According to a Wall Street Journal report, the recent global outbreak of Fusarium keratitis infections in contact lens wearers that has been overwhelmingly traced to multipurpose contact lens solutions, especially the Bausch & Lomb product ReNu with MoistureLoc, is not necessarily news to eye care industry researchers. As early as 1999, published studies found that multipurpose contact lens solutions like ReNu with MoistureLoc may be less likely to kill dangerous organisms like Fusarium.

Bausch & Lomb products were often found to be more likely to grow bacteria in laboratory experiments of multipurpose solutions, and the company apparently didn't like those results. Bausch & Lomb, a major player in the more than $6 billion annual contact lens and lens-care market, earned an estimated $2.23 billion last year, 23% of which came from the sale of contact lens-care products like ReNu MoistureLoc. But when news that ReNu solution was linked to fungal keratitis infections leading to corneal transplantation and scarring in patients in Singapore and the U.S., the company's publicly-traded stock plunged from $60 per share to $47.91 at close of business on July 25, 2006.

The following studies were all published prior to Bausch & Lomb's global recall of ReNu with MoistureLoc multipurpose contact lens cleaning solution:

• A study published in a 2000 edition of Contact Lens Spectrum found that among five popular contact-lens solutions which had Pseudomonas aeruginosa, a bacterial organism that causes common eye infections, added to samples, ReNu MultiPlus did not kill the organism as well as other brands. Bausch & Lomb argued that their own internal study found ReNu to be just as effective as other brands and demanded an "immediate retraction" of the article by Indiana State University microbiologist Kathleen Dannelly. The university stood by its researcher and refused to retract Dr. Dannelly's results.

• Studies by Alcon Inc. published in Contact Lens and Anterior Eye found multipurpose solution brands under conditions that simulated regular use by contact lens wearers, such as skipping rinsing and rubbing steps before leaving lenses to soak overnight, made multipurpose solutions less able to kill test organisms, including Fusarium.

• In 2003, University of Texas Southwestern researchers found that multipurpose solutions increase the binding of bacteria cells to the cornea, which they determined could potentially contribute to the increased risk of eye infections in contact lens wearers.

• In 2005 New York optometrist Arthur Epstein found that several cases of contact lenses left soaking in ReNu with MoistureLoc for a week became covered with what appeared to be a fungus. Although this was an informal experiment, Dr. Epstein, who is a spokesperson for the American Optometric Association, has said he has repeatedly been able to grow Fusarium and other microbes in lenses soaked for days in ReNu MoistureLoc solution. Although Dr. Epstein claims to have alerted Bausch & Lomb to his findings, Bausch & Lomb said it did not receive access to his methodology and cannot comment on unknown data. Bausch & Lomb claims its own investigation into the Fusarium outbreak, in which it added Fusarium to lenses soaked in ReNu MoistureLoc solution, did not cause the fungus to grow on lenses.

While incidences of Fusarium keratitis are still relatively rare - about 5 cases per 10,000 users - an estimated 60,000 people among that more than 125 million contact lens wearers worldwide could develop an infection each year from using multipurpose lens cleaning solution. At the present time, the Centers for Disease Control in the U.S. have concluded that there has been no statistically significant infection link to any other brand of multipurpose lens cleaning solution other than those manufactured by Bausch & Lomb.

Source: Sylvia Pagan Westphal, "Bausch & Lomb Solution Recall Exposes Risks for Eye Infections," Wall Street Journal, July 26, 2006.