Schein O D, Poggio E C
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston 02114.
Cornea. 1990;9 Suppl 1:S55-8; discussion S62-3. doi: 10.1097/00003226-199010001-00023.
A case-control study of ulcerative keratitis in soft contact lens (CL) users compared three groups of daily wear or extended wear patients: (a) 86 patients with ulcerative keratitis, (b) 61 hospital-based controls, and (c) 410 population-based controls. Overnight lens use, whether regularly with extended wear lenses or occasionally with daily wear lenses, emerged as the preeminent risk factor for ulcerative keratitis. It increased risk by 10 to 15 times in users of extended wear lenses and by 9 times in users of daily wear lenses when these groups were compared with subjects engaged in strict daily wear of daily wear lenses. Even when actual overnight wear was not taken into account, the relative risk was four times greater in users of extended wear lenses than in users of daily wear lenses. The study found a marginal association (p = 0.056) between lens care frequency in general and ulcerative keratitis in comparing ulcerative keratitis cases with population controls. Of the individual hygiene-related measures, evidence of a protective effect was strongest for cleaning the lens case. Smokers showed a threefold greater risk than nonsmokers, regardless of the type of lens worn. An incidence study found the rate of ulcerative keratitis to be approximately 1 in 2,500 daily wear lens users and 1 in 500 extended wear lens users per year. This finding was statistically consistent with the risk ratio noted in the case-control study. Extrapolations suggest that 4,000 of the 9 million U.S. users of daily wear soft lenses develop ulcerative keratitis annually. Among the 4 million U.S. extended wear soft lens users, 8,000 may do so per year.
一项针对软性隐形眼镜（CL）使用者溃疡性角膜炎的病例对照研究，比较了三组日戴或长戴患者：（a）86例溃疡性角膜炎患者，（b）61例医院对照者，以及（c）410例人群对照者。过夜佩戴镜片，无论是长期佩戴长戴型镜片还是偶尔佩戴日戴型镜片，都成为溃疡性角膜炎的首要危险因素。与严格日戴日戴型镜片的受试者相比，长戴型镜片使用者患溃疡性角膜炎的风险增加了10至15倍，日戴型镜片使用者增加了9倍。即使不考虑实际的过夜佩戴情况，长戴型镜片使用者的相对风险也比日戴型镜片使用者大四倍。在比较溃疡性角膜炎病例与人群对照者时，该研究发现一般镜片护理频率与溃疡性角膜炎之间存在微弱关联（p = 0.056）。在各项与个人卫生相关的措施中，清洁镜盒的保护作用证据最为有力。吸烟者无论佩戴何种类型的镜片，其患病风险都比不吸烟者高三倍。一项发病率研究发现，溃疡性角膜炎的发病率约为每年每2500名日戴型镜片使用者中有1例，每500名长戴型镜片使用者中有1例。这一发现与病例对照研究中指出的风险比在统计学上一致。据推测，美国900万日戴软性隐形眼镜使用者中，每年有4000人会患上溃疡性角膜炎。在美国400万长戴软性隐形眼镜使用者中，每年可能有8000人患病。
