title: Microbial adhesion to silicone hydrogel lenses:  a review.
abstract: OBJECTIVE
  Microbial adhesion to contact lenses is believed to be one of the initiating events in the formation of many corneal infiltrative events, including microbial keratitis, that occur during contact lens wear. The advent of silicone hydrogel lenses has not reduced the incidence of these events. This may partly be related to the ability of microbes to adhere to these lenses. The aim of this study was to review the published literature on microbial adhesion to contact lenses, focusing on adhesion to silicone hydrogel lenses.
  
  
  METHODS
  The literature on microbial adhesion to contact lenses was searched, along with associated literature on adverse events that occur during contact lens wear. Particular reference was paid to the years 1995 through 2012 because this encompasses the time when the first clinical trials of silicone hydrogel lenses were reported, and their commercial availability and the publication of epidemiology studies on adverse events were studied.
  
  
  RESULTS
  In vitro studies of bacterial adhesion to unworn silicone hydrogel lens have shown that generally, bacteria adhere to these lenses in greater numbers than to the hydroxyethyl methacrylate-based soft lenses. Lens wear has different effects on microbial adhesion, and this is dependent on the type of lens and microbial species/genera that is studied. Biofilms that can be formed on any lens type tend to protect the bacteria and fungi from the effects on disinfectants. Fungal hyphae can penetrate the surface of most types of lenses. Acanthamoeba adhere in greater numbers to first-generation silicone hydrogel lenses compared with the second-generation or hydroxyethyl methacrylate-based soft lenses.
  
  
  CONCLUSIONS
  Microbial adhesion to silicone hydrogel lenses occurs and is associated with the production of corneal infiltrative events during lens wear.
authors.affiliation: School of Optometry and Vision Science, University of New South Wales, Sydney, Australia. m.willcox@unsw.edu.au
authors.forename: Mark D P
authors.initials: MD
authors.lastname: Willcox
mesh_terms: D001422:Bacterial Adhesion; D001424:Bacterial Infections / Q000209:etiology*; D018441:Biofilms; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D003316:Corneal Diseases / Q000382:microbiology*; D006801:Humans; D020100:Hydrogels; D012828:Silicones
chemical_list: D020100:Hydrogels; D012828:Silicones