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M. Madison Slusher, MD; Quentin N. Myrvik, PhD; Jon C. Lewis, PhD; Anthony G. Gristina, MD

Arch Ophthalmol. 1987;105(1):110-115.

Abstract
• While medical scientific knowledge pertaining to bacterial adhesion to biomaterials has become a rapidly growing field in most areas of medicine, its significance in ophthalmic infections has not been emphasized. Corneal bacterial ulceration in patients wearing extended-wear contact lenses has become a problem of epidemic proportions. The designation of the contact lens itself as a suitable substratum for bacterial colonization and as a source of subsequent inoculum to compromised epithelial cells are important factors in the pathophysiology of corneal ulcer formation. We demonstrate polysaccharide-(biofilm-)mediated adhesion to two ophthalmic pathogens (Pseudomonas aeruginosa and Staphylococcus epidermidis) to the surface of a typical extended-wear contact lens in vitro using cytochemistry and scanning and transmission electron microscopic techniques. This interaction between the biomaterial and bacterial organisms, which represents a favorable self-protective environment for propagation and inoculation, is a previously overlooked area of importance in the mechanism of corneal ulceration associated with hydrophilic (soft) contact lenses.

Author Affiliations
From the Departments of Ophthalmology (Dr Slusher), Microbiology and Immunology (Dr Myrvik), and Pathology (Dr Lewis), and the Section on Orthopedic Surgery, Department of Surgery (Dr Gristina), Wake Forest University Medical Center, Winston-Salem, NC.

Footnotes
Accepted for publication Sept 8, 1986.

Reprint requests to Wake Forest University Medical Center, 300 S Hawthorne Rd, Winston-Salem, NC 27103 (Dr Gristina).

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