Risk Factors for Moderate and Severe Microbial Keratitis in Daily Wear Contact Lens Users

Stapleton, Fiona; Edwards, Katie; Keay, Lisa; Naduvilath, Thomas; Dart, John; Brian, Garry; Holden, Brien A.

doi:10.1016/j.ophtha.2012.01.052

Cited by 191 publications

(155 citation statements)

References 31 publications

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“…Similar findings have been described in a separate study examining risk factors in an Australian population with moderate and severe contact lens-related microbial keratitis in daily wear lens users. 16 Previously published studies have also reported associations between certain multipurpose solution types and Fusarium and Acanthamoeba outbreaks of contact lens-related microbial keratitis. [25][26][27] Certain polymeric biguanide-based care solutions have been demonstrated to be less effective against bacterial biofilms in comparison with hydrogen peroxide or polyquaternium-based solutions.…”

Section: Discussionmentioning

confidence: 98%

“…9 However, findings in other studies shown higher socioeconomic class to be linked to an increased risk of microbial keratitis. 6,8,16 Further research is required to establish the association between race, SES, and microbial keratitis and any potential confounders. Those aged between 25 and 44 years had an increased risk of developing microbial keratitis compared with younger wearers aged between 14 and 24 years.…”

Section: Discussionmentioning

confidence: 99%

“…Poor hand hygiene has been consistently previously reported as a risk factor. 6,13,16 Poor hand hygiene may result in the introduction of possible pathogens during lens insertion and lens manipulation during wear and microbial contamination of storage cases. 24 This is an important compliance message both for the initial dispensing of contact lenses and during aftercare visits.…”

Section: Discussionmentioning

confidence: 99%

“…6,13,16 In brief, microbial keratitis was defined by either a positive corneal culture or a corneal infiltrate and overlying epithelial defect with ONE OR MORE of the following characteristics:…”

Section: Case Ascertainmentmentioning

confidence: 99%

“…Written consent was obtained from cases to allow access to medical records and subjects completed a selfadministered questionnaire 6,13,16,17 to establish potential risk factors, including contact lens type, wear habits, hygiene compliance and history, and demographics. Risk factors considered in the analysis are shown in Table 1.…”

Section: Case Ascertainmentmentioning

confidence: 99%

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Risk factors for contact lens-related microbial keratitis in Singapore

Lim

Carnt

Farook

et al. 2015

Eye

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Purpose: To investigate independent risk factors for contact lens-related microbial keratitis in Singapore and estimate their impact on disease load. Methods: Cases were contact lens wearers presenting to Singapore National Eye Centre with microbial keratitis between 2008 and 2010. Community contact lens wearers were recruited as controls. All wearers completed a previously validated questionnaire describing contact lens wear history, hygiene and compliance habits, and demographics. Risk factors significant in univariate analysis (Po0.2) were evaluated in a multivariate model. Results: In all, 58 cases of microbial keratitis and 152 contemporaneous controls were identified. When controlling for other variables, Chinese had a 7 × lower risk compared with other races (95% CI: 2.3-21.3, P = 0.001). Those aged between 25 and 44 years were at 3 × increased risk compared with younger wearers (95% CI: 1.1-9.6, P = 0.04). Occasional overnight contact lens wear (less often than one night per week) was associated with a 4 × higher risk (95% CI: 1.2-15.4, P = 0.03) compared with daily use. Not washing hands before handling was associated with a 13 × increased risk (95% CI: 1.9-84.8, P = 0.008). Use of multipurpose solution A carried a 16 × higher risk compared with hydrogen peroxide (95% CI: 1.5-174.0, P = 0.02). The combined PAR% for modifiable risk factors (occasional overnight wear, not washing of hands, and MPS A) was 82%. Conclusions: Consistent with previous findings, independent risk factors for contact lens-related microbial keratitis include poor hand hygiene, occasional overnight wear, and type of lens care solution. Prolonged overnight or extended contact lens use was infrequent in this population.

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