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Augenheilkunde 1. November 2008

Contact lens related corneal infiltrates and ulcers – a retrospective study of 134 eyes

BACKGROUND: An increase in corneal infiltrates and ulcers, especially among young contact lens users was noticed in our out-patient service over the last years. This prompted us to examine contact lens related corneal infiltrates and ulcers.

PATIENTS AND METHODS: Retrospective study of 119 consecutive patients (134 eyes) who did wear contact lenses. 15 had problems in both eyes. We evaluated age of the patients, proportion of soft and hard contact lenses, number and location of infiltrates, the type of bacteria and the permanent corneal damage caused by scarring.

RESULTS: Out of the 134 eyes evaluated 127 (94.8%) used soft contact lenses and 7 (5.2%) had used hard contact lenses for refractive correction. Mean age of patients was 28.4 years ± 12.9a. 80.6% (108 eyes) had central solitary infiltrates, 14.9% (20 eyes) had multiple peripheral infiltrates, and 4.5% (6 eyes) developed corneal ulcers. In 25.4% (34 eyes) we were able to isolate bacteria. Most of the bacteria were found in eyes with soft lenses (33 out of 34 eyes, 97%), in only one (3%) case a hard contact lens was used. Gram-negative bacteria such as serratia spp. (7 eyes), pseudomonas spp. (6 eyes), stenotrophomonas maltophilia (6 eyes) and klebsiella oxytoca (5 eyes) were predominantly isolated. 26 of 127 eyes (20.5%) with soft contact lens related keratitis healed with a corneal scar, resulting in permanent visual damage.

CONCLUSION: The majority of keratitis was caused by wearing soft contact lenses. One fifth of these comparatively young patients retained a corneal scar. These findings should influence the information given to a patient concerning the choice of refractive correction.

B. Neumaier-Ammerer, U. Stolba, H. Feichtinger, S. Binder, Spektrum der Augenheilkunde 5/2008

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