Infectious keratitis risk increases 10-fold in extended-wear contact lens users
ATLANTIC CITY, N.J. — The risk of contact lens-related infectious keratitis is increased 10-fold among extended-wear contact lens users, a speaker said here.
“It’s not a common disease, infection related to contact lenses,” Douglas R. Lazzaro, MD, said at the Current Concepts in Ophthalmology meeting. “There have been a lot of studies going back almost 30 years. [The risk] is about three to five cases per 10,000 in daily wear users.”
Lazzaro said a study found that the risk of infectious keratitis is increased 10-fold among patients who use extended-wear lenses once or twice in a 30-day period.
Risk factors for contact lens-associated infectious keratitis include hypoxia, inappropriate lens fit and extended-wear use. Steroids and tobacco use also increase the risk of infectious keratitis, Lazzaro said.
Staphylococcus and Pseudomonas are the most common organisms causing contact lens-related infectious keratitis, Lazzaro said. Fungal associations are also common.
Staphylococcus generally responds well to fourth-generation fluoroquinolones, but methicillin-resistant Staphylococcus epidermidis has a variable response. All Staphylococcus species respond to vancomycin, he said.
Lazzaro said that Pseudomonas has shown resistance to fluoroquinolones and aminoglycosides.
Acanthamoeba is rare and often diagnosed incorrectly. Data on corneal collagen cross-linking in the treatment of Acanthamoeba are inconclusive, Lazzaro said.
Some bacteria form a biofilm on the ocular surface that inhibits antibiotics from penetrating tissue and killing bacteria, he said.
Disclosure: Lazzaro has no relevant financial disclosures.