Risk Factors for Contact Lens Complications in US Clinical Practices

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 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). Conclusions. 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. (Optom Vis Sci 2010;87:725–735)