J Korean Ophthalmol Soc > Volume 54(9); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(9):1327-1338.
DOI: https://doi.org/10.3341/jkos.2013.54.9.1327    Published online September 15, 2013.
Analysis of Inpatients with Contact Lens Related Bacterial Keratitis: Causative Microorganisms, Clinical Aspects, and Prognostic Factors.
Chan Ho Cho, Sang Bumm Lee
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. sbummlee@ynu.ac.kr
콘택트렌즈와 관련된 세균각막염의 분석: 원인 균주, 임상 양상 및 예후 인자
조찬호⋅이상범
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
Abstract
PURPOSE
To investigate causative microorganisms, clinical characteristics, and prognostic factors for inpatients with contact lens related bacterial keratitis. METHODS: Seventy-three eyes of inpatients with contact lens related bacterial keratitis and hospitalized at Yeungnam University Hospital between January 1998 and December 2011 were reviewed retrospectively. Their bacteriological profiles and clinical characteristics were evaluated. RESULTS: Females in their 20s (35/73 eyes, 47.9%) were the most common gender and age group. Thirty eyes (30/45 eyes, 66.7%) used daily-wear soft contact lenses. The most common predisposing factor was sleeping while wearing contact lenses (30 eyes, 41.1%). Positive culture rate was 53.4%. The ratio of gram-positive and -negative bacteria was 8.3%: 91.6%. The most commonly-isolated microorganisms were Pseudomonas spp. (39.6%), followed by Serratia spp. (29.2%). The characteristics of the corneal lesions were: a central lesion in 49 eyes (67.1%), a lesion less than 5 mm2 in size in 54 eyes (74.0%), and hypopyon in 8 eyes (11.0%). The mean log MAR BCVA improved from 0.93 +/- 0.88 on the initial visit to 0.25 +/- 0.48 on the final visit. Twelve eyes (16.4%) had a BCVA of 0.3 or less after remission medical treatment. A BCVA less than 0.1 on the initial visit was a significant risk factor for poor visual outcome (p = 0.005) after remission medical treatment. CONCLUSIONS: BCVA less than 0.1 on the initial visit, epithelial defect sized over 5 mm2, epithelial healing time over 10 days, and central corneal lesion were associated with poor visual outcome after remission medical treatment in contact lens related bacterial keratitis.
Key Words: Bacterial isolates;Bacterial keratitis;Contact lens;Prognostic factor;Visual outcome


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