Pseudomonas keratitis associated with daily wear of silicone hydrogel contact lenses.
OBJECTIVE
To report two cases of pseudomonas keratitis associated with daily wear of silicone hydrogel contact lenses.


METHODS
Medical records of two patients who developed pseudomonas keratitis while wearing silicone hydrogel lenses on a daily-wear schedule are reviewed and discussed.


RESULTS
A 13-year-old girl who wore ACUVUE Advance lenses (Johnson & Johnson Vision Care, Jacksonville, FL) 12 to 14 hours daily developed a paracentral corneal ulcer in her left eye 4 months after beginning contact lens use. Cultures were positive for Pseudomonas aeruginosa. The ulcer responded to fortified antibiotics and resolved in 10 days. Best-corrected visual acuity after resolution of the ulcer was 20/25. A 58-year-old woman with a 30-year history of rigid gas-permeable contact lens wear was refitted with O2 Optix lenses (CIBA Vision, Duluth, GA). Six months later, she had a 4.9 x 4.0 mm epithelial defect with an underlying stromal infiltrate in the right eye. Cultures were positive for P. aeruginosa. The ulcer responded to fortified antibiotics and resolved in 30 days. Best-corrected visual acuity after resolution of the ulcer was 20/30.


CONCLUSIONS
Increased oxygen permeability associated with silicone hydrogel contact lenses may reduce, but does not eliminate, the risk of pseudomonas keratitis. Studies have yet to quantify the risk of keratitis associated with daily wear of these lens materials. Further study is necessary to identify the risks of complications with daily wear of silicone hydrogel lenses and to determine which factors may contribute to those risks.
Schornack
Muriel M
MM
Department of Ophthalmology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. schornack.muriel@mayo.edu
Faia
Lisa J
LJ
Griepentrog
Gregory J
GJ
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003519:Cyclopentolate / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012189:Retrospective Studies; D012826:Silicone Elastomers; D014031:Tobramycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D012826:Silicone Elastomers; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D003519:Cyclopentolate; D002437:Cefazolin; D014031:Tobramycin