AAO-SOE Joint Meeting research highlights

Today's scientific program at the 2008 Joint Meeting of the American Academy of Ophthalmology (Academy) and European Society of Ophthalmology (SOE) includes presentations of broad public interest: contamination of contact lens storage cases among refractive surgery candidates; and evolving physician practices regarding LASIK and other refractive surgery for people with HIV/AIDS. Contamination of Contact Lens Storage Cases of Refractive Surgery Candidates

Millions of people around the world wear contact lenses, with 24 million wearers in the U.S. alone. While contact lens care is generally very safe, lenses that are not properly cleaned and disinfected increase the risk of severe eye infection. Any lens that is removed from the eye needs to be cleaned and disinfected before it is reinserted. Care of contact lenses includes cleaning the storage case, since it is a potential source of infection.

Assaf Kratz, MD, and Tova Lifshitz, MD, of Soroka University Medical Center in Israel, and their colleagues studied the rate of contamination in contact lens storage cases by taking samples of the contact lens disinfection solution from lens cases belonging to candidates for refractive surgery. Thirty storage cases of 16 asymptomatic candidates were tested for the study. In two-thirds of the storage cases, at least one pathogen was detected. The most common pathogen was Pseudomonas (41.2 percent), a known cause of severe corneal infections. Fungal pathogens were found in 3.3 percent of the cases. Pathogens were found in all of the types of storage solutions that were studied; some solutions tested positive for pathogens every time they were tested among the samples. The pathogens can cause keratitis, an often painful inflammation of the cornea; complications from keratitis can lead to vision loss.

"The picture that arises from this study is disturbing," the authors conclude. "It seems that the commonly used disinfecting solutions provide little protection from contamination of contact lens storage cases." The authors urge contact lens wearers to closely adhere to contact lens care guidelines, including frequent cleaning and replacing their lens case regularly, in order to prevent contamination.

Refractive Surgical Practices in Persons with Human ImmunodeficiencyVirus (HIV) Positivity

People who are HIV-positive are now living longer, healthier lives, thanks to antiretroviral therapy and other treatment advances, and the number of HIV-positive people seeking LASIK, intraocular lenses following cataract removal, and similar procedures is likely to grow in coming years. Ahmad A. Aref, M.D., Pennsylvania State Hershey Eye Center, Pennsylvania State University College of Medicine, and colleagues recently investigated current care practices and opinions by sending a confidential online questionnaire to members of the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Of the 25 percent of surgeons who responded, 51 percent considered persons with HIV to be acceptable candidates for elective refractive surgery, but only 12.5 percent considered people with AIDS to be so. The majority of respondents (72.7 percent) who perform these procedures in persons with HIV or AIDS said they take additional precautions, such as addressing one eye at a time rather than bilaterally, scheduling the patient last in a given day, and increasing attention to equipment and staff hygiene.

"Refractive surgery care practices and outcomes in HIV/ AIDS patients need to be formally studied, with the goal of ensuring optimal vision improvement and overall patient health and safety," the authors conclude.

Source: American Academy of Ophthalmology