Incidence of Conjunctivitis and Keratitis with Reusable Ophthalmic Laser Lenses at an Academic Medical Center

To determine the incidence of keratitis and conjunctivitis associated with reusable contact lens use during ophthalmic laser procedures at an academic medical center.

All laser procedures were performed at a single nonprofit academic medical center (Jacksonville, FL, USA). Data from patients that underwent neodymium-doped yttrium-aluminum-garnet (Nd:YAG) capsulotomy or selective laser trabeculoplasty (SLT) with reusable contact lenses between 2014 and 2023 was analyzed retrospectively. The post-procedure infection rate, defined as the incidence of newly diagnosed superficial keratitis and/or conjunctivitis within two weeks of the laser procedure, was calculated by dividing the total number of affected eyes by the total cohort size. A break-even analysis was conducted to evaluate the economic impact of reusable lens implementation.

A total of 2285 eyes of 1363 patients were included in this study. The incidence of previous conjunctivitis in this cohort was small (0.4%) and no eyes had a prior history of keratitis. Of the 1372 Nd:YAG capsulotomy and 913 SLT procedures performed, only one eye (0.044%) developed signs of post-operative conjunctivitis and none developed keratitis. The single case of unilateral conjunctivitis occurred within one day of a Nd:YAG capsulotomy and was secondary to medicamentosa. A cost analysis showed that reusable ophthalmic laser lenses become more cost-effective than disposable lenses after approximately 86 SLT procedures and 91 Nd:YAG capsulotomies, while reducing medical waste by 79%.

Given the negligible rate of conjunctivitis, substantial cost savings, and significant reduction in environmental waste associated with reusable capsulotomy and trabeculoplasty lenses, the routine use of disposable ophthalmic lenses should be reconsidered.