Biocompatibility of hydrogen peroxide in soft contact lens disinfection: antimicrobial activity vs. biocompatibility--the balance

Critical factors of soft contact lens care include adequate disinfection and neutralization of the chemical constituents of the disinfecting system before reinsertion. Three cases of microbial keratitis are described that exemplify the critical nature of disinfection with adequate antimicrobial activity. Disinfection rates are described for a 3% solution of hydrogen peroxide (H2O2) against multiple microorganisms. The results indicate that H2O2 is equivalent to heat disinfection when used for appropriate lengths of time. Problems associated with chemical disinfection include lens fit alterations, which may lead to epithelial trauma. However, unless antimicrobial chemicals can be rinsed, neutralized, or degraded, they can also injure the corneal and conjunctival epithelium. Repeated exposure of the corneal epithelium to oxidizing agents renders it vulnerable to complications.