Trends in contact lens-related corneal ulcers

Purpose: To analyze the frequency of contact lens-related corneal ulcers and its relationship to the type of contact lens and care. Methods: Charts of 376 patients with corneal ulcers seen at the Cornea Service of Wills Eye Hospital from July 1, 1999 to December 3 1, 2002 were retrospectively reviewed. All patients with contact lens-related corneal ulcers were identified, and information regarding cultures, lens type, usage, and cleaning was obtained. Results: Of the 376 cases, 113 (30%) were related to contact lens use. The contact lens history was recorded in 83 of 113 cases (73%). The soft daily wear frequent replacement lens was the most common lens type associated with corneal ulcers (n = 36/83, 43%). Corneal cultures were performed in 71 of 113 cases (63%) and were positive in 51 of 71 cases (72%). The most common microorganism involved was Pseudomonas aeruginosa (n = 17/51, 33%). The frequency of contact lens-related corneal ulcers from 1999-2002 (n = 113/376, 30%) was significantly greater than that from years 1996-1999 (n 37/299, 12%) at our institution (P < 0.05). Conclusion: There was a significant increase in the number of contact lens-related corneal ulcers between 1999 and 2002 compared with previous years (P < 0.05). The contact lens type most frequently associated with corneal ulcers was the soft daily-wear frequent-replacement contact lens (43%). Contact lens-related corneal ulcers continue to be a serious problem despite a shift in the market to the use of frequent-replacement daily-wear contact lenses and advances in contact lens technology.