Bausch & Lomb’s ReNu with MoistureLoc lens cleaning solution was the only contact lens solution that was a contributing factor in the outbreak of fungal eye infections in the U.S. since June of 2005, according to the team of federal disease control experts and leading eye doctors analyzing adverse event reports on behalf of the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention. Their report, published in today’s edition of the Journal of the American Medical Association (JAMA), challenges Bausch & Lomb’s assertion that it was customers’ failure to properly clean and store their contact lenses that contributed to their infections rather than a defect in the product itself.

It is still not clear exactly how ReNu with MoistureLoc contributes to Fusarium keratitis, the rare fungal infection that was confirmed in the 164 cases analyzed by researchers. Previously, Fusarium keratitis was only rarely seen among some rural agricultural workers who might have received a scratch in their eye from a plant that contained the fungus. Previous research reports found that the majority of users reported using ReNu with MoistureLoc to clean and care for their contact lenses prior to contracting Fusarium keratitis. Just over one-third of the total survey of 164 patients suffering from Fusarium keratitis in the U.S. required corneal transplants to recover from the damage to their eyes.

The reports authors concluded that there was still not enough evidence to identify the exact problem with Bausch & Lomb’s product, and that more research is needed. Dr. Todd P. Margolis of the Proctor Foundation for Ophthalmology Research at the University of California in San Francisco co-authored the commentary that accompanied today’s JAMA report. Dr. Margolis stated that cases of Fusarium keratitis may have started to rise before ReNu with MoistureLoc was first marketed. “There are many cases out there that haven’t been fully investigated,” Dr. Margolis said. While adverse event reports concerning Fusarium keratitis have slowed down considerably, healthcare experts continue to hear reports of infections that appear to be related to ReNu with MoistureLoc.

Bausch & Lomb recalled ReNu with MoistureLoc in the U.S. on May 15, 2006, after removing the product from some Asian markets as early as February. The company eventually concluded that the product formulation might allow Fusarium to colonize a lens case or bottle cap, especially if a consumer tops off his existing solution in a contact lens case instead of completely replacing it. Researchers found that while there was some evidence that topping off solution may raise a person’s risk of infection, there appeared to be no difference between the practices of the people who were infected and those contact lens wearers who remained healthy.

“Practicing good contact lens hygiene is a prudent and common-sense measure for all contact lens wearers, irrespective of contact lens solution used,” Dr. Douglas C. Chang wrote in an e-mail interview according to the New York Times. Dr. Chang is a CDC fungal disease specialist and lead author of the report. “However, the most important message for contact lens wearers is to stop using MoistureLoc.”

Sources: Barnaby J. Feder, “Lens Solution Caused Eye Infections, Report Says,” New York Times, August 22, 2006, accessed August 23, 2006; Douglas C. Chang, MD, et. al, “Multistate Outbreak of Fusarium Keratitis Associated With Use of a Contact Lens Solution,” Journal of the American Medical Association 296:8 (August 23-30, 2006).