Pseudomonas corneal ulcers associated with daily wear of disposable hydrogel contact lenses

Three cases of Pseudomonas corneal ulceration occurred in a population of 120 patients who wore Acuvue disposable contact lenses on a daily wear basis for an average of 6.3 months (representing an annualized incidence of 4.8%). Factors thought to be of etiological significance in the development of the ulcers include (1) omission of surfactant cleaning, (2) omission of a rub and rinse step, (3) use of a disinfecting solution of marginal efficacy, (4) use of a lens that attracts and rapidly deposits protein, and (5) patient noncompliance. We advocate that disposable contact lenses used on a daily wear basis should be subjected to surfactant cleaning prior to overnight disinfection.