[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.161.155.6. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
July 1990

Time Course of Experimental Pseudomonas aeruginosa Keratitis in Contact Lens Overwear

Author Affiliations

From the Eye Research Institute (Drs Lawin-Brüssel, Refojo, and Kenyon, and Mss Leong and Hanninen) and Department of Ophthalmology (Drs Lawin-Brüssel, Refojo, and Kenyon), Harvard Medical School, Boston, Mass.

Arch Ophthalmol. 1990;108(7):1012-1019. doi:10.1001/archopht.1990.01070090114052
Abstract

• New perfilcon contact lenses (71% water) were placed on one eye of 36 rabbits under complete tarsorrhaphy for 7 days. The lenses were then removed, and 18 were incubated for 1 hour with a suspension of 1 × 108 colony-forming units per milliliter of Pseudomonas aeruginosa and replaced on their respective corneas. The remaining 18 eyes were inoculated with 0.1 mL of the P aeruginosa suspension; the lenses were not replaced. All eyes were again closed by tarsorrhaphy for 4, 8, 16, 24, 36, or 48 hours. Ulcerative keratitis occurred in contact lens-wearing eyes only, as P aeruginosa penetrated the epithelium at 8 to 36 hours, and polymorphonuclear leukocyte migration began at 24 hours. Compared with conventional abrasion-wound models, the time course of infectious keratitis in this model was delayed, possibly due to less preexisting corneal trauma, but our findings suggest that soft contact lens wear facilitates bacterial invasion and also inhibits the host inflammatory response.

