Abstract
Purpose :
This study investigated risk factor for contact lens (CL)-related corneal infections in wearers of coloured or decorative CLs compared with infections in other CL wearers.
Methods :
This study was part of the ACSIKS surveillance study of infectious keratitis in Asia and reports a multisite prospective surveillance study of cases of CL related corneal infections over 3 years (2012-2014) from 9 countries and 11 sites across South East Asia. Proportions and chi-squared tests were used to compare the demographics and wear habits between cosmetic and other CL wearers with corneal infections.
Results :
Six hundred and 94 contact lens (CL) wearers with corneal infections were identified. Wearers were classified into cosmetic (n=199) and other CL wearers (n=495). Corneal infections in cosmetic CL wearers comprised 28% of CL-related infections but the rates varied between countries, ranging 7-54% (p<0.001). Countries with rates >40% included Thailand (54%), Philippines (46%) and Korea (41%). Compared with soft CL wearers with corneal infections, cosmetic CL wearers were more likely to be female (89% vs 60%; p< 0.05), younger (aged below 25 68% vs 44%; p< 0.001), to have a shorter period of lens wear experience (40% vs 21%, p<0.001), to wear lenses for fewer hours per day (45% vs 34%, <10 hours per day, p<0.001) and for fewer days each week(24% vs 16%, lens use for 2-4 days per week; p<0.001). Topping off solution in storage cases was more common (35% vs 25%, p<0.05) and air drying of cases was less common in cosmetic users (11% vs 21%, p<0.05). Cosmetic wearers were less likely to have had a check with an eyecare practitioner in the last 12 months (34% vs 41%; p<0.05). Other compliance factors were similar between cosmetic and refractive CL wearers, including the frequency of occasional overnight CL use and frequency of CL disinfection. Lenses worn by cosmetic CL wearers were more likely to be hydrogel materials and manufactured with pigment on the back surface.
Conclusions :
Cosmetic CL infections represent a significant proportion of CL-related infections in certain Asian countries. Compared with other soft CL wearers, cosmetic CL users with corneal infections are younger, more likely to be female and more likely to be wearing hydrogel contact lenses. Internet supply, quality control of these products and regulation of their sale in different jurisdictions provide significant challenges in managing this population of vulnerable wearers.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.