Seal D V, Dalton A, Doris D
Tennent Institute of Ophthalmology, Western Infirmary, Glasgow, UK.
Eye (Lond). 1999 Apr;13 ( Pt 2):226-30. doi: 10.1038/eye.1999.56.
To establish the efficacy of the two most popular contact lens disinfecting systems--one-step hydrogen peroxide and multipurpose disinfecting solution--for 1 month's use in practice in the absence of tap water rinsing.
This was a descriptive, prospective microbiological study of contact lens contamination with ideal hygiene compliance and new lenses and storage cases. One hundred and fifty contact lens wearers were instructed to avoid risk factors identified for Acanthamoeba infection. They were randomly assigned to use one of three disinfecting systems and taught to follow manufacturers' instructions. In addition, they were taught to avoid all use of tap water for contact lens hygiene, except for hand washing.
There was no isolation of Acanthamoeba from any lens storage case, precluding the chance of amoebic infection. The multi-purpose solution gave the lowest rate of bacterial contamination, with 78% sterility and 15% of cases with < 10(4) bacteria/ml. For both one-step peroxide and multi-purpose solutions, Gram-negative bacteria were reduced in frequency compared with values expected historically, while Bacillus sp. were found more frequently. Storage cases of both one-step peroxide systems leaked fluid.
On the basis of contamination in previous studies, when hydrogen peroxide and other chemical disinfectants were used together with tap water washing, it was expected that approximately 40% of lens storage cases would yield bacteria, often with a high count, and that up to 8% would yield Acanthamoeba. Such contamination did not occur, however, in this study. The multipurpose solution, for 1 month's use, gave the lowest rate of bacterial contamination with only 7% of storage cases harbouring bacteria at > 10(4)/ml and with 78% sterility. One of the two one-step hydrogen peroxide systems performed equally well. Importantly, Acanthamoeba was not isolated from any of the 150 storage cases. Whether lens storage cases need to be sterile or contain < 10(3) bacteria/ml solution within them is debatable, but it is essential that Acanthamoeba be absent from them.
在不使用自来水冲洗的情况下，确定两种最常用的隐形眼镜消毒系统——一步法过氧化氢和多功能消毒溶液——在实际使用1个月时的有效性。
这是一项描述性、前瞻性的微生物学研究，研究对象为具有理想卫生依从性、新镜片和储存盒的隐形眼镜污染情况。150名隐形眼镜佩戴者被告知要避免已确定的棘阿米巴感染风险因素。他们被随机分配使用三种消毒系统中的一种，并按照制造商的说明进行操作。此外，他们还被告知，除了洗手外，在隐形眼镜卫生方面要避免使用所有自来水。
在任何镜片储存盒中均未分离出棘阿米巴，排除了阿米巴感染的可能性。多功能溶液的细菌污染率最低，无菌率为78%，15%的病例细菌含量<10⁴/ml。对于一步法过氧化氢和多功能溶液，革兰氏阴性菌的频率与历史预期值相比有所降低，而芽孢杆菌属的发现频率更高。两种一步法过氧化氢系统的储存盒均有漏液现象。
根据以往研究中的污染情况，当过氧化氢和其他化学消毒剂与自来水冲洗一起使用时，预计约40%的镜片储存盒会产生细菌，且细菌数量通常较高，高达8%的储存盒会产生棘阿米巴。然而，本研究中并未出现此类污染。使用1个月的多功能溶液细菌污染率最低，只有7%的储存盒细菌含量>10⁴/ml，无菌率为78%。两种一步法过氧化氢系统中的一种表现同样良好。重要的是，在150个储存盒中均未分离出棘阿米巴。镜片储存盒是否需要无菌或盒内溶液细菌含量<10³/ml存在争议，但其中不存在棘阿米巴至关重要。
