Sandoval Helga P, Crosson Craig E, Holzer Mike P, Vroman David T, Solomon Kerry D
Magill Research Center for Vision Correction and South Carolina Lions Eye Research Center, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Cataract Refract Surg. 2003 Sep;29(9):1727-32. doi: 10.1016/s0886-3350(03)00513-3.
To determine whether residual cleaner could be detected in the rinse solution of surgical instruments after a standard cleaning protocol.
Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.
The wavelength for maximum absorbance of 5 cleaners (Endozime) [The Ruhof Corp.], Enzol/Cidezyme [Advanced Sterilization Products], and Klenzyme [Steris Co.] enzymatic detergents; Palmolive Ultra dishwashing liquid [Colgate-Palmolive Co.]; and Universal concentrated surgical instrument cleaner and lubricant [B. Graczyk, Inc.]) was determined. Identically designed stainless-steel and titanium instruments were cleaned using a standardized protocol. Water temperatures of 25 degrees C (room temperature) or 40 degrees C (warm temperature) were used to rinse the instruments. The amount of residual cleaner in each rinse solution and remaining on each instrument at the completion of the cleaning procedure as a percentage of the total cleaner was determined.
Residues of all cleaners were detected using a standard protocol involving rinse solutions at 25 degrees C. Increasing the temperature of the rinse solutions significantly reduced the cleaner residues (P<.05, Friedman repeated-measures analysis of variance on ranks test and Student-Newman-Keuls test) regardless of the instrument material. No significant difference was detected in the residual cleaners on stainless-steel and titanium instruments.
Lower levels of cleaner residue were found on surgical instruments after a standard cleaning protocol using warm rinse water. Because cleaner residue has been reported to cause inflammation (eg, diffuse lamellar keratitis) after laser in situ keratomileusis (LASIK), it is advisable to use cleaners and cleaning protocols that result in acceptable cleaning without detectable levels of cleaner residue to avoid potentially harmful effects to the cornea after LASIK.
确定在执行标准清洁方案后，能否在手术器械的冲洗液中检测到残留清洁剂。
美国南卡罗来纳州查尔斯顿市南卡罗来纳医科大学斯托姆眼科研究所马吉尔视力矫正研究中心。
测定5种清洁剂（Endozime [鲁霍夫公司]）、Enzol/Cidezyme [高级消毒产品公司]、Klenzyme [史特瑞思公司] 酶洗涤剂、棕榄超浓缩餐具洗涤剂 [高露洁棕榄公司] 以及通用浓缩手术器械清洁剂和润滑剂 [B. 格拉齐克公司]）的最大吸光度波长。使用标准化方案清洁设计相同的不锈钢和钛制器械。用25摄氏度（室温）或40摄氏度（温水）的水温冲洗器械。测定每次冲洗液中以及清洁程序完成后残留在每个器械上的清洁剂残留量占清洁剂总量的百分比。
采用涉及25摄氏度冲洗液的标准方案能检测到所有清洁剂的残留。无论器械材质如何，提高冲洗液温度均能显著减少清洁剂残留（P<0.05，弗里德曼重复测量秩次方差分析和学生 - 纽曼 - 基尔斯检验）。在不锈钢器械和钛制器械上检测到的残留清洁剂无显著差异。
使用温水冲洗的标准清洁方案后，手术器械上的清洁剂残留水平较低。由于据报道清洁剂残留会在准分子原位角膜磨镶术（LASIK）后引发炎症（如弥漫性层间角膜炎），建议使用能实现可接受清洁效果且无可检测到的清洁剂残留水平的清洁剂和清洁方案，以避免LASIK术后对角膜产生潜在有害影响。
