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Robin L. Chalmers, John J. McNally, Lisa J. Keay, Jami R. Kern; Risk Factors for Corneal Infiltrative Events in Soft Contact Lens (SCL) Wearers: A Case Control Study in 2010. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6488.
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To evaluate the association of symptomatic SCL-related corneal infiltrative events (CIEs) with SCL material, LCP products and other risk factors.
Cases with symptomatic CIEs were identified in a retrospective, multi-center case control study at 5 academic eye care centers. Each case was matched to 3 controls each who had received eye care near the time of the case’s last full exam at that center. Controls wore SCLs but were not matched for demographic or SCL factors. Clinical diagnoses were established by an expert panel who were masked to SCL and LCP brand. Univariate analysis was conducted and any factors that were significant at the p=0.20 level were placed in a multivariate conditional logistic regression model. Interactions were tested by removing all daily disposable (DD) and all extended wear (EW) cases in separate models.
Clinical records from 166 patients with symptomatic CIEs and known EW status were reviewed, adjudicated and analyzed. Cases used >50 SCL brands and >10 LCP brands. Age, increasing CL Power, EW, reusable SCLs, silicone hydrogels and student status were significant univariate factors. In the multivariate analysis, age (1.05X/year; 1.03, 1.06 95% C.I.), EW (4.18X, 2.44, 7.15) and Reusable SCL (6.27X, 1.88, 20.97) were significant. Among daily wearers, the only significant factors were age (1.05X/year, 1.03, 1.08), reusable SCLs (11.48X, 1.41, 93.49) and silicone hydrogel SCLs (1.94X, 1.03, 3.66). Without DD, age (1.04X/year, 1.02, 1.06), EW (4.42X, 2.53, 7.71) and silicone hydrogel SCLs (1.80X, 1.01, 3.22) were significantly associated with CIEs.
Corneal infiltrative events were positively associated with younger patient age, EW, and reusable SCLs. The leading SCL and LCP brands were not significantly associated with development of CIEs in any model. Among DW users, silicone hydrogels were also significant risk factor for CIEs. Use of DD lenses was protective for CIEs. Improvements in SCL storage case hygiene and environment may be a mechanism for reducing risk of CIEs.
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