Risk for microbial keratitis: Comparative metaanalysis of contact lens wearers and post-laser in situ keratomileusis patients.
To compare the risk for microbial keratitis in contact lens wearers stratified by wear schedule with the risk after laser in situ keratomileusis (LASIK).



Hamilton Eye Institute and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.



Comparative metaanalysis and literature review.



An extensive literature search was performed in the PubMed database between December 2014 and July 2015. This was followed by a metaanalysis using a mixed-effects modeling approach.



After 1 year of daily soft contact lens wear, there were fewer microbial keratitis cases than after LASIK, or approximately 2 cases fewer cases per 10 000 (P = .0609). If LASIK were assumed to have essentially a 1-time risk for microbial keratitis, 5 years of extrapolation would yield 11 more cases per 10 000 with daily soft contact lens wear than with LASIK, or approximately 3 times as many cases (P < .0001). The extended use of soft contact lenses led to 12 more cases at 1 year than LASIK, or approximately 3 times as many cases (P < .0001), and 81 more cases at 5 years (P < .0001). When incorporating an estimated 10% retreatment rate for LASIK, these results changed very little.



Microbial keratitis is a relatively rare complication associated with contact lens use and LASIK postoperatively. The risk for microbial keratitis was similar between patients using contact lenses for 1 year compared with LASIK. Over time, the risk for microbial keratitis was higher for contact lens use than for LASIK, specifically with extended-wear lenses.
From the Department of Ophthalmology (Masters, Waite), Hamilton Eye Institute, and the Department of Preventive Medicine (Kocak), University of Tennessee Health Science Center, Memphis, Tennessee, USA. Electronic address: jordanmasters5@gmail.com.
Jordan
J
Masters
From the Department of Ophthalmology (Masters, Waite), Hamilton Eye Institute, and the Department of Preventive Medicine (Kocak), University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Mehmet
M
Kocak
From the Department of Ophthalmology (Masters, Waite), Hamilton Eye Institute, and the Department of Preventive Medicine (Kocak), University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Aaron
A
Waite
D003261:Contact Lenses / Q000009:adverse effects*; D003320:Corneal Ulcer / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D011183:Postoperative Complications; D012307:Risk Factors