After the Renu MoistureLoc thing, I got smart/silly/scared/wise and
bought the PuriLens system (no financial interest, blah, blah, blah).
The few studies I saw seemed to indicate pretty good efficacy against
most of the creepy-crawlies ... except ... of course ...
acanthamoeiba.

Not sure I really plan to be *that* careful or *that* meticulous, BUT
... if I did swim in the ocean, I would likely use a "standard"
chemical method in addition.

So far, the PuriLens seems to do a heck of a job taking my potential
exhaustion/laziness out of the equation and maintaining at least a
high (if not ultimate) level of cleanliness and sterility.

The whole "15 minutes" thing, too ... neat.

Kind of wonder, by the way, whether a *second* 15-minute cycle would
be any more effective against acanthamoeba than just one go.....

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra
ct&list_uids=14722469&query_hl=13&itool=pubmed_docsum

OR: http://tinyurl.com/ord42

Disinfection capacity of PuriLens contact lens cleaning unit against
Acanthamoeba.

Hwang TS, Hyon JY, Song JK, Reviglio VE, Spahr HT, O'Brien TP.

Ocular Microbiology and Immunology Laboratory, The Wilmer Eye
Institute, Johns Hopkins University School of Medicine, 600 North
Wolfe Street, Woods 259, Baltimore, MD 21287-9121, USA.

PURPOSE: The PuriLens contact lens system is indicated for cleaning
and disinfection of soft (hydrophilic) contact lenses by means of
subsonic agitation to remove lens deposits and microorganisms, and
ultraviolet irradiation of the storage solution for disinfection. The
capacity of the PuriLens system to disinfect storage solutions
contaminated with known concentrations of Staphylococcus aureus,
Pseudomonas aeruginosa, and Acanthamoeba species was evaluated.
METHODS: An in vitro assessment of the antibacterial and antiparasitic
efficacy of the PuriLens system was performed. Separated batches of
the storage solution for the cleansing system were contaminated with
stock strains of S. aureus and P. aeruginosa. A comparison of the
microbiologic content was made between the solution before and after
the cycle. RESULTS: The PuriLens system effectively eradicated S.
aureus and P. aeruginosa organisms after a 15-minute cycle. However,
viable cysts of acanthamoeba were recovered in the solution after the
15-minute cycle. CONCLUSIONS: The PuriLens system is highly efficient
in protecting against contamination with common bacterial ocular
pathogens. Acanthamoeba cysts, however, can survive in the solution or
contact lens bath undergoing integrated subsonic debridement and
indirect ultraviolet light disinfection. Use of chemical disinfecting
solutions that contain agents such as chlorhexidine or other cationic
antiseptics may be advisable in conjunction with use of the PuriLens
device, especially in high-risk settings.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra
ct&list_uids=10946984&query_hl=13&itool=pubmed_docsum

OR: http://tinyurl.com/p82fk

Evaluation of the PuriLens contact lens care system: an automatic care
system incorporating UV disinfection and hydrodynamic shear cleaning.

Choate W, Fontana F, Potter J, Schachet J, Shaw R, Soulsby M, White E.

Department of Physiology and Biophysics, University of Arkansas for
Medical Sciences, Little Rock 72205, USA.

PURPOSE: This study evaluates lens care using the PuriLens System, an
advanced way to clean and disinfect soft hydrophilic lenses using
subsonic agitation and UV radiation, respectively. METHODS: A
two-period crossover lens cleaning and safety investigation was
conducted using 80 patients. Disinfecting efficacy was tested in
accordance with standard FDA protocols. Lens compatibility was studied
with Group I and Group IV lenses during the equivalent of a 6-month
care regimen by measuring: lens power, base curve, wet diameter,
refractive index, clarity, and tint. Safety was evaluated through
slit-lamp findings, wearing time, comfort, and visual acuity. RESULTS:
The mean wearing time of patients in the study was 13.79 hours. No
slit lamp findings greater than grade 2 were noted. Visual acuity was
20/25 or better in 92.5% of examinations. None of the patients lost
more than two lines of acuity. Lens surface evaluation showed no
deposits (grade 0) to very slight deposits (grade 1) in 94.4% of
examinations. Lenses cleaned with the PuriLens System were cleaner by
a statistically significant margin (P=0.02) compared to lenses
digitally cleaned with a leading multi-purpose solution (ReNu, Bausch
& Lomb). Overall, neither the Group I nor Group IV lenses were
affected after 180 cleaning cycles. CONCLUSIONS: The PuriLens System
provides automatic lens care compliance, superior antimicrobial
efficacy, and eliminates the need for daily digital cleaning.

I think you are in need of updating your numbers, which reflect the
annual incidence in the overall population.  Contact lens wearer is one
of the chief risk factors for this disease.  The updated incidence is 1
in 30,000 soft contact lens wearers per year.

Then, you should be telling them that their risk of contracting the
disease is 1 in 30,000 per year, which will go up significantly if they
swim in their lenses, rinse them with non-sterile solution, or fail to
disinfect them properly.

Cancer may not be preventable, but acanthamoeba keratitis is highly
preventable if patients avoid the major risk factors, which include
swimming in their contact lenses (34%), and failure to disinfect their
lenses (62%).

DrG
http://www.copfameye.com

my daugther who was fourteen at the time contracted

Can you share with us where she was swimming?  (pool, pond, ocean?)

thanks

w.stacy, o.d.

Dr. G and I agree with you, of course.  We make every effort to
carefully educate our patients about the risks and ways to mitigate
them. The contact industry has responded by producing lenses that have
less impact on cornea physiology and disinfection products that do the
job.  Our peer journals have articles addressing this issue, most
recently this month: the big cover story in one such journal. We hear
the warnings and advice at continuing education seminars. Most
professional and competent eye doctors do indeed tell their patients how
to manage their eye care. Helping to keep our patient's eyes healthy is
our job and ethical responsibility, not to mention it's good for
business.

But the wearer must take the ultimate responsibility to "do the right
thing" after they are fully informed and this, I think is where the
problem lies.

Save a buck, stretch out the longevity of the lens, re-use (or don't
use) appropriate lens care products, re-order lenses by mail without a
prescription and without routine eye doctor visits, dig in the garden
and forget about washing up before handling lenses, ignore symptoms of
things gone wrong until it's too late.

There's only so much education and hand-holding we can do.

The problem is not with the contact lenses but with how they are used
and handled. Look at the recent fungus scare. Less than a dozen people
with "severe" problems and a hundred or so affected people out of 30
million regular contact lens wearers is an issue blown way out of
proportion. The reality of thousands of people with completely avoidable
and preventable "minor "eye health issues that can escalate to "serious"
and resulting from poor lens fitting or lens care is a major concern.

I'm sorry to hear about your daughter. Your advocacy will help to
prevent these kinds of tragedies from affecting others. It's been
difficult to get the US federal and state governments to do their part.
We try. You are trying. Thanks for your efforts.

LB, O.D.