References
1.
Donnenfeld ED, Cohen EJ, Arentsen JJ, Genvert GI, Laibson PR.  Changing trends in contact lens associated corneal ulcers: an overview of 116 cases . CLAO J . 1986;12:145-149.
2.
Alfonso E, Mandelbaum S, Fox MJ, Forster RK.  Ulcerative keratitis associated with contact lens wear . Am J Ophthalmol . 1986;101:429-433.
3.
Bowden FW III, Cohen EJ, Arentsen JJ, Laibson PR.  Patterns of lens care practices and lens product contamination in contact lens associated microbial keratitis . CLAO J . 1989;15:49-54.
4.
Chalupa E, Swarbrick HA, Holden BA, Sjöstrand J.  Severe corneal infections associated with contact lens wear . Ophthalmology . 1987;94:17-22.Article
5.
Cohen EJ, Laibson PR, Arentsen JJ, Clemons CS.  Corneal ulcers associated with cosmetic extended wear soft contact lenses . Ophthalmology . 1987;94:109-114.Article
6.
Dart JKG.  Predisposing factors in microbial keratitis: the significance of contact lens wear . Br J Ophthalmol . 1988;72:926-930.Article
7.
Dart JKG, Seal DV.  Pathogenesis and therapy of Pseudomonas aeruginosa keratitis . Eye . 1988;2( (suppl) ):S46-S55.Article
8.
Baum J, Panjwani N.  Adherence of Pseudomonas to soft contact lenses and cornea: mechanisms and prophylaxis . In: Cavanagh HD, ed. The Cornea: Transactions of the World Congress on the Cornea III . New York, NY: Raven Press; 1988:301-307.
9.
Costerton JW, Geesey GG, Cheng KJ.  How bacteria stick . Sci Am . 1978;238:86-95.Article
10.
Ramphal R, Pyle M.  Evidence for mucins and sialic acid as receptors for Pseudomonas aeruginosa in the lower respiratory tract . Infect Immun . 1983;41:339-344.
11.
Abraham SN, Beachy EH, Simpson WA.  Adherence of Streptococcus pyogenes, Escherichia coli and Pseudomonas aeruginosa to fibronectin-coated and uncoated epithelial cells . Infect Immun . 1983;41:1261-1268.
12.
Hazlett LD, Moon M, Berk RS.  In vivo identification of sialic acid as the ocular receptor for Pseudomonas aeruginosa . Infect Immun . 1986;51:687-689.
13.
Binder PS.  Complications associated with extended wear of soft contact lenses . Ophthalmology . 1979;86:1093-1101.Article
14.
Kessler E, Mondino BJ, Brown SI.  The corneal response to Pseudomonas aeruginosa: histopathological and enzymatic characterization . Invest Ophthalmol Vis Sci . 1977;16:116-125.
15.
Lemp MA, Blackman HJ.  Ocular surface defense mechanisms . Ann Ophthalmol . 1981;13:61-63.
16.
Selinger DS, Selinger RC, Reed WP.  Resistance to infection of the external eye: the role of tears . Surv Ophthalmol . 1979;24:33-38.Article
17.
Hyndiuk RA, Snyder RW.  Bacterial keratitis . In: Smolin G, Thoft RA, eds. The Cornea: Scientific Foundations and Clinical Practice . 2nd ed. Boston, Mass: Little Brown & Co Inc; 1987:193-225.
18.
Friedlaender MH.  Humoral and cellular responses of ocular inflammation . Int Ophthalmol Clin . 1983;23( (1) ):3-14.Article
19.
Butrus SI, Klotz SA, Misra RP.  The adherence of Pseudomonas aeruginosa to soft contact lenses . Ophthalmology . 1987;94:1310-1314.Article
20.
Duran JA, Refojo MF, Gipson IK, Kenyon KR.  Pseudomonas attachment to new hydrogel contact lenses . Arch Ophthalmol . 1987;105:106-109.Article
21.
Van Horn DL, Davis SD, Hyndiuk RA, Pederson HJ.  Experimental Pseudomonas keratitis in the rabbit: bacteriologic, clinical, and microscopic observations . Invest Ophthalmol Vis Sci . 1981;20:213-221.
22.
DiGaetano M, Stern GA, Zam ZS.  The pathogenesis of contact lens-associated Pseudomonas aeruginosa corneal ulceration, II: an animal model . Cornea . 1986;5:155-158.Article
23.
Duran JA, Refojo MF, Kenyon KR.  Hydrogel contact lens-induced Pseudomonas keratitis in a rabbit model . Cornea . 1987;6:258-260.Article
24.
Ramphal R, McNiece MT, Polack FM.  Adherence of Pseudomonas aeruginosa to the injured cornea: a step in the pathogenesis of corneal infections . Ann Ophthalmol . 1981;13:421-425.
25.
Hyndiuk RA.  Experimental Pseudomonas keratitis . Trans Am Ophthalmol Soc . 1981;79:541-624.
26.
Spurr-Michaud SJ, Barza M, Gipson IK.  An organ culture system for study of adherence of Pseudomonas aeruginosa to normal and wounded corneas . Invest Ophthalmol Vis Sci . 1988;29:379-386.
27.
Koch JM, Refojo MF, Hanninen L, Leong FL, Kenyon KR.  Pseudomonas keratitis related to extended soft contact lens wear in a rabbit model . Invest Ophthalmol Vis Sci . 1989;30( (suppl) ):42.
28.
Aswad MI, Barza M, Baum J.  Effect of lid closure on contact lens-associated Pseudomonas keratitis . Arch Ophthalmol . 1989;107:1667-1670.Article
29.
Hart DE, Schkolnick JA, Bernstein S, Wallach D, Gross DF.  Contact lens induced giant papillary conjunctivitis: a retrospective study . J Am Optom Assoc . 1989;60:195-204.
30.
SAS User's Guide: Basics, Version 5 Edition . Cary, NC: SAS Institute; 1985:1181.
31.
Koch JM, Refojo MF, Leong FL, Kenyon KR.  Keratopathy of the rabbit cornea following complete eyelid closure . Acta Ophthalmol . 1989;67( (suppl) ):108-114.Article
32.
Graham CM, Dart JKG, Buckley RJ.  Extended wear hydrogel and daily wear hard contact lenses for aphakia . Ophthalmology . 1986;93:1489-1494.Article
33.
Holden BA, Sweeney DF, Vannas A, et al.  Effects of long-term extended contact lens wear on the human cornea . Invest Ophthalmol Vis Sci . 1985;26:1489-1501.
34.
Efron N, Carney LG.  Oxygen levels beneath the closed eyelid . Invest Ophthalmol Vis Sci . 1979;18:93-95.
35.
Katz J, Kaufman HE.  Corneal exposure during sleep (nocturnal lagophthalmos) . Arch Ophthalmol . 1977;95:449-453.Article
36.
Stern GA, Zam ZS.  The pathogenesis of contact lens-associated Pseudomonas aeruginosa corneal ulceration, I: the effect of contact lens coatings on adherence of Pseudomonas aeruginosa to soft contact lenses . Cornea . 1986;5:41-45.Article
37.
Dart JK, Badenoch PR.  Bacterial adherence to contact lenses . CLAO J . 1986;12:220-224.
38.
Stern GA, Lubniewski A, Allen C.  The interaction between Pseudomonas aeruginosa and the corneal epithelium: an electron microscopic study . Arch Ophthalmol . 1985;103:1221-1225.Article
39.
Stern GA, Weitzenkorn D, Valenti J.  Adherence of Pseudomonas aeruginosa to the mouse cornea: epithelial vs stromal adherence . Arch Ophthalmol . 1982;100:1956-1958.Article
40.
Klotz SA, Au Y-K, Misra RP.  A partialthickness epithelial defect increases the adherence of Pseudomonas aeruginosa to the cornea . Invest Ophthalmol Vis Sci . 1989;30:1069-1074.
41.
Robb RM, Kuwabara T.  Corneal wound healing, I: the movement of polymorphonuclear leukocytes into corneal wounds . Arch Ophthalmol . 1962;68:636-642.Article
42.
Basu PK, Minta JO.  Chemotactic migration of leucocytes through corneal layers: an in vitro study . Can J Ophthalmol . 1976;11:235-240.
43.
Chusid MJ, Davis SD.  Experimental bacterial keratitis in neutropenic guinea pigs: polymorphonuclear leukocytes in corneal host defense . Infect Immun . 1979;24:948-952.
44.
Kenyon KR, Berman M, Rose J, Gage J.  Prevention of stromal ulceration in the alkaliburned rabbit cornea by glued-on contact lens: evidence for the role of polymorphonuclear leukocytes in collagen degradation . Invest Ophthalmol Vis Sci . 1979;18:570-587.
45.
Jones DB.  Pathogenesis of bacterial and fungal keratitis . Trans Ophthalmol Soc UK . 1978;98:367-371.
46.
Steuhl KP, Döring G, Henni A, Thiel H-J, Botzenhart K.  Relevance of host-derived and bacterial factors in Pseudomonas aeruginosa corneal infections . Invest Ophthalmol Vis Sci . 1987;28:1559-1568.
×