title: Risk factors for contact lens-related fusarium keratitis: a case-control study in Singapore.
abstract: 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.
authors.affiliation: 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
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Peng-Lim
authors.initials: PL
authors.lastname: Ooi
authors.forename: Donald T H
authors.initials: DT
authors.lastname: Tan
authors.forename: Wei-Boon
authors.initials: WB
authors.lastname: Khor
authors.forename: Chee-Weng
authors.initials: CW
authors.lastname: Fong
authors.forename: Jayne
authors.initials: J
authors.lastname: Lim
authors.forename: Howard Y
authors.initials: HY
authors.lastname: Cajucom-Uy
authors.forename: Derrick
authors.initials: D
authors.lastname: Heng
authors.forename: Suok-Kai
authors.initials: SK
authors.lastname: Chew
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.forename: Ai-Ling
authors.initials: AL
authors.lastname: Tan
authors.forename: Cheng-Leng
authors.initials: CL
authors.lastname: Chan
authors.forename: Steven
authors.initials: S
authors.lastname: Ting
authors.forename: Paul A
authors.initials: PA
authors.lastname: Tambyah
authors.forename: Tien-Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: 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
chemical_list: D018639:Contact Lens Solutions