Chlorhexidine Effects on Corneal Epithelium and Endothelium

Green, Keith; Livingston, Velda; Bowman, Karl M.; Hull, D

doi:10.1001/archopht.1980.01020040125020

Cited by 84 publications

(34 citation statements)

References 8 publications

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“…Chlorhexidine, however, has excellent germicidal properties (12,13,(16)(17)(18)21) with persistent effect (16,17,21) and has been successfully used in contact lens solutions. Toxicological studies have shown that chlorhexidine is safe as a contact lens disinfectant (2,10), and direct topical application of concentrations of up to 2% causes neither visible nor light microscopic corneal changes (9,15), although superficial epithelial changes are noted by electron microscopy (4,6). We have investigated the efficacy of various concentrations of aqueous chlorhexidine gluconate in experimental models to study its use as a potential preoperative antiseptic agent for the eye.…”

mentioning

confidence: 44%

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Hamill¹,

Osato²,

Wilhelmus³

1984

Antimicrob Agents Chemother

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Chlorhexidine gluconate is a bisguanide germicide currently available with 70% isopropanol (Hibistat, Hibitane) or a detergent (Hibiclens, Hibiscrub) for preoperative skin preparation. As these solvents are toxic to the cornea, we investigated the safety and efficacy of aqueous chlorhexidine solutions for ophthalmic use. Chlorhexidine in Tris-glycine buffer was evaluated for retardation of epithelial regeneration after experimental corneal abrasion in rabbits. Irrigant concentrations of 2.0 and 4.0% chlorhexidine significantly slowed the healing rate (0.546 and 0.076 mm/h, respectively) compared with saline controls (0.938 mm/h). Irrigant concentrations of .l% did not statistically delay healing (P > 0.4). In a separate group of animals, the right conjunctivae of pigmented rabbits were inoculated with Staphylococcus epidermidis (_107 organisms per eye) and irrigated with 40 ,lI of aqueous chlorhexidine in concentrations of 0.1, 0.5, and 1.0%; the left eyes were irrigated with saline or left untreated. Quantitative conjunctival cultures were obtained, and the total number of organisms recovered per eye was calculated. All chlorhexidine-treated eyes showed significant reduction in organisms compared with either untreated or saline-irrigated control eyes (P < 0.001). In vitro antimicrobial susceptibility testing demonstrated chlorhexidine in concentrations of 0.1 to 4% to be highly active against a variety of gram-positive and gram-negative bacterial pathogens by disk diffusion and broth diffusion assays.

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mentioning

confidence: 44%

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Hamill¹,

Osato²,

Wilhelmus³

1984

Antimicrob Agents Chemother

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“…As an example, the periorbi tal use of a detergent containing 4% chlorhexidine in duced irreparable damage to the cornea of an anaesthe tised patient [ 18]. The application of a chlorhexidine solu tion >0.05% to the eye is contraindicated, since swelling of the stroma was demonstrated to be due to the use of a 0.05% solution of chlorhexidine gluconate [19]. When a 0.1 % solution is applied, the outcome is a loss of the sur face layers of the corneal epithelium and the microvilli of the second layer [20]; the conjunctival reaction sets in with a solution stronger than 0.005-0.05% [21].…”

Section: Periorbital Antisepsissupporting

confidence: 39%

Prophylactic Use of Topical Anti-lnfectives in Ophthalmology

Krämer¹,

Behrens–Baumann

1997

Ophthalmologica

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The prophylactic use of topical anti-infectives is indicated on the eye (1) prior to any surgery on the eye, by periorbital and conjunctival administration and, if required, intraoperatively as well; (2) in the form of the CredÉ prophylaxis against ophthalmia neonatorum; (3) with accidental pathogenic contamination of the eye; (4) to prevent conjunctivitis by intensive care surgical patients; (5) for the antiseptic irrigation of donor bulbi prior to keratoplasty, and (6) if required, to prevent ocular infection in a given epidemiological situation. The drug of first choice is poly vinylpyrrolidone-iodine at a concentration ranging from 1.5 to 5%. Another topical anti-infective is a 0.02 or 0.01% solution of polyhexanide, a promising medication, currently in the process of being approved.

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“…This differs from corneas that are bathed on their anterior surfaces with silicone oil where low swelling rates of about 3-5 pm/h occur [10,12], The stability of the control tissue swelling rate, however, indi cates that the cornea is behaving in the same manner over the experimental time period, but that even Na+/K+ BTS cannot serve to maintain constant corneal thickness. Switch ing the epithelial bathing solution to a K+-free solution, with all other conditions remaining constant, caused the cornea to undergo a greater degree of initial swelling.…”

Section: Discussionmentioning

confidence: 47%

“…as measured on a Precision uOsmette osmometer. Per fusion of the epithelium was at 2 ml/min with with drawal of the solution by vacuum [12], Iso-osmotic substitution of KCI was made with NaCl (K+-free BTS). and the solution had an osmolarity of 302 mosm at pH 7.4.…”

Section: Aterials and M Eth O D Smentioning

confidence: 42%

Tear Potassium Contributes to Maintenance of Corneal Thickness

et al. 1992

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Isolated rabbit corneas were bathed on their endothelial surfaces with normal Krebs bicarbonate Ringer solution, while the epithelial surfaces were bathed in a basic tear solution containing sodium and potassium. When bathed in basic tear solution alone, corneal swelling occurred at an average of 12 μm/h over a 3-hour period. Corneal swelling occurred at a rate of about 21 μm/h when the epithelial solution was switched from normal basic tear solution to an iso-osmotic K⁺-free basic tear solution. Corneal swelling then slowed, and in the final hour of a 3-hour exposure to K⁺-free tear solution, the corneas deswelled at about 10 μm/h. The data indicate that potassium is a necessary solute for the maintenance of normal corneal thickness. The results suggest that a lacrimal dysfunction that would cause a decrease in the potassium content of tears may influence corneal thickness and also suggest that the inclusion of potassium in artificial tears is important.

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Chlorhexidine Effects on Corneal Epithelium and Endothelium

Cited by 84 publications

References 8 publications

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Prophylactic Use of Topical Anti-lnfectives in Ophthalmology

Tear Potassium Contributes to Maintenance of Corneal Thickness

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