Corneal ulcers in patients with cosmetic extended-wear contact lenses

Although cosmetic extended-wear contact lenses are generally safe, they can be associated with a number of complications. A review of 124 cases of corneal ulcers treated between Jan. 1, 1982, and June 1, 1983, disclosed six cases in otherwise healthy patients (four women and two men, ranging in age from 15 to 41 years) who wore extended-wear contact lenses for correction of myopia. In five of the six, the contact lenses had undergone recent manipulation. Two patients had changed their contact lenses without proper disinfection procedures. Five of the six had been treated with antibiotics before corneal scrapings were cultured and three had been treated with corticosteroids. The cultures grew gram-negative rods (in three cases Pseudomonas organisms and in one case Serratia organisms); both patients whose cultures grew no organisms had received antibiotics. Vigorous treatment with tobramycin and cefazolin eyedrops and cycloplegics produced final corrected visual acuities of 20/20, 20/30, 20/60, 20/20, and 20/50. In the sixth case, the final uncorrected visual acuity was counting fingers at 1 foot.