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Author: Rootman DS, Krajden M
Publication: J Ocul Pharmacol 1993 Fall;9(3):271-6
Abstract: We have previously shown the pharmacokinetic value of delivering gentamicin to the rabbit anterior segment using the Morgan Therapeutic Lens. The present study utilized an intrastromal injection model of Pseudomonas keratitis to test the therapeutic efficacy of continuous flow delivery of gentamicin with the Morgan Lens. All eyes (n = 52) received an intrastromal injection of approximately 1800 colony-forming units (CFU) of Pseudomonas aeruginosa. At 22 hours after injection, eyes were perfused for 6 hours with saline or gentamicin (1, 2.5 or 5 mg/ml), or received gentamicin drops (13.6 mg/ml) at 15 minutes for four doses, then hourly for 6 hours. Corneas were homogenized and plated to determine bacterial survival, and expressed as log colonies (CFU). Log CFU recovered were 7.37 +/- 0.04, 6.64 +/- 0.20, 5.64 +/- 0.31, and 3.56 +/- 0.50 log CFU for saline perfusion, 1, 2.5, 5 mg/ml gentamicin perfusion respectively. Following six hours of treatment with topical fortified gentamicin drops, 5.93 +/- 0.34 log CFU were recovered. Gentamicin perfusion (5 mg/ml) was significantly different from saline or the other treatment groups (P < 0.05). Continuous corneal perfusion with the Morgan Therapeutic Lens demonstrated an increasing dose response curve with increasing perfusate concentration. It was effective in the treatment of experimental Pseudomonas keratitis.
Thanks for the opportunity to sing the praises of the Morgan Lens! Those of us who have been in the field for a while wonder what we ever did without them! We find two general uses for the lenses. One is for contact irritation: most typically, splashes. After local anesthetic, for ease of insertion, the lenses fit comfortably on patients of all ages and provide gentle and thorough irrigation of irritant substances. We have many cases of this type. The second most common use is for patients show suffer multiple injuries due to automobile accidents, major trauma, burns, falls, etc. Not only does the lens thoroughly irrigate the eye, removing most or all of the debris that has accumulated, it more importantly frees up the nurse's hands so that she can perform other lifesaving functions. Quite frankly, eye irrigation was treated as "the bottom of the list" often because other patient's other injuries were more devastating with higher morbidity and mortality. Particularly in the burn patient, the soothing effect of the irrigation and potential to prevent infection or further injury, make it an easy to use, valuable asset for patient care.Registered Nurse (Montana)
The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.