Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA.
Eye Contact Lens. 2010 Nov;36(6):334-9. doi: 10.1097/ICL.0b013e3181f579f7.
Patient noncompliance with recommended hygienic practices in contact lens wear is often considered a significant risk factor for microbial keratitis and adverse contact lens-related events. Despite advancements in lens materials and care solutions, noncompliant behavior continues to hinder efforts to maximize contact lens safety. The objective of this pilot study was to assess the relationship between perceived and actual compliance with awareness of risk and behavior.
One hundred sixty-two established contact lens wearers were sequentially evaluated after their routine contact lens examination at the Optometry Clinic at the University of Texas Southwestern Medical Center at Dallas, TX. Each patient was questioned by a single trained interviewer regarding his or her lens care practices and knowledge of risk factors associated with lens wear.
Eighty-six percent of patients believed they were compliant with lens wear and care practices; 14% identified themselves as noncompliant. Using a scoring model, 32% demonstrated good compliance, 44% exhibited average compliance, and 24% were noncompliant; age was a significant factor (P = 0.020). Only 34% of patients who perceived themselves as compliant exhibited a good level of compliance (P<0.001). Eighty percent of patients reported an awareness of risk factors, but awareness did not influence negative behavior. Replacing the lens case was the only behavior associated with a positive history for having experienced a prior contact lens-related complication (P = 0.002).
Perceived compliance is not an indicator for appropriate patient behavior. A large proportion of patients remain noncompliant despite awareness of risk. Education alone is not a sufficient strategy to improve behavior; newer approaches aimed at improving compliance with lens care practices are urgently needed.
患者不遵守推荐的隐形眼镜佩戴卫生习惯，通常被认为是微生物角膜炎和不良隐形眼镜相关事件的重要风险因素。尽管镜片材料和护理解决方案有所进步，但不遵守行为仍在阻碍最大限度地提高隐形眼镜安全性的努力。本研究的目的是评估感知和实际合规性与风险和行为意识之间的关系。
在德克萨斯州达拉斯市德克萨斯西南医学中心的验光诊所进行常规隐形眼镜检查后，对 162 名已建立的隐形眼镜佩戴者进行了顺序评估。每位患者均由一名经过培训的访谈员询问其镜片护理习惯以及与镜片佩戴相关的风险因素的知识。
86%的患者认为自己遵守了隐形眼镜佩戴和护理习惯；14%的患者认为自己不遵守。使用评分模型，32%的患者表现出良好的依从性，44%的患者表现出平均依从性，24%的患者不依从；年龄是一个重要因素（P=0.020）。只有 34%的自认为合规的患者表现出良好的合规水平（P<0.001）。80%的患者报告意识到风险因素，但意识并没有影响负面行为。更换镜片盒是唯一与曾经历过隐形眼镜相关并发症的积极病史相关的行为（P=0.002）。
感知合规性不是适当患者行为的指标。尽管有风险意识，但仍有很大一部分患者不遵守规定。仅教育不是改善行为的充分策略；迫切需要新的方法来提高对镜片护理实践的依从性。
