Abstract • We conducted a population-based incidence study in five New England states to quantify the risk of ulcerative keratitis associated with contact lens use among aphakic persons. All practicing ophthalmologists in the five-state area were surveyed to identify prospectively all new cases of ulcerative keratitis during a 4-month period. The number of aphakic persons using specific types of contact lenses was estimated through a telephone survey of 4178 households identified by random digit dialing. The annualized incidence of ulcerative keratitis among aphakic persons using contact lenses was estimated to be 52 cases per 10 000 aphakic contact lens wearers (95% confidence interval (CI), 31.1 to 86.9). The risk of ulcerative keratitis varied substantially by lens use, with extended wear having an estimated seven-fold greater risk relative to daily wear (95% CI, 1.6 to 30.2). Rates of ulcerative keratitis in aphakic persons using contact lenses were much greater than rates among cosmetic wearers of the same lens type: for daily-wear lenses, aphakic persons were estimated to have 6.3 times the risk of cosmetic wearers (95% CI, 1.9 to 21.0), and for extended-wear lenses, aphakic persons were estimated to have 8.7 times the risk of cosmetic wearers (95% CI, 3.5 to 21.9). These risks are useful in assessing the benefits and risks of contact lens wear as an alternative to other methods of aphakic correction. References 1. Herman CL. An FDA survey of US contact lens wearers . Contact Lens Spectrum . 1987;2:89-92. 2. Gasset AR, Lobo L, Houde W. Permanent wear of soft contact lenses in aphakic eyes . Am J Ophthalmol . 1977;83:115-120. 3. Dahl AA, Brocks ER. The use of continuous wear silicone contact lenses in the optical correction of aphakia . Am J Ophthalmol . 1978;85:454-461. 4. Nesburn AB. Prolonged-wear contact lenses in aphakia . Ophthalmology . 1978;85:73-79.Crossref 5. Stark WJ, Kracher GP, Cowan CL, et al. Extended-wear contact lenses and intraocular lenses for aphakic correction . Am J Ophthalmol . 1979;88:535-542. 6. Cavanaugh HD, Bodner BI, Wilson LA. Extended wear hydrogel lenses . Ophthalmology . 1980;87:871-876.Crossref 7. Salz JJ, Schlanger JL. Complications of aphakic extended wear lenses encountered during a seven-year period in 100 eyes . CLAO J . 1983;9:241-244. 8. Eichenbaum JW, Feldstein M, Podos SM. Extended-wear aphakic soft contact lenses and corneal ulcers . Br J Ophthalmol . 1982;66:663-666.Crossref 9. Graham CM, Dart JKG, Wilson-Holt NW, Buckley RJ. Prospects for contact lens wear in aphakia . Eye . 1988;2:48-55.Crossref 10. Poggio EC, Glynn RJ, Schein OD, et al. The incidence of ulcerative keratitis among daily and extended wear soft contact lens wearers . N Engl J Med . 1989;321:779-783.Crossref 11. Kraff MC, Sanders DR, Lieberman HL, Kraff J. Secondary intraocular lens implantation . Ophthalmology . 1983;90:324-326.Crossref 12. Egan KM, Seddon JM, Glynn RJ, Gragoudas ES, Albert DM. Epidemiologic aspects of uveal melanoma . Surv Ophthalmol . 1988;32:239-251.Crossref 13. Waksberg J. Sampling methods for random digit dialing . J Am Stat Assoc . 1978;73:40-46.Crossref 14. US Department of Commerce, Bureau of the Census. Population Estimates and Projections: Current Population Reports . Washington, DC: Government Printing Office; 1986. Series P-25, No. 1010. 15. US Bureau of the Census. General Population Characteristics: Massachusetts . Washington, DC: Government Printing Office; 1980. PC80-1-B23, Vol 1, Part23. 16. Cochran WG. Sampling Techniques . 3rd ed. New York, NY: John Wiley & Sons Inc; 1977. 17. Bickel PJ, Doksum KA. Mathematical Statistics: Basic Ideas and Selected Topics . San Francisco, Calif: Holden-Day; 1977:30-32. 18. Rothman KJ. Modern Epidemiology . Boston, Mass: Little Brown & Co Inc; 1986:177-236. 19. Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR, Microbial Keratitis Study Group. The relative risk of ulcerative keratitis between extended and daily wear soft contact lens wearers: a case-control study . N Engl J Med . 1989;321:773-778.Crossref
Archives of Ophthalmology – American Medical Association
Published: Jan 1, 1991
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