Posters - What are the factors contributing to the occurrence of contact lens induced peripheral ulceration (CLPU): A study of its pathogenesis in a rabbit model

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Posters

What are the factors contributing to the occurrence of contact lens induced peripheral ulceration (CLPU): A study of its pathogenesis in a rabbit model

(P.Z.J. Wu, H. Zhu, A. Thakur, F. Stapleton, M.D.P. Willcox)
The Cooperative Research Centre For Eye Research and Technology,
University of New South Wales, Sydney, NSW, Australia.

Purpose:

CLPU is a major contact lens induced adverse response, in which the pathogenesis is not well understood. Both S. aureus and S. epidermidis are frequently isolated from CLPU patients and staphylococci have been suspected to be the cause of CLPU. The aim of this experiment is to investigate the causative agent of this corneal condition, as to whether bacterial surface antigens, or secretory products is responsible, and whether live bacteria and corneal surface trauma are necessary to cause CLPU.

Method:

S. aureus 031 and S. epidermidis 019, isolated from CLPU patients, were chosen in preparation of bacterial products. Inactivated bacterial suspension and bacterial culture supernatant were applied daily to contact lens wearing eye for a duration of 4 week. A rabbit model of corneal ulcer was produced by making corneal superficial scratches in the peripheral and central cornea with subsequent wearing of contact lens, which was pre-soaked in live bacterial suspension ( S. aureus 031 or S. epidermidis 019).

Results:

Bacterial products alone failed to produce corneal lesions in contact lens wearing eyes. Corneal ulcers may be produced only in the presence of live S. aureus, and a superficial trauma on the corneal surface was required to generate such corneal ulcer. The corneal lesions demonstrated mild to moderate inflammatory reaction clinically; they occurred more frequently in peripheral cornea than in central cornea and healed without the need of antibiotics.

Conclusions:

Contact lens induced peripheral ulceration may be induced by the colonisation of S. aureus on the ocular surface as well as on contact lens, but only in the presence of pre-traumatic change in corneal surface. The corneal ulcers occurring in the animal model are more frequently produced in the peripheral cornea than the central cornea, and heals without the need of antibiotics, mimicking the contact lens induced peripheral ulceration in human.

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