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Risk factors for acanthamoeba keratitis in contact lens users: a case-control study
C F Radford1, A S Bacon, J K Dart
1Moorfields Eye Hospital, London.
BMJ (Clinical Research Ed.)
|June 17, 1995
Summary
Improper disinfection of daily wear soft contact lenses, especially disposable ones, significantly increases Acanthamoeba keratitis risk. Using effective disinfection systems could prevent over 80% of these infections.
Area of Science:
- Ophthalmology
- Microbiology
- Public Health
Background:
- Acanthamoeba keratitis (AK) is a severe microbial keratitis.
- Contact lens wear is a primary risk factor for AK.
- An increase in AK cases linked to contact lens use necessitates investigation.
Purpose of the Study:
- To identify the specific reasons behind the rising incidence of contact lens-related Acanthamoeba keratitis.
- To determine the risk factors associated with AK in contact lens wearers.
Main Methods:
- A case-control study was conducted.
- Cases comprised patients with contact lens-related AK treated between September 1989 and August 1992.
- Controls were non-diseased contact lens users; data collected via questionnaires on lens use and hygiene.
Main Results:
- Daily wear disposable lenses showed a significantly higher risk (crude RR=49.45) compared to conventional soft lenses.
- Lack of disinfection (RR=55.86) and use of chlorine-based disinfection (RR=14.63) were major risk factors for AK.
- No other tested factors, including socioeconomic status or age, showed a significant association.
Conclusions:
- Failure to disinfect daily wear soft contact lenses is a primary risk factor for AK.
- Chlorine-based disinfection systems offer little protection against Acanthamoeba, increasing AK risk.
- Implementing effective disinfection systems could prevent over 80% of AK cases, particularly those linked to disposable lenses.