Trends in contact lens-related corneal ulcers

To identify changes in number of contact lens-related corneal ulcers per year and the type of contact lenses involved.

Charts of 299 patients with corneal ulcers seen at the Cornea Service of Wills Eye Hospital from January 1, 1996, to June 30, 1999, were retrospectively reviewed. A corneal ulcer was defined as an infiltrate that was treated at least hourly with topical fortified antibiotics or fluoroquinolones.

Of these 299 cases, 37 (12.4%) were related to contact lens use. Contact lens-related ulcers accounted for 10.7% of all corneal ulcers in 1996, 15.3% in 1997, 8.6% in 1998, and 18.2% in the first 6 months of 1999. The contact lenses most commonly associated with ulcers were conventional soft daily-wear contact lenses (33%). There were similar numbers of ulcers associated with extended wear (n = 16) and daily wear (n = 17) of soft contact lenses. In addition, the number of cases associated with conventional (n = 17) and disposable/frequent replacement (n = 16) lenses were similar. Corneal cultures were performed in 15 (40.5%) cases and were positive in 8. There has been a significant decrease in the number of contact lens-related ulcers treated at our institution compared with previous years (1988-1999, p < 0.01).

The number of contact lens-related corneal ulcers in the past 4 years was significantly fewer than previous years at our institution. A similar number of ulcers were associated with conventional and disposable/frequent replacement lenses despite the commercial preponderance of the latter type of lenses.