Hyphal Penetration of Worn Hydrogel Contact Lenses by Fusarium

PURPOSE:To determine the relative susceptibility of worn and unworn hydrogel contact lenses to penetration by hyphae of the Fusarium solani-Fusarium oxysporum species complex. METHODS:Hydrogel contact lenses (lotrafilcon A, balafilcon A, senofilcon A, galyfilcon A, and etafilcon A) were removed from their original packages and placed directly on the eyes of 24 experienced contact lens wearers for 8-9 hours. Lenses were removed, each placed in 3.0 mL sterile phosphate buffered saline (PBS), and inoculated with 10 conidia of fusaria. Similar sets of unworn lenses were soaked in Sabouraudʼs dextrose broth for 2 hours prior to exposure to fusaria conidia in PBS. The entire surface of lenses was examined with microscopy for 14 days for the development of coiled hyphae in the lens matrix (ie, penetration pegs [PP]). RESULTS:A total of 21 of 54 worn hydrogel lenses representing 4 types of silicone hydrogel and one type of hydroxyethylmethacrylate lens were penetrated by the fusaria. Compared to unworn lenses, 9 of the 21 PP-positive worn lenses showed earlier and more extensive penetration than seen with the unworn lenses. Several worn lenses compared to their unworn counterparts showed negligible or delayed penetration. CONCLUSIONS:Worn hydrogel contact lenses without a history of exposure to disinfection solutions compared to unworn lenses of similar status may show enhanced or decreased susceptibilities to penetration by Fusarium. This suggests that tear characteristics are an additional factor in the invasive contamination of hydrogel contact lenses by Fusarium.