O2 AND CONTACT LENS INDUCED BACTERIAL BINDING

自1980年以来，随着患者通过通宵穿戴接触到越来越多的药物， 隐形眼镜的使用已成为感染性角膜炎的主要原因。 因为通宵使用是配戴隐形眼镜的主要风险因素 对于这种并发症，人们的注意力集中在隔夜镜片的作用上- 诱导低氧在细菌角膜结合测定中的应用目的 这个建议是：1)调查每天或过夜的假说 配戴隐形眼镜对角膜上皮造成分级缺氧性损伤 与晶状体的氧气透过率成反比 (DK/L(总分))；以及由此造成的缺氧损害程度决定了 铜绿假单胞菌(PA)的细菌结合量 与晶状体相关传染病相关的最重要的微生物 人类角膜炎，2)确定晶状体类型在PA结合中的作用 并研究了水凝胶隐形眼镜导致 明显更高的角膜损伤程度，因此姿势不同 与硬性镜片相比，促进细菌角膜粘连的风险更大。至 为了实现这些目的，在#年提出了以下实验目标 人和兔的研究：(1)建立临床相关性 氧气透过率、晶状体诱导的角膜上皮细胞 脱屑和泪液乳酸脱氢酶(LDH)测定 人类患者右眼配戴四种硬性和四种水凝胶镜片 8小时(每日佩戴)和24小时至三个月(延长 使用活体串联扫描共聚焦显微镜(TSCM)。(2)至 建立体内氧传递率的临床相关性 和撕裂乳酸脱氢酶，以及铜绿假单胞菌与人脱落细胞的结合 从同一测试晶状体的左眼收集的表面角膜细胞- 成群结队地穿着养生衣。(3)测量隐形眼镜诱发 铜绿假单胞菌的角膜总结合力及相对结合率的测定 结合对脱落表面上皮细胞的贡献和 兔体内残留脱屑角膜表面结合的实验研究 模拟并关联PA与DK/L(总)的刚性和 水凝胶镜片佩戴。(4)在临床上确立单纯缺氧的作用 在使用体内TSCM促进上皮脱皮增加方面， 泪液乳酸脱氢酶水平升高以及相关的假单胞菌结合增加 人类患者角膜表面脱落细胞的变化 在紧贴的护目镜下暴露于氮气-二氧化碳。

Since 1980, with increasing patient exposure through overnight wear, contact lens use has become the leading cause of infectious keratitis. Since overnight use is the dominant risk factor identified with lens wear for this complication, attention is focused on the role of overnight lens- induced hypoxia in determining bacterial corneal binding. The purpose of this proposal is: 1) to investigate the hypothesis that daily or overnight contact lens wear produces graded hypoxic injury to the corneal epithelium in inverse proportion to the oxygen transmissibility of the lens (Dk/l(total)); and that the resulting degree of hypoxic damage determines the amount of bacterial binding with Pseudomonas aeruginosa (PA), one of the most important organisms associated with lens related infectious keratitis in man, and, 2) to determine the role of lens-type in PA binding and investigate the hypothesis that hydrogel contact lenses cause significantly higher degrees of corneal damage and hence pose different risks in promoting bacterial corneal adhesion than rigid lenses. To achieve these purposes, the following experimental aims are proposed in human and rabbit studies: (1) To establish the clinical correlation between oxygen transmissibility,lens-induced corneal epithelial desquamation, and tear lactate dehydrogenase (LDH) measurements in the right eyes of human patients for four rigid and four hydrogel lenses worn for periods of 8 hours (daily wear) and 24 hours to three months (extended wear) using in vivo tandem scanning confocal microscopy (TSCM). (2) To establish the clinical correlation in vivo between oxygen transmissibility and tear LDH, and binding of Pseudomonas aeruginosa to exfoliated human surface corneal cells collected from the left eyes of the same test lens- wearing groups and wearing regimens. (3) To measure contact lens-induced total corneal binding of Pseudomonas aeruginosa and determine the relative contributions of binding to exfoliated surface epithelial cells and binding to the residual desquamated corneal surface in the in vivo rabbit model and correlate PA binding with Dk/L(total) for both rigid and hydrogel lens wear. (4) To establish clinically the role of hypoxia alone in promoting increased epithelial desquamation using in vivo TSCM, elevated tear LDH levels, and associated increased Pseudomonas binding to exfoliated surface corneal cells in human patients following variable nitrogen-CO2 exposure beneath tightly fitted goggles.