Influence of wear and overwear on surface properties of etafilcon A contact lenses and adhesion of Pseudomonas aeruginosa.

PURPOSE To determine changes in physicochemical surface properties of contact lenses (CLs) during daily wear and effects of lens wear on adhesion of a Pseudomonas aeruginosa strain from a patient with CL-related keratitis. METHODS Ten new CL wearers used ionic, etafilcon A lenses with 58% water on both eyes for approximately 10 hours each day during 10 and 50 days. All lenses were treated daily with an appropriate lens care solution. After the CLs were worn for 10 days (first pair of lenses) and 50 days (second pair, representing overwear), hydrophobicity by water contact angles, surface roughness by atomic force microscope, elemental surface composition by x-ray photoelectron spectroscopy (XPS), and adsorbed proteins by SDS-PAGE were determined on one lens. The lens from the contralateral eye was placed in a parallel plate flow chamber for bacterial adhesion after each time interval. RESULTS Water contact angles on lenses changed from 45 degrees on unused lenses to 61 degrees +/- 25 degrees after 10 days of wear and changed significantly (P < 0.05) to 27 degrees +/- 14 degrees after 50 days of wear. Surface roughness increased significantly (P < 0.05) from 4 +/- 2 nm (unused) to 10 +/- 7 nm after 50 days of wear. These changes were accompanied by adsorption of proteinaceous material, as evidenced by XPS and SDS-PAGE, demonstrating adsorption of lysozyme, tear lipocalin, and a 30-kDa protein. Initial bacterial adhesion to worn CLs was lower than to unworn CLs. Furthermore, detachment of adhering bacteria from worn lenses was easier than from unworn lenses. The changes observed in the physicochemical surface properties of the lenses after the CLs were worn for 50 days were accompanied by reports of discomfort by 6 of the 10 new CL wearers. Multiple regression analysis revealed that the most predictive variables for an effect on initial deposition after 10 days of wear were hydrophobicity, roughness, the presence of nitrogen-rich material, including the presence of a 30-kDa protein, and the presence of oxygen-rich material-that is, the type of oxygen adsorbed (O equal or parallel C or Ocjs0807;C). After 50 days of wear, roughness and the presence of tear lipocalin were most predictive. CONCLUSIONS This study demonstrates that the physicochemical surface properties changed after wear and overwear, whereas overwear of the lenses decreased initial adhesion of P. aeruginosa #3 under the present experimental conditions.