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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.
Three Army soldiers were on their way to us following an explosion of an improvised device. The driver had goggles on and suffered extensive facial trauma and all three had eye injuries from the debris that hit them. We got bilateral Morgan Lenses in all three and flushed each with several liters of LR. Followed with antibiotics, they were rebandaged and on an emergency air evacuation that evening. These men were grateful for the care they received. The technicians and physicians here are thankful that everyone knew what to do to get the lens system set up and running. I am grateful to you for the opportunity to access the class online and ability to present it shortly after we arrived. One of the others did have a corneal laceration that we could assess after flushing. We feel confident that all will have the best outcomes thanks to the Morgan Lens use.
We also had a patient who experienced an electrical explosion (a generator) to his face. We used Morgan Lenses to irrigate his eyes and sent him on an air evacuation flight to Germany. He has since returned to duty and is doing well with minimal residual sight loss.Military Registered Nurse (Active Duty)
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.