Soft contact lenses are bathed with tear components during wear and surface deposits accumulate. This report shows thatPseudomonas aeruginosaadheres to the surface of worn extended wear contact lenses in direct proportion to the amount of lens surface deposits as determined by the Rudko method (P<. 05). More hydrophobic bacteria adhered 10 times greater than bacteria which were relatively hydrophilic (P<. 005). The effect upon bacterial adhesion of enzyme and surfactant cleaning of worn extended wear contact lenses was investigated by two independent methods: one involving a high inoculum and the other a low inoculum ofPseudomonas.Treatment of worn lenses with commercially available enzymes such as papain and pork pancreatin as well as treatment with neuraminidase, mannosidase, glucosidase and alkylcarboxylic acid for as long as 48 hours failed to reduce subsequent bacterial adhesion in both the high and low inoculum experiments. We conclude that soft contact lens surface deposits are a major determinant in the adhesion ofPseudomonas aeruginosato the worn lens surface and that enzyme cleaning of worn lenses does not significantly reduce bacterial adhesion.