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Klin Monbl Augenheilkd 2009; 226(5): 396-403
DOI: 10.1055/s-0028-1109256
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© Georg Thieme Verlag KG Stuttgart · New York

Desinfektion von Kontakt-Tonometern – ein systematischer Review

Disinfecting Contact Tonometers – a Systematic ReviewA. S. Neubauer1 , P. Heeg2 , A. Kampik1 , C. Hirneiss1
  • 1Augenklinik, Ludwig-Maximilians-Universität, München
  • 2Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Tübingen
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Publication History

Eingegangen: 16.11.2008

Angenommen: 28.1.2009

Publication Date:
08 June 2009 (online)

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Zusammenfassung

Hintergrund: Die verfügbare Evidenz zur Desinfektion von Kontakt-Tonometern sollte dargestellt werden. Material und Methoden: Ein systematischer Review aller Artikel über die Desinfektion von Kontakt-Tonometerköpfchen wurde durchgeführt. Artikel, die bis Juli 2008 publiziert waren, wurden über die Datenbanken Medline, Embase sowie Referenzen der eingeschlossenen Artikel identifiziert. Zwei Personen führten die Datenbanksuche und Beurteilung der gefundenen Studien durch. Ergebnisse: Insgesamt wurden 89 Artikel identifiziert, von denen 58 eingeschlossen werden konnten. Davon waren 18 klinische Studien, 17 experimentelle mikrobiologische Studien, 8 Expertenmeinungen oder Leitlinienempfehlungen und 15 Reviews, Anwendungs-Surveys oder die technische Beschreibung einer neuen Methode. Die klinischen Studien belegen im Wesentlichen die Bedeutung der Fragestellung sowie mögliche Patientenschäden durch einige Desinfektionsmethoden, zeigen jedoch uneinheitliche Ergebnisse hinsichtlich der Wirksamkeit. Die experimentellen Studien untersuchten eine Vielzahl an bakteriologischen und virologischen Fragestellungen sowie Materialschäden durch Desinfektionsverfahren. Sowohl eine Chlor-basierte als auch Wasserstoffperoxid-basierte Flüssigdesinfektion erwiesen sich dabei als wirksam, wenn sie 5 min angewandt wurden. Inkonsistente Ergebnisse bestehen für die Alkohol-Wischtücher sowie für UV-Desinfektion – für beide wurden insbesondere Materialschäden beschrieben. Die Empfehlungen der amerikanischen Leitlinien sowie die meisten Expertenempfehlungen werden von den Daten evidenzbasiert gestützt. Schlussfolgerungen: Hypochlorit-basierte und Wasserstoffperoxid-basierte Desinfektionsmittel stellen bei 5 min Einwirkzeit wirksame und relativ sichere Verfahren zur Desinfektion von Tonometerköpfchen dar.

Abstract

Objective: The aim of this study is to provide the best available evidence on how to disinfect contact Goldman tonometers. Methods: A systematic review of all articles on disinfection of contact tonometers was conducted. Articles published up to July 2008 were identified in Medline, Embase and references from included articles. Two observers participated in the data retrieval and assessment of the studies identified. Results: A total of 89 articles was retrieved, of which 58 could be included. Of those, 18 were clinical studies, 17 experimental microbiological studies, 8 expert assessments or guidelines and 15 reviews, surveys, descriptions of new methods. The clinical studies illustrate the importance of the problem, possible side effects of some disinfection methods but yield inconclusive results regarding efficacy. Experimental studies investigated a variety of bacterial and virological questions as well as material damage by disinfection. Both chlorine-based and hydrogen peroxide-based liquid disinfection were shown to be effective if applied for 5 min. Inconsistent results exist for alcohol wipes and UV disinfection – material damage has been described for both. The US guidelines and most expert recommendations are supported by evidence of the existing data. Conclusions: Chlorine-based and hydrogen peroxide-based liquid disinfections for 5 minutes are effective and relatively safe for disinfecting contact tonometers.

Schlüsselwörter

Mikrobiologie - Glaukom - Tonometer - systematischer Review

Key words

microbiology - glaucoma - tonometry - systematic review

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PD Dr. Aljoscha S. Neubauer

Augenklinik, Ludwig-Maximilians-Universität

Mathildenstr. 8

80336 München

Phone: + 49/89/51 60 38 11

Fax: + 49/89/51 60 51 60

Email: aljoscha.neubauer@med.uni-muenchen.de

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