O2 AND CONTACT LENS INDUCED BACTERIAL BINDING

自1980年以来，随着患者通过过夜佩戴暴露的增加， 接触透镜的使用已经成为感染性角膜炎的主要原因。 由于隔夜使用是透镜配戴的主要风险因素 对于这种并发症，注意力集中在隔夜透镜的作用上， 在确定细菌角膜结合中诱导缺氧。 的目的 这个建议是：1）调查假设，每天或过夜 接触透镜配戴对角膜上皮产生分级的缺氧损伤 与透镜的氧气透过率成反比 (Dk/l（总））;缺氧损伤的程度决定了 与铜绿假单胞菌（PA）结合的细菌的量， 与透镜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 并研究水凝胶隐形眼镜导致 角膜损伤程度明显更高，因此 与硬性镜片相比，到 为了达到这些目的，提出了以下实验目标， 人和兔研究：（1）建立临床相关性 氧气的透过率，镜片诱导的角膜上皮 脱落，和泪液乳酸脱氢酶（LDH）的测量， 佩戴四个刚性镜片和四个水凝胶镜片的人类患者的右眼 8小时（每日佩戴）和24小时至三个月（延长） 磨损）使用体内串联扫描共聚焦显微镜（TSCM）。 (2)到 在体内建立氧传输率与 和泪液LDH，以及铜绿假单胞菌与脱落的人 从同一测试透镜的左眼采集的表面角膜细胞- 穿戴组和穿戴方案。(3)测量角膜接触镜引起的 总角膜结合铜绿假单胞菌，并确定相对 与脱落的表面上皮细胞结合的贡献， 与体内兔的残留脱屑角膜表面结合 模型和关联PA结合与Dk/L（总）的刚性和 水凝胶透镜佩戴。(4)在临床上确定缺氧单独的作用 在使用体内TSCM促进增加的上皮脱落中， 泪液LDH水平升高，以及相关的假单胞菌与 在人类患者中， 在戴紧的护目镜下暴露于氮气和二氧化碳中。

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.