Risk for microbial keratitis

Comparative metaanalysis of contact lens wearers and post-laser in situ keratomileusis patients

Jordan Masters, Mehmet Kocak, Aaron Waite

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose To compare the risk for microbial keratitis in contact lens wearers stratified by wear schedule with the risk after laser in situ keratomileusis (LASIK). Setting Hamilton Eye Institute and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. Design Comparative metaanalysis and literature review. Methods An extensive literature search was performed in the PubMed database between December 2014 and July 2015. This was followed by a metaanalysis using a mixed-effects modeling approach. Results After 1 year of daily soft contact lens wear, there were fewer microbial keratitis cases than after LASIK, or approximately 2 cases fewer cases per 10 000 (P = .0609). If LASIK were assumed to have essentially a 1-time risk for microbial keratitis, 5 years of extrapolation would yield 11 more cases per 10 000 with daily soft contact lens wear than with LASIK, or approximately 3 times as many cases (P < .0001). The extended use of soft contact lenses led to 12 more cases at 1 year than LASIK, or approximately 3 times as many cases (P < .0001), and 81 more cases at 5 years (P < .0001). When incorporating an estimated 10% retreatment rate for LASIK, these results changed very little. Conclusions Microbial keratitis is a relatively rare complication associated with contact lens use and LASIK postoperatively. The risk for microbial keratitis was similar between patients using contact lenses for 1 year compared with LASIK. Over time, the risk for microbial keratitis was higher for contact lens use than for LASIK, specifically with extended-wear lenses.

Original languageEnglish (US)
Pages (from-to)67-73
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume43
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Laser In Situ Keratomileusis
Keratitis
Contact Lenses
Hydrophilic Contact Lens
Retreatment
Ophthalmology
PubMed
Lenses
Appointments and Schedules
Databases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

Risk for microbial keratitis : Comparative metaanalysis of contact lens wearers and post-laser in situ keratomileusis patients. / Masters, Jordan; Kocak, Mehmet; Waite, Aaron.

In: Journal of Cataract and Refractive Surgery, Vol. 43, No. 1, 01.01.2017, p. 67-73.

Research output: Contribution to journalArticle

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abstract = "Purpose To compare the risk for microbial keratitis in contact lens wearers stratified by wear schedule with the risk after laser in situ keratomileusis (LASIK). Setting Hamilton Eye Institute and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. Design Comparative metaanalysis and literature review. Methods An extensive literature search was performed in the PubMed database between December 2014 and July 2015. This was followed by a metaanalysis using a mixed-effects modeling approach. Results After 1 year of daily soft contact lens wear, there were fewer microbial keratitis cases than after LASIK, or approximately 2 cases fewer cases per 10 000 (P = .0609). If LASIK were assumed to have essentially a 1-time risk for microbial keratitis, 5 years of extrapolation would yield 11 more cases per 10 000 with daily soft contact lens wear than with LASIK, or approximately 3 times as many cases (P < .0001). The extended use of soft contact lenses led to 12 more cases at 1 year than LASIK, or approximately 3 times as many cases (P < .0001), and 81 more cases at 5 years (P < .0001). When incorporating an estimated 10{\%} retreatment rate for LASIK, these results changed very little. Conclusions Microbial keratitis is a relatively rare complication associated with contact lens use and LASIK postoperatively. The risk for microbial keratitis was similar between patients using contact lenses for 1 year compared with LASIK. Over time, the risk for microbial keratitis was higher for contact lens use than for LASIK, specifically with extended-wear lenses.",
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