Microbiological examination of bandage soft contact lenses used in laser refractive surgery

BACKGROUND: Disposable soft contact lenses are known to be colonized by bac teria and play a key role in bacterial keratitis pathogenesis. Such lenses, commonly used after laser refractive surgery procedures in which postopera tive corneal infiltrations are sometimes observed, are potentially a substr ate for bacterial inoculation. This study evaluates the extent of such a co ntamination. METHODS: Sixty disposable lenses collected from 60 eyes of patients who und erwent photorefractive keratectomy (PRK), photoastigmatic refractive kerate ctomy (PARK), or laser in situ keratomileusis (LASIK) for the treatment of myopia or hyperopia were collected under sterile conditions over 4 months a nd cultured in various media. Results were statistically analyzed and the c orrelation with clinical and epidemiological data was examined. RESULTS: Eleven (18.3%) of the examined lenses were contaminated with Staph ylococcus epidermidis. No other bacteria or fungi were found. Contamination was significantly more common among female patients (P=.036). Correlation with the other clinical or operative parameters examined was statistically insignificant. CONCLUSIONS: Contamination was independent of the surgical procedure and fe males who were frequent users of eyelid cosmetics: displayed higher contami nation frequencies, suggesting that bacteria possibly originate fi om eyeli d nora. The isolation of Staphylococcus epidermidis requires close postoper ative surveillance, since it is a known cause of keratitis. Prophylactic po stoperative treatment with tobramycin, gentamycin, or sulphonamides could b e indicated.