Chalmers Robin L, Keay Lisa, Long Bill, Bergenske Peter, Giles Tim, Bullimore Mark A
Indiana University School of Optometry, Bloomington, Indiana, USA.
Optom Vis Sci. 2010 Oct;87(10):725-35. doi: 10.1097/OPX.0b013e3181f31f68.
To determine significant risk factors for any inflammatory and infectious events with soft contact lenses (SCL) in a large retrospective clinical chart review.
Charts of patients who presented for SCL care from October 2005 through March 2006 were reviewed and observed for a potential of at least 2 years. Charts from those with office visits involving an event-requiring pharmacologic treatment and/or interruption of SCL wear were scanned and later adjudicated by a masked panel. Significant factors from a univariate analysis were included in a multivariate analysis for all events and subcategories of events separately. Overnight wear was not consistently recorded and was not analyzed.
Charts from 1276 SCL wearers comprised 4120 visits and 1454 years of SCL wear (2908 eye/yr) and included 306 events of interest in 228 patients. In a multivariate analysis, age <25 years was significantly associated with presenting any event, inflammatory events, and infectious events that may or may not be CL-related [incidence rate ratio (IRR) = 1.3; 95% CI, 1.0 to 1.7; 2.6X, 1.5 to 4.6; and 2.0X, 1.2 to 3.3, respectively]. Ametropia >5.00 D increased risk of any event (IRR = 1.5; 1.2 to 1.9) and for other infectious events (IRR = 1.9; 1.2 to 3.2). Use of daily disposable lenses associated with lid irritation (IRR = 4.5; 2.1 to 9.8) but was not significantly associated with any other type of events. New and hydrogel lens wearers had a lower incidence of all event types (IRR = 0.07; 0.01 to 0.46 and 0.77; 0.59 to 0.99, respectively).
Eighty-two percent of these SCL wearers did not present with any complications during the observation period >2 years. The risk factors for inflammatory and infectious events among SCL wearers in clinical practice are similar to those reported in prospective clinical trials. High ametropia and age <25 years are the risk factors that impact the most types of events.
通过一项大型回顾性临床图表审查，确定软性隐形眼镜（SCL）相关的任何炎症和感染事件的显著风险因素。
回顾2005年10月至2006年3月期间接受SCL护理的患者图表，并观察至少2年。扫描那些因事件需要药物治疗和/或中断SCL佩戴而进行门诊就诊的患者图表，随后由一个盲法小组进行判定。单因素分析中的显著因素分别纳入所有事件及其子类别事件的多因素分析。过夜佩戴情况记录不一致，未进行分析。
1276名SCL佩戴者有4120次就诊记录，累计SCL佩戴时长1454年（每年2908眼），其中228名患者发生306起感兴趣的事件。在多因素分析中，年龄<25岁与出现任何事件、炎症事件以及可能与CL相关或不相关的感染事件显著相关[发病率比（IRR）分别为1.3；95%可信区间（CI）为1.0至1.7；2.6倍，1.5至4.6；以及2.0倍，1.2至3.3]。屈光不正>5.00 D会增加任何事件（IRR = 1.5；1.2至1.9）以及其他感染事件（IRR = 1.9；1.2至3.2）的风险。使用日抛型镜片与眼睑刺激相关（IRR = 4.5；2.1至9.8），但与其他任何类型事件无显著关联。新佩戴者和水凝胶镜片佩戴者所有事件类型的发生率较低（IRR分别为0.07；0.01至0.46和0.77；0.59至0.99）。
在超过2年的观察期内，这些SCL佩戴者中有82%未出现任何并发症。临床实践中SCL佩戴者发生炎症和感染事件的风险因素与前瞻性临床试验报告的相似。高度屈光不正和年龄<25岁是影响最多类型事件的风险因素。
