Study Evaluates Microbiologically, Opened Saline Bottles for
Scleral lenses have become a widely used treatment option for patients with irregular corneas and ocular surface disease. Successful wear entails use of a nonpreserved saline solution to fill the lens before application on the eye.

The purpose of this study was to evaluate solution from opened bottles of multidose preservative-free saline for microbiological growth and to better understand study participant hygiene habits while handling these bottles for scleral lens wear.

Eligible study participants in this single-center prospective study were patients who routinely used multidose preservative-free saline solution for scleral lens rinsing and filling. Study participants completed a 12-question survey regarding their scleral lens hygiene habits and donated their opened multidose preservative-free saline bottle which was processed for bacterial and fungal cultures.

--35 participants (19 males, 16 females) with ages ranging from 6 to 81 years were included.

--Indications for scleral lens wear included those with irregular corneas and ocular surface disease. The overall rate of microbial contamination among saline samples was 62.9% (n = 22). 21 different microorganisms were identified.

--The survey responses did not differ significantly for any of the questions with regard to likelihood of positive culture.

--There were no significant age or sex differences between participants with positive or negative culture results.

--No significant differences were found between isolation of specific microorganisms and any of the survey responses.

This study indicates that once the bottle has been opened, off-label multidose preservative-free saline, which is widely used to rinse and fill scleral lenses before application on the eye, can become infected with microorganisms. To of the risk of ocular complications, eye care practitioners and scleral lens patients should be mindful of these possible contaminations and prioritize lens, hand, and environmental hygiene.