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The Impact of Overnight Wear on the Risk of Contact Lens—Associated Ulcerative Keratitis

The Impact of Overnight Wear on the Risk of Contact Lens—Associated Ulcerative Keratitis Abstract Objective: To assess the relative risk of contact lens—associated ulcerative keratitis by lens type and related lenswearing behavior. Design: Case-control study. Setting/Participants: Forty practice-based case patients with contact lens—associated ulcerative keratitis and 180 control patients matched to the case patients' dispensing practitioner and date of contact lens prescription. Results: Compared with users of daily-wear soft lenses, users of disposable soft contact lenses had a 13.33-fold (95% confidence interval [CI], 5.35 to 33.20) excess risk of ulcerative keratitis. However, after adjusting for overnight wear, the excess risk associated with disposable contact lenses is reduced to 3.21 (95% CI, 1.22 to 14.36). Overall, overnight wear of contact lenses conferred an 8.25-fold excess risk (95% CI, 3.33 to 25.58) of ulcerative keratitis after controlling for lens type. No protective effect of standard compared with substandard lens hygiene was found. The risk of ulcerative keratitis attributable to overnight wear was estimated at 49% for users of daily-wear lenses and 74% for users of lenses approved for overnight wear. Conclusion: Overnight wear of contact lenses is the overwhelming risk factor for ulcerative keratitis among contact lens users. We estimate that 49% to 74% of cases of contact lens—associated ulcerative keratitis could be prevented by eliminating overnight wear. References 1. Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR, the Microbial Keratitis Study Group. The relative risk of ulcerative keratitis among users of dailywear and extended-wear soft contact lenses: a case-control study . N Engl J Med . 1989;321:773-778.Crossref 2. Dart JKG, Stapleton F, Minassian D. Contact lenses and other risk factors in microbial keratitis . Lancet . 1991;338:650-653.Crossref 3. Herman CL. An FDA survey of US contact lens wearers . Contact Lens Spectrum . 1987;2:89-92. 4. Mummert R. 20/20. 1992;19:35. 5. Buehler PO. Schein OD, Stamler JF, Verdier DD, Katz J. The increased risk of ulcerative keratitis among disposable soft contact lens users . Arch Ophthalmol . 1992;110:1555-1558.Crossref 6. Matthews TD, Frazer DG, Minassian DC, Radford CF, Dart JKG. Risks of keratitis and patterns of use with disposable contact lenses . Arch Ophthalmol . 1992;110:1559-1562.Crossref 7. Cornfield J. A statistical problem arising from retrospective studies . In: Neyman J, ed. Proceedings of the Third Berkeley Symposium on Mathematical Statistics and Probability . Berkeley, Calif: University of California Press; 1956. 8. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease . J Natl Cancer Inst . 1959;22:719-748. 9. Poggio EC, Glynn RJ, Schein OD, et al. The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses . N Engl J Med . 1989;321:779-783.Crossref 10. Poggio EC, Abelson M. Complications and symptoms in disposable extended wear lenses compared with conventional soft daily-wear and soft extended wear lenses . CLAO J . 1993;19:31-39. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Impact of Overnight Wear on the Risk of Contact Lens—Associated Ulcerative Keratitis

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References (12)

Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1994.01090140062024
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To assess the relative risk of contact lens—associated ulcerative keratitis by lens type and related lenswearing behavior. Design: Case-control study. Setting/Participants: Forty practice-based case patients with contact lens—associated ulcerative keratitis and 180 control patients matched to the case patients' dispensing practitioner and date of contact lens prescription. Results: Compared with users of daily-wear soft lenses, users of disposable soft contact lenses had a 13.33-fold (95% confidence interval [CI], 5.35 to 33.20) excess risk of ulcerative keratitis. However, after adjusting for overnight wear, the excess risk associated with disposable contact lenses is reduced to 3.21 (95% CI, 1.22 to 14.36). Overall, overnight wear of contact lenses conferred an 8.25-fold excess risk (95% CI, 3.33 to 25.58) of ulcerative keratitis after controlling for lens type. No protective effect of standard compared with substandard lens hygiene was found. The risk of ulcerative keratitis attributable to overnight wear was estimated at 49% for users of daily-wear lenses and 74% for users of lenses approved for overnight wear. Conclusion: Overnight wear of contact lenses is the overwhelming risk factor for ulcerative keratitis among contact lens users. We estimate that 49% to 74% of cases of contact lens—associated ulcerative keratitis could be prevented by eliminating overnight wear. References 1. Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR, the Microbial Keratitis Study Group. The relative risk of ulcerative keratitis among users of dailywear and extended-wear soft contact lenses: a case-control study . N Engl J Med . 1989;321:773-778.Crossref 2. Dart JKG, Stapleton F, Minassian D. Contact lenses and other risk factors in microbial keratitis . Lancet . 1991;338:650-653.Crossref 3. Herman CL. An FDA survey of US contact lens wearers . Contact Lens Spectrum . 1987;2:89-92. 4. Mummert R. 20/20. 1992;19:35. 5. Buehler PO. Schein OD, Stamler JF, Verdier DD, Katz J. The increased risk of ulcerative keratitis among disposable soft contact lens users . Arch Ophthalmol . 1992;110:1555-1558.Crossref 6. Matthews TD, Frazer DG, Minassian DC, Radford CF, Dart JKG. Risks of keratitis and patterns of use with disposable contact lenses . Arch Ophthalmol . 1992;110:1559-1562.Crossref 7. Cornfield J. A statistical problem arising from retrospective studies . In: Neyman J, ed. Proceedings of the Third Berkeley Symposium on Mathematical Statistics and Probability . Berkeley, Calif: University of California Press; 1956. 8. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease . J Natl Cancer Inst . 1959;22:719-748. 9. Poggio EC, Glynn RJ, Schein OD, et al. The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses . N Engl J Med . 1989;321:779-783.Crossref 10. Poggio EC, Abelson M. Complications and symptoms in disposable extended wear lenses compared with conventional soft daily-wear and soft extended wear lenses . CLAO J . 1993;19:31-39.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Feb 1, 1994

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