Morgan lens safe and effective for long-term use in corneal infections

Prolonged use of the lens saved the eyes of six patients affected by Pseudomonas aeruginosa.

Issue: February 1, 2002

ByMichela Cimberle

VERONA, Italy – The Morgan lens, which is traditionally used for short, 1-to-2-day treatment of corneal alkali burns, can be used to treat infections for longer periods of up to 16 days, according to a physician here.

The device is intended to deliver continuous medication to the injured cornea. It consists of a plastic cup that floats above the surface of the eye, between the cornea and eyelids, with a central hole in which drugs are administered through a plastic cannula.

An ultimate solution

“It all began with a young boy with a deep corneal infection,” said Roberto Bellucci, MD, head of Verona Ophthalmic Unit. “Part of the stroma had become a yellow-green mass, and the rest of the eye was red and very sore (figure 1). The boy was 17 years old and was a contact-lens wearer for a –2 D of myopia. We suspected a Pseudomonas aeruginosa infection and administered the appropriate therapy, both systemically and locally. The laboratory confirmed our diagnosis, but after a few hours the eye had worsened. I feared I would have to enucleate the eye the following day. As a last resort, I decided to use the Morgan lens (MorTan, Inc.) to continuously deliver antibiotics to the eye.”

The antibiotic solution of Amikacin, ceftriaxone and piperacilline in saline was prepared by Luigina Rosa, MD. The lens was fitted under topical anesthesia.

“We knew it was going to be a long, slow treatment, and decided to leave the lens in place until enucleation or recovery (figure 2),” Dr. Bellucci said.

“The following day, the eye was stable, and we considered this a success. After 2 days, the colliquated part of the cornea could be partially removed, and the eye was no longer painful,” he said.

Battle won

The Morgan lens was changed every 3 days, and remained on the eye for a total of 11 days. After lens removal, therapy was continued for 2 more weeks by applying the same topical antibiotics that had been used with the Morgan lens.

“The eye recovered completely, with corneal scar and thinning limited to the affected area. At the end of treatment, our young patient had 20/40 visual acuity with astigmatic hyperopic correction. No toxic effect or other drawback was associated with the prolonged use of the Morgan lens,” Dr. Bellucci said.

Additional cases

“In the past year, we have come across five more eyes with Pseudomonal Aeruginosa infection,” Dr. Rosa said. “All of them were of soft contact lens wearers. We sent an alert to the local medical authority, as we feared something was wrong with disinfection of contact lenses in our area. We found out, however, that patients used different disinfection methods.”

The Morgan lens was used in all these cases, with excellent results in all of them. The longest period of treatment was 16 days, with no adverse effect of the lens reported on any of these eyes.

“The Morgan lens has now entered in our standard protocols of treatment for corneal infection,” Dr. Rosa said. “I believe those eyes would have been lost without continuous irrigation with antibiotics. Moreover, the amount of parenterally injected antibiotics could be greatly reduced, with consequent benefits for the general state of health of our patients.”

The ocular infection suggested the prolonged use of the lens.

The lens in place. The patients wore it for 2 weeks without damage.

For Your Information:

Roberto Bellucci, MD, can be reached at Ospedale di Verona, Unità Operativa di Oculistica, Piazzale Stefani 1, 37126 Verona, Italy; (39) 045-807-3035; fax: (39) 045-807-2289; e-mail: roberto.bellucci@mail.azosp.vr.it. Dr. Bellucci has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.

Luigina Rosa, MD, is in practice at the Desenzano Hospital Eye Clinic. She can be reached at Ospedale di Desenzano, Unità Operativa di Oculistica, Via Montecroce, 25015 Desenzano (BS), Italy; (39) 030-914-5322; fax: (39) 030-914-5312.

MorTan, Inc., makers of the Morgan lens, can be reached at PO Drawer 8719, Missoula, MT 59807; (406) 728-2522 or (800) 423-8657; fax: (406) 728-9332; e-mail: mortan@morganlens.com; Web site: www.morganlens.com.