Chika Shigeyasu1, Masakazu Yamada, Masahiko Fukuda, Shizuka Koh, Takashi Suzuki, Hiroshi Toshida, Yoshinori Oie, Ryohei Nejima, Hiroshi Eguchi, Ryo Kawasaki, Kohji Nishida. 1. Department of Ophthalmology (C.S., M.Y.), Kyorin University School of Medicine, Tokyo, Japan; Department of Ophthalmology (M.F.), Kindai University Faculty of Medicine, Nara Hospital, Nara, Japan; Department of Ophthalmology (S.K., Y.O., R.K., K.N.), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology (T.S.), Toho University School of Medicine, Omori Medical Center, Tokyo, Japan; Department of Ophthalmology (H.T.), Juntendo University School of Medicine, Shizuoka Hospital, Shizuoka, Japan; Miyata Eye Hospital (R.N.), Miyazaki, Japan; and Department of Ophthalmology (H.E.), Kindai University Faculty of Medicine, Osakasayama, Japan.
Abstract
OBJECTIVES: To examine the severe ocular complications associated with contact lens wearing in Japan. METHOD: A questionnaire was sent to 964 ophthalmologist training facilities inquiring for cases of contact lens-associated complications from April 2016 to March 2018. The inclusion criteria were as follows: (1) corrected distance visual acuity ≤0.1 decimal after treatment for 3 months, (2) corneal perforation observed during follow-up, and (3) requiring surgery. A secondary analysis was conducted, inquiring for further information on the type of contact lens, clinical manifestations, and course of treatment. RESULTS: Forty-two patients with infectious keratitis met the inclusion criteria. Eight patients were users of rigid gas-permeable contact lens, and 34 were users of soft contact lens. Microbiological tests were positive in 73.0%. The organisms isolated in microbiological culture were bacteria in 11 patients (Pseudomonas aeruginosa in 9 patients), fungi in 2 patients, and Acanthamoeba in 14 patients. Ten patients were treated with local antibiotics, 11 with a combination of systemic antibiotics, and 21 with a combination of surgical approaches, including 13 with corneal transplantation. CONCLUSIONS: The major cause of serious contact lens-associated ocular complications was microbial keratitis, and P. aeruginosa and Acanthamoeba were the major pathogens in Japan.
OBJECTIVES: To examine the severe ocular complications associated with contact lens wearing in Japan. METHOD: A questionnaire was sent to 964 ophthalmologist training facilities inquiring for cases of contact lens-associated complications from April 2016 to March 2018. The inclusion criteria were as follows: (1) corrected distance visual acuity ≤0.1 decimal after treatment for 3 months, (2) corneal perforation observed during follow-up, and (3) requiring surgery. A secondary analysis was conducted, inquiring for further information on the type of contact lens, clinical manifestations, and course of treatment. RESULTS: Forty-two patients with infectious keratitis met the inclusion criteria. Eight patients were users of rigid gas-permeable contact lens, and 34 were users of soft contact lens. Microbiological tests were positive in 73.0%. The organisms isolated in microbiological culture were bacteria in 11 patients (Pseudomonas aeruginosa in 9 patients), fungi in 2 patients, and Acanthamoeba in 14 patients. Ten patients were treated with local antibiotics, 11 with a combination of systemic antibiotics, and 21 with a combination of surgical approaches, including 13 with corneal transplantation. CONCLUSIONS: The major cause of serious contact lens-associated ocular complications was microbial keratitis, and P. aeruginosa and Acanthamoeba were the major pathogens in Japan.