title: Risk Factors for Contact Lens-Related Microbial Keratitis: A Case-Control Multicenter Study.
abstract: OBJECTIVE
  The most feared complication of contact lens (CL) wear is microbial keratitis (MK), even though its incidence remains low. This study aimed to identify the risk factors of CL-related MK in a large, prospective, multicenter case-control study.
  
  
  METHODS
  A multicenter case-control study was designed. The CL-related MK subpopulation (Case) was compared with healthy CL wearers (Control) using a 52-item anonymous questionnaire designed to determine subject demographics and lens wear history. Univariate and multivariate logistic regression analyses were performed to compare both groups.
  
  
  RESULTS
  The study enrolled 499 cases and 508 controls. The risk factors associated with the greatest increased odds of CL-related MK were as follows: using disinfecting solution more than 3 months (odds ratio [OR]=1.94), cosmetic CL wear and use of multipurpose disinfection solution (1.37 each), overnight wear, and soft lens use (OR=1.24 each). The protective factors associated with the greatest reduction in OR were fitting by an ophthalmologist (OR=0.73) and hyperopia versus myopia (OR=0.75).
  
  
  CONCLUSIONS
  The infectious determinants were linked to the type of lenses, hygiene routine, CL handling, disinfecting solution, and storage case. This study aimed to highlight the increasingly CL-related MK, which likely occurs because of lack of patient information regarding basic rules of hygiene and CL care and handling.
authors.affiliation: Service d'Ophtalmologie (A.S., T.B.), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France; and Service de Méthodologie et Biostatistiques (N.M.), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Sauer
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: Tristan
authors.initials: T
authors.lastname: Bourcier
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018639:Contact Lens Solutions; D003261:Contact Lenses / Q000009:adverse effects* / Q000145:classification; D003320:Corneal Ulcer / Q000453:epidemiology* / Q000382:microbiology; D004203:Disinfection / Q000379:methods; D004209:Disposable Equipment; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006920:Hygiene; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018639:Contact Lens Solutions