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November 1992

The Increased Risk of Ulcerative Keratitis Among Disposable Soft Contact Lens Users

Author Affiliations

From the Dana Center for Preventive Ophthalmology, The Wilmer Institute, The Johns Hopkins University, Baltimore, Md (Drs Buehler, Schein, and Katz), and Michigan State University, Grand Rapids (Drs Stamler and Verdier). Dr Buehler is currently at the Oregon Health Sciences Center, Portland. None of the authors has a proprietary interest in any contact lens type.

Arch Ophthalmol. 1992;110(11):1555-1558. doi:10.1001/archopht.1992.01080230055019

• Previous controlled studies on contact lens-associated ulcerative keratitis were performed before the widespread use of disposable contact lenses. Therefore, a controlled study was undertaken to determine the relative risk of ulcerative keratitis among users of disposable soft contact lenses compared with the risk among users of other lens types. Forty-six consecutive cases of contact lens-associated ulcerative keratitis were identified between January 1990 and June 1992 at a corneal specialty practice in western Michigan. Five controls, matched to each case patient according to the dispensing date and prescribing practitioner, were obtained for 42 cases (91%). Users of dailywear rigid gas-permeable lenses had the lowest risk of developing ulcerative keratitis. Relative to users of daily-wear soft contact lenses, users of extended-wear soft contact lens had an age-adjusted and sex-adjusted relative risk of 1.87 (95% confidence interval, 0.61 to 5.71). Disposable soft contact lens users had the highest risk of developing ulcerative keratitis, with an adjusted relative risk of 14.16 (95% confidence interval, 5.47 to 37.63) compared with daily-wear soft contact lens users and 7.66 (95% confidence interval, 2.27 to 25.83) compared with conventional extended-wear soft contact lens users.

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