title: Severe ocular infections with contact lens: role of multipurpose solutions.
abstract: OBJECTIVE
  To determine whether multipurpose solutions, widely used for contact lens disinfections, could be at the origin of ocular pathologies (contact lens intolerance and ocular infections).
  
  
  METHODS
  An observational cohort study (questionnaire analysis) was carried out to estimate the number of contact lens wearers, type of infection, and type of lens care regimen used by patients. Besides, multipurpose solutions cytotoxicity (necrosis and apoptosis) was evaluated on a conjunctival cell line using cytofluorometry.
  
  
  RESULTS
  In the general population, 59% of contact lens wearers use multipurpose solutions whereas 35% use oxidative products. Of the questioned contact lens wearers with ocular infections, 80% used multipurpose solutions. Multipurpose solutions are therefore not efficient enough against microorganisms, and cannot be considered as disinfectant solutions but only as preservatives. However, preservatives are known to be toxic to ocular surface, so apoptosis induced by multipurpose solutions could lead to ocular surface diseases. Our cytofluorometry study allowed us to demonstrate that contact lens multipurpose solutions containing preservatives are cytotoxic through caspase 3 induction, chromatin condensation and P2X7 cell-death receptor activation, in contrast with unpreserved sterile saline solutions that were found inert.
  
  
  CONCLUSIONS
  Multipurpose solutions seem to be preservative but not disinfecting solutions. They are not adapted to the final rinse of contact lenses because of apoptosis induction. It could explain part of lens intolerance.
authors.affiliation: Université Paris Descartes, France.
authors.forename: M
authors.initials: M
authors.lastname: Dutot
authors.forename: H
authors.initials: H
authors.lastname: Paillet
authors.forename: C
authors.initials: C
authors.lastname: Chaumeil
authors.forename: J-M
authors.initials: JM
authors.lastname: Warnet
authors.forename: P
authors.initials: P
authors.lastname: Rat
mesh_terms: D000293:Adolescent; D000328:Adult; D017209:Apoptosis / Q000187:drug effects; D001419:Bacteria / Q000302:isolation & purification; D053148:Caspase 3 / Q000378:metabolism; D002460:Cell Line; D015331:Cohort Studies; D003228:Conjunctiva / Q000166:cytology / Q000187:drug effects / Q000201:enzymology; D018639:Contact Lens Solutions / Q000009:adverse effects* / Q000494:pharmacology; D003261:Contact Lenses / Q000009:adverse effects*; D003315:Cornea / Q000382:microbiology; D004789:Enzyme Activation / Q000187:drug effects; D004866:Equipment Contamination; D015817:Eye Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D055815:Young Adult
chemical_list: D018639:Contact Lens Solutions; C505407:CASP3 protein, human; D053148:Caspase 3