Risk factors for contact lens-related fusarium keratitis: a case-control study in Singapore.
OBJECTIVE
To evaluate the specific contact lens-related or other factors that may contribute to the outbreak of Fusarium keratitis.


METHODS
A case-control study was conducted of Fusarium keratitis in contact lens users in Singapore from March 1, 2005, to May 31, 2006, and included 61 patients with Fusarium keratitis and 188 population-based and 179 hospital-based control subjects. Interviewers asked about contact lens solution use and other risk factors.


RESULTS
Patients with Fusarium keratitis were more likely to use ReNu contact lens solutions (Bausch & Lomb, Rochester, NY) 58 [95.1%] of 61 cases) than were either population-based (62 [34.3%] of 181) or hospital-based (50 [30.1%] of 166) control subjects. After controlling for age, sex, contact lens hygiene, and other factors, the use of ReNu with MoistureLoc significantly increased the risk of Fusarium keratitis (odds ratio, 99.3; 95% confidence interval, 18.4-535.4; P<.001), and the risk was 5 times higher compared with the risk with use of ReNu MultiPlus, a multipurpose solution (odds ratio, 21.5; 95% confidence interval, 4.0-115.5; P<.001).


CONCLUSIONS
The use of ReNu contact lens solutions significantly increased the risk of contact lens-related Fusarium keratitis in Singapore. Our data support the recall of ReNu MultiPlus from the Singapore market and the need for further investigations into the role of ReNu MultiPlus in the development of Fusarium keratitis in other populations.
Saw
Seang-Mei
SM
Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 16 Medical Drive, Singapore 117597, Republic of Singapore. cofsawsm@nus.edu.sg
Ooi
Peng-Lim
PL
Tan
Donald T H
DT
Khor
Wei-Boon
WB
Fong
Chee-Weng
CW
Lim
Jayne
J
Cajucom-Uy
Howard Y
HY
Heng
Derrick
D
Chew
Suok-Kai
SK
Aung
Tin
T
Tan
Ai-Ling
AL
Chan
Cheng-Leng
CL
Ting
Steven
S
Tambyah
Paul A
PA
Wong
Tien-Yin
TY
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D018639:Contact Lens Solutions / Q000009:adverse effects; D003261:Contact Lenses / Q000009:adverse effects*; D003320:Corneal Ulcer / Q000209:etiology*; D004203:Disinfection / Q000379:methods; D005260:Female; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology*; D016017:Odds Ratio; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology
D018639:Contact Lens Solutions