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F. Stapleton, K. Edwards, L. Keay, T. Naduvilath, J.K. G. Dart, G. Brian, D. Sweeney, B.A. Holden; The Incidence of Contact Lens Related Microbial Keratitis in Australia . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5025.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Since the publication of studies reporting incidence of contact lens (CL)–related microbial keratitis (MK), CL types and modes of wear have altered, with the introduction of silicone hydrogel (SH) and daily disposable (DD) CLs. No population–based data are available on the risk of disease with these CL types. A prospective study was carried out to determine the incidence of CL–related MK in Australia. Methods: New cases of CL–related MK presenting to ophthalmic practitioners between 10/2003–9/2004 were identified using either Internet or postal/fax report. A clinical definition was used and cases were stratified by severity. The number of CL wearers in the community was established using a telephone survey of randomly selected households. Six–month data are reported. Results: 81% of ophthalmic practitioners responded and 151 cases of CL–related MK were reported. In the population study, 967 controls were identified, with 7.5% using DD CLs and 9.3% SH CLs. The annual incidence of all CL–related MK was 4.8 (95% CI 3.7–5.9) per 10,000 wearers). The annual incidence of moderate and severe or culture proven keratitis in DD CL users was 0.9 (0.7–1.3), in daily wear (DW) soft CL users 3.1 (2.9–3.3), DW SH CL users 4.5 (3.5–6.4), extended wear (EW) soft CL users 11.7 (8.2–20.6) and in EW SH CL users 19.3 (13.9–31.3) per 10,000 wearers. Visual loss occurred more frequently following MK with EW soft CL use compared with EW SH CL use (p<0.05). MK with EW SH CL use appeared to be associated with a longer duration of continuous use than in EW soft CL use (p=0.08). Conclusions: While the data have yet to be independently reviewed, the incidence of CL–related keratitis in hydrogel use is similar to that previously reported. Overnight use of any CL is associated with a higher risk than DW use. DD CL use appears to be associated with a lower risk than for DW of soft CLs. There was no significant difference in incidence between EW SH and EW soft CLs, although severity and duration of continuous use may differ.
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