Surgical glove-associated diffuse lamellar keratitis.
OBJECTIVE
To demonstrate a potential cause of a prolonged epidemic of diffuse lamellar keratitis (DLK).


METHODS
This retrospective review analyzed an epidemic of diffuse lamellar keratitis over a 3-year period in a single surgery center. Altering the brand of surgical gloves used during surgery was associated with an elimination of the DLK epidemic. Optical microscopy, scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS), and Fourier transform infrared (FTIR) spectroscopy were performed on both brands of surgical gloves to allow for comparisons and determine possible surface contaminants responsible for the DLK outbreaks.


RESULTS
The incidence of DLK during the epidemic ranged from 2% to 38% on a quarterly basis for the 3-year period. A change in the brand of surgical gloves resulted in a cessation of DLK. Surface analysis of both brands of gloves revealed extensive silicone oil contamination on the internal and external surfaces of the DLK-associated gloves and insignificant amounts of silicone oil on the external surface of the DLK-free gloves.


CONCLUSIONS
Silicone oil contamination of surgical gloves appears to be associated with epidemic DLK.
Hoffman
Richard S
RS
Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA. rshoffman@finemd.com
Fine
I Howard
IH
Packer
Mark
M
Reynolds
Tony P
TP
Bebber
Cherie Van
CV
D003319:Corneal Stroma / Q000473:pathology*; D004577:Electron Probe Microanalysis; D004866:Equipment Contamination; D005932:Gloves, Surgical / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D008855:Microscopy, Electron, Scanning; D009216:Myopia / Q000601:surgery; D012189:Retrospective Studies; D012827:Silicone Oils / Q000009:adverse effects*; D017550:Spectroscopy, Fourier Transform Infrared
D012827:Silicone Oils