Microbial Bioburden of Orthokeratology Contact Lens Care System

Lo, Jung; Kuo, Ming‐Tse; Chien, Chun-Chih; Tseng, Shin-Ling; Lai, Yu-Hsuan; Fang, Po-Chiung

doi:10.1097/icl.0000000000000130

Cited by 8 publications

(4 citation statements)

References 42 publications

(91 reference statements)

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“…Though atropine, especially in low concentrations (0.01%) has been demonstrated to slow myopia progression in children minimal deleterious effects on accommodation, pupil size or post-cessation refractive power (“rebound”), widespread uptake has been limited by lack of availability [ 19 ]. Though orthokeratology has received fairly wide acceptance in urban parts of East Asia [ 20 ], cost and concerns over infection from nocturnal use of tight contact lenses [ 21 – 22 ] make this approach unsuitable for large-scale programs that might significantly reduce the burden of myopia in the region.…”

Section: Introductionmentioning

confidence: 99%

Pilot study of a novel classroom designed to prevent myopia by increasing children’s exposure to outdoor light

et al. 2017

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We sought to assess light characteristics and user acceptability of a prototype Bright Classroom (BC), designed to prevent children’s myopia by exposing them to light conditions resembling the outdoors. Conditions were measured throughout the school year in the glass-constructed BC, a traditional classroom (TC) and outdoors. Teachers and children completed user questionnaires, and children rated reading comfort at different light intensities. A total of 230 children (mean age 10.2 years, 57.4% boys) and 13 teachers (36.8 years, 15.4% men) completed questionnaires. The median (Inter Quartile Range) light intensity in the BC (2,540 [1,330–4,060] lux) was greater than the TC (477 [245–738] lux, P < 0.001), though less than outdoors (19,500 [8,960–36,000] lux, P < 0.001). A prominent spectral peak at 490–560 nm was present in the BC and outdoors, but less so in the TC. Teachers and children gave higher overall ratings to the BC than TC, and light intensity in the BC in summer and on sunny days (>5,000 lux) was at the upper limit of children’s comfort for reading. In summary, light intensity in the BC exceeds TC, and is at the practical upper limit for routine use. Children and teachers prefer the BC.

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Section: Introductionmentioning

confidence: 99%

Pilot study of a novel classroom designed to prevent myopia by increasing children’s exposure to outdoor light

et al. 2017

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“…Another reason why OOK CL wearers are more susceptible to infection is that they are relatively young and, according to a previous report, the microbial contamination rate of OOK CL care system in this age group is high. 21 Although compared to nocturnal soft CL wearers, the use of OOK, a kind of rigid gas-permeable lenses, should minimize the risk of AK because it is easy to remove the attached Acanthamoeba trophozoites and cysts from the smooth and more homogeneous surface of these CL. 22,23 In addition to patient noncompliance such as use of homemade saline, suboptimal disinfection of lens, and adding new solution to an existing volume of used solution in the lens case, CL-associated AK was associated with contact with contaminated water sources, such as swimming in contaminated water or the use of tap water for lens rinsing and storage.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Overnight orthokeratology-associated Acanthamoeba keratitis at a tertiary referral hospital in Taiwan: A retrospective case-control study

