Staphylococcus aureus ulcer associated with continuous wear of silicone hydrogel contact lenses.
OBJECTIVE
To report a case of culture-positive Staphylococcus aureus keratitis associated with continuous wear of lotrafilcon A lenses.


METHODS
The case report of a patient who developed microbial keratitis while wearing lotrafilcon A contact lenses is presented.


RESULTS
A 41-year-old white man had worn polymacon contact lenses successfully for at least 10 years. He habitually replaced the lenses every 1 to 2 years and frequently wore them continuously for up to 3 months. He was refitted with silicone hydrogel lenses and was advised to remove and replace the lenses monthly. Approximately 18 months later, he developed a midperipheral, culture-positive S. aureus ulcer in his right eye. He was treated with fortified cefazolin and gentamicin for 2 weeks, followed by ciprofloxacin for 2 weeks. The ulcer resolved completely. The patient's final visual acuity was 20/20 in the affected eye.


CONCLUSIONS
The increased oxygen permeability of silicone hydrogel contact lens materials may reduce the risk of hypoxic complications of continuous contact lens wear. As this case shows, however, even patients who have continuously worn lenses with very low oxygen permeability without incident can develop microbial keratitis when wearing silicone hydrogel lenses. Contact lens practitioners should inform patients of the potential risks of continuous wear and of factors that may increase those risks.
Schornack
Muriel M
MM
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA. schornack.muriel@mayo.edu
Peterson
Daniel
D
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D020100:Hydrogels; D008297:Male; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012828:Silicones; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D005466:Fluorocarbons
D000900:Anti-Bacterial Agents; D002437:Cefazolin; D002939:Ciprofloxacin; D005839:Gentamicins; D020100:Hydrogels; D012828:Silicones; C481129:lotrafilcon A; D005466:Fluorocarbons