title: Multipurpose care solution-induced corneal surface disruption and Pseudomonas aeruginosa internalization in the rabbit corneal epithelium.
abstract: OBJECTIVE
  To evaluate the effects of a chemically preserved multipurpose contact lens care solution (MPS) on the corneal epithelial surface and Pseudomonas aeruginosa (PA) internalization in the rabbit corneal epithelium.
  
  
  METHODS
  Rabbits were fit in one eye with a silicone hydrogel lens (balafilcon A) soaked overnight in a borate-buffered MPS (BioTrue). The contralateral eye was fit with a lens removed directly from the blister pack containing borate-buffered saline (control). Lenses were worn for 2 hours. Upon lens removal, corneas were challenged ex vivo with invasive PA strain 6487 and assessed for PA internalization. Ultrastructural changes were assessed using scanning electron (SEM) and transmission electron microscopy (TEM).
  
  
  RESULTS
  Scanning electron microscopy showed frank loss of surface epithelium in MPS-exposed eyes, while control eyes exhibited occasional loss of surface membranes but retention of intact junctional borders. Transmission electron microscopy data supported and extended SEM findings, demonstrating the presence of epithelial edema in MPS-treated eyes. There was a 12-fold increase in PA uptake into the corneal epithelium following wear of the MPS-treated lens compared to control (P = 0.008).
  
  
  CONCLUSIONS
  These data demonstrate that corneal exposure to MPS during lens wear damages the surface epithelium and are consistent with our previous clinical data showing an increase in bacterial binding to exfoliated epithelial cells following MPS use with resultant increased risk for lens-mediated infection. These findings also demonstrate that the PA invasion assay may provide a highly sensitive quantitative metric for assessing the physiological impact of lens-solution biocompatibility on the corneal epithelium.
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
authors.forename: Leila C
authors.initials: LC
authors.lastname: Posch
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
authors.forename: Meifang
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Robertson
mesh_terms: D000818:Animals; D001422:Bacterial Adhesion / Q000187:drug effects*; D015169:Colony Count, Microbial; D018639:Contact Lens Solutions / Q000009:adverse effects*; D003261:Contact Lenses / Q000382:microbiology*; D004195:Disease Models, Animal; D019573:Epithelium, Corneal / Q000382:microbiology* / Q000473:pathology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D018613:Microscopy, Confocal; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D011817:Rabbits
chemical_list: D018639:Contact Lens Solutions
keywords: Pseudomonas aeruginosa; contact lens; corneal epithelium; microbial keratitis; multipurpose solution