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Multicenter Study
. 2017 Aug 16;12(8):e0181343.
doi: 10.1371/journal.pone.0181343. eCollection 2017.

Risk factors and causative organisms in microbial keratitis in daily disposable contact lens wear

Fiona Stapleton  1   2   3 , Thomas Naduvilath  2 , Lisa Keay  1   2   3   4 , Cherry Radford  5 , John Dart  5   6 , Katie Edwards  1   2   3   7 , Nicole Carnt  1   2 , Darwin Minassian  6 , Brien Holden  1   2   3
Affiliations
Multicenter Study

Risk factors and causative organisms in microbial keratitis in daily disposable contact lens wear

Fiona Stapleton et al. PLoS One. .

Abstract

Purpose: This study investigated independent risk factors and causative organisms in microbial keratitis in daily disposable contact lens (CL)-wearers.

Methods: A multisite prospective case-control study was undertaken. Cases were daily disposable CL-wearers attending Moorfields Eye Hospital with microbial keratitis and those reported through a one-year surveillance study in Australia and in New Zealand. A population-based telephone survey identified daily disposable CL-wearing controls. Subjects completed a questionnaire describing CL-wear history, hygiene and demographics. The sample used for risk factor analysis was weighted in proportion to the CL-wearing population at each location. Corneal scrape results were accessed. Independent risk factors were determined using multiple binary logistic regression. Causative organisms in different CL-wear modalities were compared using a chi-squared test.

Results: 963 daily disposable CL-wearers were identified, from which 67 cases and 374 controls were sampled. Independent risk factors were; wearing CLs every day compared with less frequent use (OR 10.4x; 95% CI 2.9-56.4), any overnight wear (OR 1.8x; 95% CI 1.6-2.1), less frequent hand washing (OR 1.8x; 95% CI 1.6-2.0), and smoking (OR 1.3x; 95% CI 1.1-1.6). Certain daily disposable CLs (OR 0.2x; 95% CI 0.1-0.2) had protective effects. Environmental organisms were less frequently recovered with daily disposable CLs (20%), compared with other modalities (36%; p<0.02).

Conclusion: Overnight wear, increased exposure in daily wear, smoking and poor hand hygiene are significant risk factors for microbial keratitis with daily disposable CLs. Risk varied with daily disposable CL type. The profile of causative organisms is consistent with less severe disease.

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Conflict of interest statement

Competing Interests: The Brien Holden Vision Institute and Vision CRC receive a royalty on the sale of certain contact lenses. Dr. Stapleton reports grants from Alcon, Fort Worth, TX, grants from Coopervision, San Francisco, CA, grants from Allergan, Irvine, CA, outside the submitted work; Dr Naduvilath, Dr Keay, Dr Radford, Dr Dart, Dr Edwards, Dr Carnt, Dr Minassian and Dr Holden have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

References

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