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HP Sandoval, MP Holzer, CE Crosson, DT Vroman, L Werner, DJ Apple; Evaluating Microkeratome Cleaning Soaps . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2086.
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Purpose: The aim of this study was to look for the presence of soap residue on surgical instruments after washing them following a standardized regimen. Method: Light absorbed wavelength was determined for each of the following soaps: Endozime®, Enzol®/Cidezyme® Enzymatic Detergent, Klenzyme®, Palmolive® Ultra Original Dishwashing liquid and UniversalTM Concentrated Surgical Instrument Cleaner and Lubricant using UV spectroscopy. Once the wavelength was determined, a standard curve of absorbance was plotted using different dilutions for each soap. Using a stainless steel and a titanium instrument, a manual and an automated standardized microkeratome cleaning protocols were followed. Distilled water at different temperatures (25ºC and 40ºC) was used to rinse the instruments. The dilution ratio was 1:125 for all the soaps except for the Palmolive® Ultra (1:50). The absorbance of the cleaning solution, rinse water at 2 and 3 minutes as well as at 24 hours after soaking were measured for each soap, then compared and analyzed. Results: The mean absorbance for the undiluted enzymatic cleaners was 1.6177 (Range 0.4863 to 3.115), 0.9910 for the Palmolive® Ultra and 1.7548 for the UniversalTM. The absorbance decreases when diluted in the cleaning solution to 0.0495 (Range 0.0066 - 0.1248), 0.9910 and 1.7548 respectively. After rinse 1, as well as after rinse 2 and 24 hours the absorbance value decreases in different proportions depending on the type of soap, instrument material and water temperature. Conclusion: Changes in the light absorbance were detected. Non-enzymatic cleaners rinsed easier than the enzymatic ones. It has been reported that soap residue could cause inflammation (e.g. diffuse lamellar keratitis) after laser in situ keratomileusis (LASIK). The soap composition, instrument material and the influence of water temperature are important factors.
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