Disposable contact lens use as a risk factor for microbial keratitis
a Moorfields Eye Hospital, London, b Institute of Ophthalmology, London
Correspondence to: Mr J K G Dart, Moorfields Eye Hospital, City Road, London EC1V 2PD.
Accepted for publication 21 April 1998
AIMS
A case-control study was performed to
evaluate soft contact lens (SCL) wear modality as a risk factor for
microbial keratitis.
METHODSContact lens wearers presenting as new
patients to Moorfields Eye Hospital accident and emergency department
during a 12 month period completed a self administered questionnaire
detailing demographic data and contact lens use habits. Cases were
patients with a clinical diagnosis of SCL related microbial keratitis.
Controls were SCL users attending with disorders unrelated to contact
lens wear. Odds ratios (estimates of relative risks) and 95%
confidence limits (CL) were calculated through multivariable logistic
regression analysis.
RESULTSThere were 89 cases and 566 controls. A
substantially increased risk with 1-4 weekly disposable SCL compared
with non-disposable SCL was identified among both daily wear (DW) (odds
ratio =3.51, 95% CL 1.60-7.66, p=0.002) and extended wear (odds ratio
4.76, 95% CL 1.52-14.87, p=0.007) users after adjustment for
demographic, lens use and hygiene variables. Other significant factors
among DW users were "occasional" overnight use, use of chlorine
based (as opposed to other chemical) systems in combination with poor storage case hygiene, and irregular disinfection.
CONCLUSIONProperties of some disposable SCL may
be partly responsible for these excess risks. It is also possible,
however, that this finding is largely a reflection of widespread
complacency among patients and practitioners with respect to disposable
SCL fitting and use.
© 1998 by British Journal of Ophthalmology
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