Abstract
Purpose: :
A strong association between Advance Medical Optics (AMO) Complete Moistureplus (CMP) and Acanthamoeba keratitis (AK) was identified resulting in its recall in May of 2007. Despite this association, nearly 40% of cases did not use the recalled solution. Thepurpose of this abstract is to analyze recent trends in the solution use of AK cases at the University of Illinois Eye and Ear Infirmary (IEEI) after its recall to determine if AK is increasingly seen with other solution use.
Methods: :
Solution use of recent AK cases at IEEI was reviewed after the AMO contact lens solution recall. A significant number of patients presenting between June of 2007 and November 31st of 2007 were excluded due to the potential for a post AMO recall spike during this six-month period. The solutions of recent cases were compared to solutions of cases seen at our institution between June of 2003 and May of 2007.
Results: :
A total of 19 AK cases were diagnosed between December 1st, 2007 and November 31st, 2008. Of these cases, 15 were female and 4 were male. The average age was 35 (14-60). 2 of 19 (11%) cases did not use contact lenses and 5 (24%) had unknown contact lens solution use. Of cases with known solution use, 4 (33%) used Opti-free, 3 (25%) used ReNu , 2 (17%) used Clear Care, 1 (6%) used AMO Complete (not AMO-CMP) and 2 (17%) used rigid gas permeable lenses and solutions. 73 cases were seen between June 2003 and May 2007 with mean age of 28 (13-70), of which 60 had known contact lens solution use. Of these patients, 28 (46%) reported use of AMO-CMP, 12 (20%) ReNu, 5 (8%) Opti-free, 1 (2%) Clear Care, 10 (17%) used store brands and 4 (7%) RGP lenses and solutions.
Conclusions: :
Despite the recall of AMO-CMP May of 2007, AK cases continue to be seen with use of other contact lens solutions with increasing proportions. For the remaining major contact lens solutions, the absolute number of AK cases, yearly, is increasing to levels which, individually, are above the previously understood total incidence of AK in this area. This indicates that prevention of a continued increase in the absolute number of AK cases will require identification of further risk factors and/or a sizeable modification to current contact lens related behaviors and solutions.
Keywords: Acanthamoeba • contact lens • cornea: clinical science