Brien Holden Vision Institute, Sydney, Australia.
Ophthalmology. 2012 Aug;119(8):1516-21. doi: 10.1016/j.ophtha.2012.01.052. Epub 2012 Apr 21.
To establish risk factors for moderate and severe microbial keratitis among daily contact lens (CL) wearers in Australia.
A prospective, 12-month, population-based, case-control study.
New cases of moderate and severe microbial keratitis in daily wear CL users presenting in Australia over a 12-month period were identified through surveillance of all ophthalmic practitioners. Case detection was augmented by record audits at major ophthalmic centers. Controls were users of daily wear CLs in the community identified using a national telephone survey.
Cases and controls were interviewed by telephone to determine subject demographics and CL wear history. Multiple binary logistic regression was used to determine independent risk factors and univariate population attributable risk percentage (PAR%) was estimated for each risk factor.
Independent risk factors, relative risk (with 95% confidence intervals [CIs]), and PAR%.
There were 90 eligible moderate and severe cases related to daily wear of CLs reported during the study period. We identified 1090 community controls using daily wear CLs. Independent risk factors for moderate and severe keratitis while adjusting for age, gender, and lens material type included poor storage case hygiene 6.4× (95% CI, 1.9-21.8; PAR, 49%), infrequent storage case replacement 5.4× (95% CI, 1.5-18.9; PAR, 27%), solution type 7.2× (95% CI, 2.3-22.5; PAR, 35%), occasional overnight lens use (<1 night per week) 6.5× (95% CI, 1.3-31.7; PAR, 23%), high socioeconomic status 4.1× (95% CI, 1.2-14.4; PAR, 31%), and smoking 3.7× (95% CI, 1.1-12.8; PAR, 31%).
Moderate and severe microbial keratitis associated with daily use of CLs was independently associated with factors likely to cause contamination of CL storage cases (frequency of storage case replacement, hygiene, and solution type). Other factors included occasional overnight use of CLs, smoking, and socioeconomic class. Disease load may be considerably reduced by attention to modifiable risk factors related to CL storage case practice.
确定澳大利亚日戴型接触镜（CL）使用者发生中重度微生物角膜炎的危险因素。
前瞻性、12 个月、基于人群的病例对照研究。
通过对所有眼科医生的监测，确定澳大利亚在 12 个月期间出现的新的日戴型 CL 使用者中重度微生物角膜炎的病例。通过对主要眼科中心的病历记录审核，对病例检测进行了补充。对照组为通过全国性电话调查确定的社区日戴型 CL 使用者。
通过电话对病例和对照组进行访谈，以确定研究对象的人口统计学和 CL 使用史。采用多元二项逻辑回归分析确定独立危险因素，并估计每个危险因素的单变量人群归因风险百分比（PAR%）。
独立危险因素、相对风险（95%置信区间[CI]）和 PAR%。
在研究期间，共报告了 90 例与日戴 CL 相关的中重度病例。我们使用日戴 CL 确定了 1090 例社区对照者。对年龄、性别和镜片材料类型进行调整后，中重度角膜炎的独立危险因素包括储存盒卫生差 6.4 倍（95%CI，1.921.8；PAR%，49%）、不频繁更换储存盒 5.4 倍（95%CI，1.518.9；PAR%，27%）、溶液类型 7.2 倍（95%CI，2.322.5；PAR%，35%）、偶尔过夜戴镜（每周＜1 晚）6.5 倍（95%CI，1.331.7；PAR%，23%）、高社会经济地位 4.1 倍（95%CI，1.214.4；PAR%，31%）和吸烟 3.7 倍（95%CI，1.112.8；PAR%，31%）。
与日戴 CL 使用相关的中重度微生物角膜炎与 CL 储存盒污染相关的因素独立相关（包括储存盒更换频率、卫生和溶液类型）。其他因素包括偶尔过夜戴镜、吸烟和社会经济地位。通过关注与 CL 储存盒使用相关的可改变危险因素，可能会显著降低疾病负担。
