Dart J K, Stapleton F, Minassian D
Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, UK.
Lancet. 1991 Sep 14;338(8768):650-3. doi: 10.1016/0140-6736(91)91231-i.
Microbial keratitis is a potentially binding disease that is rare in normal eyes unless associated with contact lens (CL) wear. To assess the risks of CL use, and other major causes, for keratitis, a case-control study of 91 cases of keratitis including 60 CL users was done. Relative risks (RR) and population attributable risk percentages (PAR%) for keratitis were estimated for different causes and for the different types of CL. The RR (95% confidence intervals) for CL wear was 80 (38-166) and for trauma cases 14 (6-32) compared with cases of keratitis without a predisposing condition. The PAR% for microbial keratitis attributed to CL wear was 65%. The RR for overnight wear soft lenses was 21 (7-60), for daily-wear soft lenses 3.6 (1-14), and for polymethylmethacrylate hard lenses 1.3 (0-9) compared with gas-permeable hard lenses. Continuous periods of CL wear for more than 6 days was associated with increased risk. CL wear is now the commonest cause, and has the highest risk, for new cases of microbial keratitis at Moorfields Eye Hospital. Soft CLs, especially extended-wear lenses, carry a significantly higher risk than do hard lenses for this disease.
微生物性角膜炎是一种潜在的致盲性疾病，在正常眼睛中很少见，除非与佩戴隐形眼镜（CL）有关。为了评估使用隐形眼镜及其他主要病因导致角膜炎的风险，我们对91例角膜炎患者进行了病例对照研究，其中包括60例隐形眼镜佩戴者。我们估计了不同病因和不同类型隐形眼镜导致角膜炎的相对风险（RR）和人群归因风险百分比（PAR%）。与无易感因素的角膜炎病例相比，佩戴隐形眼镜的RR（95%置信区间）为80（38-166），外伤病例为14（6-32）。因佩戴隐形眼镜导致的微生物性角膜炎的PAR%为65%。与透气硬镜相比，过夜佩戴软性隐形眼镜的RR为21（7-60），日戴软性隐形眼镜为3.6（1-14），聚甲基丙烯酸甲酯硬镜为1.3（0-9）。连续佩戴隐形眼镜超过6天会增加风险。在摩尔菲尔德眼科医院，佩戴隐形眼镜现在是新发性微生物性角膜炎最常见的病因，且风险最高。对于这种疾病，软性隐形眼镜，尤其是长戴型隐形眼镜，比硬性隐形眼镜的风险要高得多。
