title: Residual cleaner after normal cleaning of laser in situ keratomileusis instruments.
abstract: OBJECTIVE
  To determine whether residual cleaner could be detected in the rinse solution of surgical instruments after a standard cleaning protocol.
  
  
  METHODS
  Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Helga P
authors.initials: HP
authors.lastname: Sandoval
authors.forename: Craig E
authors.initials: CE
authors.lastname: Crosson
authors.forename: Mike P
authors.initials: MP
authors.lastname: Holzer
authors.forename: David T
authors.initials: DT
authors.lastname: Vroman
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Solomon
mesh_terms: D000704:Analysis of Variance; D003902:Detergents; D004350:Drug Residues; D006358:Hot Temperature; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D012996:Solutions; D013193:Stainless Steel; D014025:Titanium; D014867:Water
chemical_list: D003902:Detergents; D012996:Solutions; D014867:Water; D013193:Stainless Steel; D014025:Titanium