MoisturePlus Contact Lens Solution as a Source of Acanthamoeba Keratitis

Hasler, Simon; Dedes, Wasiliki; Mathis, Alexander; Grimm, Felix; Thiel, Michael

doi:10.1097/ico.0b013e318183a34b

Cited by 9 publications

(3 citation statements)

References 8 publications

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“…It has been established that no evidence exists in either outbreak to support solution contamination in sealed production lot testing 9, 18. PCR testing of unsealed solution bottles is not supportive of lot contamination, because it lacks confirmation of the source as well as the viability of the genetic material detected 23. Further, the diversity of fungal isolates in the CDC study and of Acanthamoeba isolates in the Chicago study makes it highly unlikely that a single source contamination occurred with either solution 9, 24…”

Section: Proposed Pathogenesis Of Contact-lens Related Atypical Keratmentioning

confidence: 99%

Recent Outbreaks of Atypical Contact Lens-Related Keratitis: What Have We Learned?

Joslin

2010

American Journal of Ophthalmology

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Purpose-To examine the public health implications of two recent outbreaks of atypical contact lens-related infectious keratitis.Design-A perspective based on the literature and authors' experience.Results-The contact lens-related fusarium and acanthamoeba keratitis outbreaks were both detected by dramatic rises seen in tertiary care centers in Singapore and the US, respectively. Case control studies in both outbreaks each were able to identify a strong association with the use of different contact lens disinfection solutions. Their respective recalls resulted in a steep decline of fusarium keratitis, but not of acanthamoeba keratitis. Early investigations into each solution association implicate components not directly related to their primary disinfectant, but the true pathogenesis remains unknown. However, the number of Acanthamoeba cases individually attributed to each of almost all available disinfection systems exceeds previously understood total US incidence, suggesting other risk factors. Current standards do not require demonstration of anti-acanthamoebal activity. Yet, despite the inclusion of fusarium in mandatory testing for solutions, current pre-market testing was not predictive of the outbreak.Conclusions-The two recent outbreaks of atypical contact-lens related keratitis have reinforced the value of tertiary care eye care centers in detecting early rises in rare infections and the power of adaptable, well-designed epidemiologic investigations. While fusarium keratitis has significantly declined with the recall of Renu with Moistureloc, the persistence of Acanthamoeba keratitis begs fundamental changes in contact lens hygiene practices, inclusion of acanthamoeba as a test organism and contact lens disinfectant test regimens for all contact lens-related pathogens which are verifiably reflective of end user contact lens wear complications.

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Section: Proposed Pathogenesis Of Contact-lens Related Atypical Keratmentioning

confidence: 99%

Recent Outbreaks of Atypical Contact Lens-Related Keratitis: What Have We Learned?

Joslin

2010

American Journal of Ophthalmology

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“…The overall ineffectiveness of leading commercial MPS formulations against Acanthamoeba is not surprising as the majority of these products contain chemically similar active ingredients which possess minimal antiprotozoal properties. Specific MPS formulations have been implicated in the past as a risk factor for contracting Acanthamoeba -associated keratitis, with evidentiary ribosomal presence of the organism in the solution which indicated a clear relationship between use and disease [ 21 ]. The presence of Acanthamoeba spp.…”

Section: Introductionmentioning

confidence: 99%

Comparative in vitro effectiveness of a novel contact lens multipurpose solution on Acanthamoeba castellanii

Fears

Metzinger

Killeen

et al. 2018

J Ophthal Inflamm Infect

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BackgroundA multipurpose contact lens cleaning solution (MPS) containing novel active ingredients under development was compared to two commercially available MPS solutions for effectiveness against Acanthamoeba isolates.MethodsThe Acanthamoeba isolate A. castellanii was propagated for trophozoite or cyst-containing cultures for the purpose of assessment of effectiveness of each MPS. An alamar blue-based cellular respiration assay was used to assess effectiveness against trophozoites; Trypan blue hemocytometer-based microscopic counts measured cysticidal effects. To assess the general antimicrobial potency of each solution as controls for the anti-amoebic assays, comparative bactericidal effectiveness using Serratia marcenses was also performed.ResultsMinimal effectiveness against either Acanthamoeba form was observed from either commercial MPS. In contrast, the novel MPS achieved complete kill within 1 h contact time for both Acanthamoeba trophozoite and cysts. Each commercial MPS required 6 h contact time to achieve a two to three log reduction in S. marcenses. In contrast, the experimental MPS achieved disinfection in 60 min contact time, and complete kill (< 1 CFU) at 90 min.ConclusionsResults suggest that the inclusion of a novel ingredient combination within the MPS under development clearly is required and is ideal for rapid and effective killing of Acanthamoeba species in the context of contact lens disinfection systems. The representative commercially available MPS used in this testing provided minimal effectiveness against the protozoa regardless of contact time. In addition, comparative results with the bacterial agent in the control study show distinct differences in the speed to disinfection with the novel MPS. Future MPS development should consider inclusion of novel chemical entities that are effective against Acanthamoeba species to speed disinfection and further reduce the exposure potential of users of contact lenses and cleaning systems.

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“…If daily disposable contact lenses cannot be used, then hydrogen peroxide cleaning solutions are preferred over the more common multipurpose solutions because hydrogen peroxide has shown increased efficacy against Acanthamoeba cysts and because the efficacy of multipurpose solutions against Acanthamoeba has recently been called into question. 19,20,21,30,31 Planned replacement of contact lens storage cases may also help reduce contamination. It is important for eye care professionals not only to emphasize proper contact lens wear and hygiene in the prevention of infectious keratitis but also to maintain a high clinical suspicion for AK because an early diagnosis may lead to a better visual outcome.…”

Section: Resultsmentioning

confidence: 99%

The Clinical Experience of Acanthamoeba Keratitis at a Tertiary Care Eye Hospital

Tanhehco

Colby

2010

Cornea

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MoisturePlus Contact Lens Solution as a Source of Acanthamoeba Keratitis

Cited by 9 publications

References 8 publications

Recent Outbreaks of Atypical Contact Lens-Related Keratitis: What Have We Learned?

Recent Outbreaks of Atypical Contact Lens-Related Keratitis: What Have We Learned?

Comparative in vitro effectiveness of a novel contact lens multipurpose solution on Acanthamoeba castellanii

The Clinical Experience of Acanthamoeba Keratitis at a Tertiary Care Eye Hospital

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