title: Surgical glove-associated diffuse lamellar keratitis.
abstract: 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.
authors: Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA. rshoffman@finemd.com
authors: Richard S
authors: RS
authors: Hoffman
authors: I Howard
authors: IH
authors: Fine
authors: Mark
authors: M
authors: Packer
authors: Tony P
authors: TP
authors: Reynolds
authors: Cherie Van
authors: CV
authors: Bebber
mesh_terms: 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
chemical_list: D012827:Silicone Oils