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

Disposable soft contact lenses are known to be colonized by bacteria and play a key role in bacterial keratitis pathogenesis. Such lenses, commonly used after laser refractive surgery procedures in which postoperative corneal infiltrations are sometimes observed, are potentially a substrate for bacterial inoculation. This study evaluates the extent of such a contamination.

Sixty disposable lenses collected from 60 eyes of patients who underwent photorefractive keratectomy (PRK), photoastigmatic refractive keratectomy (PARK), or laser in situ keratomileusis (LASIK) for the treatment of myopia or hyperopia were collected under sterile conditions over 4 months and cultured in various media. Results were statistically analyzed and the correlation with clinical and epidemiological data was examined.

Eleven (18.3%) of the examined lenses were contaminated with Staphylococcus 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.

Contamination was independent of the surgical procedure and females who were frequent users of eyelid cosmetics displayed higher contamination frequencies, suggesting that bacteria possibly originate from eyelid flora. The isolation of Staphylococcus epidermidis requires close postoperative surveillance, since it is a known cause of keratitis. Prophylactic postoperative treatment with tobramycin, gentamycin, or sulphonamides could be indicated.