title: Age and other risk factors for corneal infiltrative and inflammatory events in young soft contact lens wearers from the Contact Lens Assessment in Youth (CLAY) study.
abstract: OBJECTIVE
  To describe age and other risk factors for corneal infiltrative and inflammatory events (CIEs) in young, soft contact lens (SCL) wearers and to model the age-related risk.
  
  
  METHODS
  A multicenter, retrospective chart review of 3549 SCL wearers (8-33 years at first observed visit, +8.00 to -12.00D, oversampling <18 years) captured CIEs from January 2006 to September 2009. The review noted age, sex, SCL worn, use of lens care products, and SCL wearing history. Event diagnoses were adjudicated to consensus by reviewers masked to wearer identity, age, and SCL parameters. Significant univariate risk factors for CIEs were subsequently tested in multivariate generalized estimating equations.
  
  
  RESULTS
  Charts from 14,305 visits observing 4,663 SCL years yielded 187 CIEs in 168 wearers. Age was a significant nonlinear risk factor, peaking between 15 and 25 years (P < 0.008). Less than 1 year of SCL use was protective versus longer years of wear (P < 0.0003). Use of multipurpose care products (2.86×), silicone hydrogels (1.85×), and extended wear (2.37×) were significantly associated with CIEs in the multivariate model (P < 0.0001 each).
  
  
  CONCLUSIONS
  Patient age, years of lens wear, use of multipurpose care products, silicone hydrogels, and extended wear were all significantly associated with CIEs with SCL wear. Use of SCLs in young patients aged 8 to 15 years was associated with a lower risk of infiltrative events compared with teens and young adults. In terms of safety outcomes, SCLs appear to be an acceptable method of delivering optics designed to manage myopia progression in children and young teens in the future.
authors.affiliation: Indiana University School of Optometry, Bloomington, Indiana, USA. chalmers2097@gmail.com
authors.forename: Robin L
authors.initials: RL
authors.lastname: Chalmers
authors.forename: Heidi
authors.initials: H
authors.lastname: Wagner
authors.forename: G Lynn
authors.initials: GL
authors.lastname: Mitchell
authors.forename: Dawn Y
authors.initials: DY
authors.lastname: Lam
authors.forename: Beth T
authors.initials: BT
authors.lastname: Kinoshita
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Jansen
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richdale
authors.forename: Luigina
authors.initials: L
authors.lastname: Sorbara
authors.forename: Timothy T
authors.initials: TT
authors.lastname: McMahon
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D015331:Cohort Studies; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects / Q000706:statistics & numerical data; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects* / Q000706:statistics & numerical data*; D003320:Corneal Ulcer / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007634:Keratitis / Q000453:epidemiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult