Abstract • Previous controlled studies on contact lens-associated ulcerative keratitis were performed before the widespread use of disposable contact lenses. Therefore, a controlled study was undertaken to determine the relative risk of ulcerative keratitis among users of disposable soft contact lenses compared with the risk among users of other lens types. Forty-six consecutive cases of contact lens-associated ulcerative keratitis were identified between January 1990 and June 1992 at a corneal specialty practice in western Michigan. Five controls, matched to each case patient according to the dispensing date and prescribing practitioner, were obtained for 42 cases (91%). Users of dailywear rigid gas-permeable lenses had the lowest risk of developing ulcerative keratitis. Relative to users of daily-wear soft contact lenses, users of extended-wear soft contact lens had an age-adjusted and sex-adjusted relative risk of 1.87 (95% confidence interval, 0.61 to 5.71). Disposable soft contact lens users had the highest risk of developing ulcerative keratitis, with an adjusted relative risk of 14.16 (95% confidence interval, 5.47 to 37.63) compared with daily-wear soft contact lens users and 7.66 (95% confidence interval, 2.27 to 25.83) compared with conventional extended-wear soft contact lens users. References 1. Dart JKG. Predisposing factors in microbial keratitis: the significance of contact lens wear . Br J Ophthalmol . 1988;72:926-930.Crossref 2. Koidou-Tsiligianni A, Alfonson E, Forster RK. Ulcerative keratitis associated with contact lens wear . Am J Ophthalmol . 1989;108:64-67. 3. Schein OD, Ormerod LD, Barraquer E, et al. Microbiology of contact lens-related keratitis . Cornea . 1989;8:281-285.Crossref 4. Dart JKG, Stapleton F, Minassian D. Contact lenses and other risk factors in microbial keratitis . Lancet . 1991;338:650-653.Crossref 5. Ormerod LD, Smith RE. Contact lens-associated microbial keratitis . Arch Ophthalmol . 1986;104:79-83.Crossref 6. Mondino BJ, Weissman BA, Farb MD, Pettit TH. Corneal ulcers associated with daily-wear and extended-wear contact lenses . Am J Ophthalmol . 1986;102:58-65. 7. Cohen EJ, Laibson PR, Arentsen JJ, Clemons CS. Corneal ulcers associated with cosmetic extended-wear soft contact lenses . Ophthalmology . 1987;94:109-114.Crossref 8. Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR, Microbial Keratitis Study Group. The relative risk of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses: a case-control study . N Engl J Med . 1989;321:773-778.Crossref 9. Mummert R. 20/20 . 1992;19:35. 10. Killinsworth DW, Stern G. Pseudomonas keratitis associated with the use of disposable soft contact lenses . Arch Ophthalmol . 1989;107:795-796.Crossref 11. Kershner RM. Infectious corneal ulcer with overextended wearing of disposable contact lenses . JAMA . 1989;261:3549-3550.Crossref 12. Rabinowitz SM, Pflugfelder SC, Goldberg M. Disposable extended-wear contact lens-related keratitis . Arch Ophthalmol . 1989;107:1121.Crossref 13. Dunn JP Jr, Mondino BJ, Weissman BA, Donzis PB, Kikkawa DO. Corneal ulcers associated with disposable hydrogel contact lenses . Am J Ophthalmol . 1989;108:113-117. 14. Kent HD, Sanders RJ, Arentsen JJ, Cohen EJ, Laibson PR. Pseudomonas corneal ulcer associated with disposable soft contact lenses . CLAO J . 1989;15:264-265. 15. Glastonbury J, Crompton JL. Pseudomonas aeruginosa corneal infection associated with disposable contact lens use . Aust N Z J Ophthalmol . 1989;17:451.Crossref 16. Ficker L, Hunter P, Seal D, Wright P. Acanthamoeba keratitis occurring with disposable contact lens wear . Am J Ophthalmol . 1989;108:453. 17. John T. How safe are disposable soft contact lenses? Am J Ophthalmol . 1991;111:766-768. 18. Maguen E, Tsai JC, Martinez M, et al. A retrospective study of disposable extended-wear lenses in 100 patients . Ophthalmology . 1991;98:1685-1689.Crossref 19. Heidemann DG, Verdier DD, Dunn SP, Stamler JF. Acanthamoeba keratitis associated with disposable contact lenses . Am J Ophthalmol . 1990;110:630-634. 20. Breslow NE, Day NE. The Analysis of Case-Control Studies. Vol 1. In: Statistical Methods in Cancer Research . Lyon, France: World Health Organization, International Agency for Research on Cancer; 1980. IARC Scientific publication 32. 21. MacRae S, Herman C, Stulting RD, et al. Corneal ulcer and adverse reaction rates in premarket contact lens studies . Am J Ophthalmol . 1991;111:457-465. 22. Efron N, Veys V. Defects in disposable contact lenses can compromise ocular integrity . Int Contact Lens Clin . 1992;19:8-17.Crossref
Archives of Ophthalmology – American Medical Association
Published: Nov 1, 1992
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