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Contact Lens Corneal Inflammatory Events in a University Population
Aaron B Zimmerman1, Andrew J Emch, Julia Geldis
1*OD, MS, FAAO †OD, FAAO ‡MAS, FAAO The Ohio State University College of Optometry, Columbus, Ohio (ABZ, JG, GJN, GLM); and Archbold Eye Care, Archbold, Ohio (AJE).
Purpose:
To identify the contact lens-related modifiable and nonmodifiable factors associated with corneal inflammatory events (CIEs) in a university eye care center.
Methods:
Contact lens-wearing undergraduate and graduate/professional students (age range, 18 to 36 years) with CIEs and contact lens wearers without complications (non-CIEs) were surveyed about their age, education level, overnight wear, brand of lens, brand of care solution, storage case age, topping-off, and lens replacement. Logistic regression was used to assess the impact of participant characteristics (demographic and behavior) and contact lens factors on the risk of a CIE.
Results:
There were 160 participants enrolled, with 76 presenting with a CIE. Age was significant in the multivariate model (p < 0.001) as was an interaction between disinfectant and wearing schedule (p = 0.027). When daily wear (DW) and disinfectant were compared, polyquaternium-1/myristamidopropyl dimethylamine (PQ-1/MAPD) was associated with a greater risk of CIE versus peroxide (adjusted odds ratio [aOR], 18.4; 95% confidence interval [95% CI], 1.9-173.9) and versus polyhexamethylene biguanide or polyaminopropyl biguanide (PHMB) (aOR, 15.0; 95% CI, 4.5-50.0). For PHMB users only, extended wear (EW) compared with DW increased CIE risk (aOR, 10.0; 95% CI, 2.0-51.2). There was no difference in risk between EW and DW for PQ-1/MAPD (aOR, 0.8; 95% CI, 0.2, 2.6).
Conclusions:
The multivariate analysis suggests that younger age and the use of PQ-1/MAPD, particularly in DW, increase the risk of acquiring a CIE with soft contact lens wear in college-aged students. For PHMB users, EW compared with DW increases the risk of a CIE; but for PQ-1/MAPD users, there is no difference between EW and DW.
