02454nas a2200193   4500000000100000008004100001100001400042700001200056700001700068700001300085700001700098700001600115245007300131250001500204300001100219490000700230520197700237020004602214       2010                            d1 aKeay Lisa1 aLong B.1 aBergenske P.1 aGiles T.1 aBullimore M.1 aChalmers R.00aRisk factors for contact lens complications in US clinical practices  a2010/08/24  a725-350 v873 a<p>
PURPOSE: To determine significant risk factors for any inflammatory and infectious events with soft contact lenses (SCL) in a large retrospective clinical chart review. METHODS: 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. RESULTS: 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 &lt;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 &gt;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). CONCLUSIONS: Eighty-two percent of these SCL wearers did not present with any complications during the observation period &gt;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 &lt;25 years are the risk factors that impact the most types of events.
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