Hsu

Kuo

Lin

et al. 2022

Journal of the Chinese Medical Association

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Background: Acanthamoeba keratitis (AK) is a vision-threatening disease, usually associated with contact lens (CL) wear. As overnight orthokeratology (OOK) is increasingly used to control myopia, we have found incidence of OOK-associated AK is increasing. This study aimed to investigate the clinical presentation and visual outcomes of OOK-associated AK. Methods: Demographic characteristics, clinical features, and treatment outcomes were collected by reviewing the medical charts of CL-associated AK patients (n = 35) diagnosed at Taipei Veterans General Hospital from 2001 to 2016. Cases were OOKassociated AK patients (n = 13), and controls were all other CL-associated AK patients (n = 22). Student t tests and chi-square tests were used to compare cases and controls. Linear regression analyses were used to identify factors associated with the final visual outcome in CL-associated AK. Results: OOK-associated AK accounted for half of all CL-associated AK after 2010. OOK-associated AK patients and other CL-associated patients had similar best-corrected logarithm of the minimum angle of resolution visual acuity (BCLVA) before treatment (1.10 ± 0.75 vs 1.13 ± 0.76, p = 0.893), but OOK-associated AK patients were younger (17.15 ± 3.21 vs 26.36 ± 12.81 years, p = 0.004), had less severe disease (ring infiltration, 0% vs 31.82%, p = 0.023), and had better post-treatment BCLVA (0.06 ± 0.15 vs 0.51 ± 0.95, p = 0.041). Multiple linear regression analysis showed that better BCLVA after treatment in CL-associated AK was associated with initial presentation without ring infiltration (p = 0.002) but not with OOK use itself (p = 0.793). Twenty-six of 35 CL-associated AK patients had final BCLVA equal to or better than 0.10 (Snellen visual acuity of 6/7.5). All 13 OOK-associated AK cases were treated with chlorhexidine 0.02% ± voriconazole 1% ± oral voriconazole, and 12 of these patients had final BCLVA equal to or better than 0.10. Conclusion: Most CL-associated AK patients had satisfactory visual outcomes. Half of AK at our hospital is OOK-associated since 2010. Early diagnosis and correct treatment may be the reason why OOK-associated AK patients had better vision prognosis.

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“…In the current study, the overall rate of microbial contamination of contact lens storage lens vials was 30%, which is much lower than one previously reported study with ortho-k lens wear. 50 The hydrogen-peroxide storage vials used in this study are barrel-shaped. Another study of ortho-k lenses and the combination of MPDS found a higher contamination rate in flat storage cases than barrel cases/vials.…”

Section: Discussionmentioning

confidence: 99%

Microbial Bioburden of Orthokeratology and Hydrogel Contact Lenses and Storage Cases Using a Hydrogen-Peroxide Disinfecting System

Datta

Tomiyama

Richdale

2021

JCLRS

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Background and objective: The fitting of orthokeratology (ortho-k) and multifocal soft contact lenses (SCL) is becoming increasingly popular worldwide for reducing the rate of myopia progression. However, overnight wear use of lenses and microbial contamination of contact lenses and storage vials has been shown to increase the risk of corneal inflammatory and infiltrative events (CIEs). Therefore, we conducted a pilot study to compare the rate, level, and type of microbial contamination of contact lenses and storage vialswhen participants wear ortho-k and SCL in combination with a hydrogen-peroxide disinfecting system. Material and Methods: A prospective, single-centre, randomized, crossover study was conducted to evalu-ate the rate and level of contact lens and storage vials contamination during the use of ortho-k and SCL along with a hydrogen-peroxide disinfecting solution over two 10 day wearing periods. Ocular signs and symptoms were assessed during lens wear at baseline and after each wearing period. In addition, contact lens and storage vials were collected, and the type and amount of microbial contamination were evaluated using viable culture and standard identification methods.Results: Twenty-five adults were enrolled, and 21 completed the study. One (5%) ortho-k lens, five (24%) ortho-k storage vials, one (5%) SCL and one (5%) SCL storage vial were contaminated (P > 0.05), predominantly with Gram-positive bacteria. None of the participants had contamination with both ortho-k and SCL. No significant differences were found between the ocular signs, including conjunctival redness and roughness, or conjunctival or corneal staining (all P > 0.05), irrespective of using ortho-k or SCL. Conclusion: This study provides the first data that directly compares microbial contamination of ortho-K versus SCL in patients using a hydrogen-peroxide disinfection system. However, the overall microbial contamination rate of contact lens storage vials was much lower (30%) than the previously reported study with ortho-k lens wear. The results support conducting a larger clinical trial designed to understand differences in microbial contamination with different lens materials and modalities.

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Microbial Bioburden of Orthokeratology Contact Lens Care System

Cited by 8 publications

References 42 publications

Pilot study of a novel classroom designed to prevent myopia by increasing children’s exposure to outdoor light

Pilot study of a novel classroom designed to prevent myopia by increasing children’s exposure to outdoor light

Overnight orthokeratology-associated Acanthamoeba keratitis at a tertiary referral hospital in Taiwan: A retrospective case-control study

Microbial Bioburden of Orthokeratology and Hydrogel Contact Lenses and Storage Cases Using a Hydrogen-Peroxide Disinfecting System

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