality, except for adult SCL extended wear. If axial length is below 26 mm and myopia lower than 3D, a lifetime of CL wear is more risky in comparison, except in the case of daily disposable wear. Ten years of childhood CL wear of any modality presents lower likelihood of MK than any comparable risk of vision impairment.ConclusionThe comparative lifetime risks of contact lens wear commenced at age 8 for myopia control are less than the lifetime risks of vision impairment with myopia more than 6D or axial length more than 26 mm. When only childhood CL wear is considered, the risk comparison is clearly skewed towards the positive impact of CL wear, especially in daily disposable wear. Clinicians should be confident to proactively recommend myopia control CL wear to younger children, as both the safety profile and potential preventative ocular health benefits are evident.     

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 16 h. 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 16 h 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).     

The effect of lens wear on refractive index of conventional hydrogel and silicone-hydrogel contact lenses: a comparative study.

PURPOSE: The purpose of this work was to evaluate the ability of four silicone-hydrogel contact lenses (galyfilcon A, balafilcon A, lotrafilcon A and lotrafilcon B) to retain their equilibrium water content before and after wear, through measurements of refractive index and compare with that of a conventional disposable hydrogel contact lens (etafilcon A). METHODS: The refractive indices of 115 contact lenses were measured using an automated refractometer (CLR 12-70, Index Instruments, Cambridge, U.K.) before and after a schedule of daily wear by 58 patients for 30 days in the case of silicone-hydrogel lenses and 15 days for the conventional contact lenses. RESULTS: In the silicone-hydrogel contact lenses the changes on the refractive indices were not statistically significant, however after being worn the refractive index of the conventional etalfilcon A hydrogel contact lens increased significantly (p<0.001). CONCLUSION: The results presented here show that after being worn the silicone-hydrogel contact lens, show more capacity to retain or to reach their initial equilibrium water content than conventional hydrogel contact lenses. This suggests that the silicone-hydrogel contact lenses are less susceptible to spoilation over time maintaining its biocompatibility and contributing to the clinical success of lens performance.     

Analysis of release kinetics of ocular therapeutics from drug releasing contact lenses: Best methods and practices to advance the field

Several methods have been proposed to achieve an extended and controlled release of ocular therapeutics via contact lenses; however, the experimental conditions used to study the drug release vary greatly and significantly influence the release kinetics. In this paper, we examine variations in the release conditions and their effect on the release of both hydrophilic and hydrophobic drugs (ketotifen fumarate, diclofenac sodium, timolol maleate and dexamethasone) from conventional hydrogel and silicone hydrogel lenses. Drug release was studied under different conditions, varying volume, mixing rates, and temperature. Volume had the biggest effect on the release profile, which ironically is the least consistent variable throughout the literature. When a small volume (2–30 mL) was used with no forced mixing and solvent exchange every 24 h, equilibrium was reached promptly much earlier than solvent exchange, significantly damping the drug release rate and artificially extending the release duration, leading to false conclusions. Using a large volume (200–400 mL) with a 30 rpm mixing rate and no solvent exchange, the release rate and total mass released was significantly increased. In general, the release performed in small volumes with no force mixing exhibited cumulative mass release amounts of 3–12 times less than the cumulative release amounts in large volumes with mixing. Increases in mixing rate and temperature resulted in relatively small increases of 1.4 and 1.2 times, respectively in fractional mass released. These results strongly demonstrate the necessity of proper and thorough analysis of release data to assure that equilibrium is not affecting release kinetics. This is paramount for comparison of various controlled drug release methods of therapeutic contact lenses, validation of the potential of lenses as an efficient and effective means of drug delivery, as well as increasing the likelihood of only the most promising methods reaching in vivo studies.