Clinical features, risk factors and outcomes of contact lens-related bacterial keratitis in Nottingham, UK : a 7-year study
Suresh, Lakshmi Hammoudeh, Yasmeen Ho, Charlotte S Ong, Zun Zheng Cairns, Jessica Gopal, Bhavesh P Krstic, Lazar Elsahn, Ahmad Lister, Michelle M Said, Dalia G
Suresh, Lakshmi
Hammoudeh, Yasmeen
Ho, Charlotte S
Ong, Zun Zheng
Cairns, Jessica
Gopal, Bhavesh P
Krstic, Lazar
Elsahn, Ahmad
Lister, Michelle M
Said, Dalia G
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Affiliation
University of Nottingham; Western Eye Hospital; New Cross Eye Hospital; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2024-09-12
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Abstract
Background/objectives: To examine the clinical characteristics, risk factors and outcomes of contact lens-related bacterial keratitis (CLBK) in a large UK tertiary referral centre. Subjects/methods: A retrospective analysis of all patients who presented to the Queen's Medical Centre, Nottingham, UK, with suspected CLBK between October 2015 to September 2022 (a 7-year period) was performed. Relevant data on demographic factors, CL wear behaviour, causes, clinical characteristics, and outcomes were analysed. Results: We included 138 patients with CLBK; the mean age was 42.0 ± 17.8 years and 74 (53.6%) patients were male. Most CLBK were related to soft CL wear (94.5%), particularly monthly disposable (42.5%) and daily disposable (24.4%) CLs. Poor CL wear behaviour/hygiene was documented in 57.1% cases. Among the 64 (46.4%) microbiological-positive cases (n = 73 organisms), Pseudomonas aeruginosa (36, 49.3%) and Staphylococcus spp. (16, 21.9%) were most commonly identified. Six (4.3%) cases were polymicrobial. Most (97.0%) patients were successfully treated with topical antibiotics alone, with 80.6% achieving good final corrected-distance-visual-acuity (CDVA) of ≥ 0.30 logMAR. Poor visual outcome (final CDVA < 0.30 logMAR) was significantly associated with presenting CDVA < 0.6 logMAR (p = 0.002) and central ulcer (p = 0.004). Poor corneal healing (complete healing of > 30 days from initial presentation) was significantly associated with age > 50 years (p = 0.028), female gender (p = 0.020), and infiltrate size >3 mm (p = 0.031). Conclusions: Poor CL wear behaviour/hygiene is commonly observed in CLBK, highlighting the importance of improved counselling and awareness regarding CL use and hygiene. When presented early and managed appropriately, most patients are able to achieve good clinical outcomes with medical treatment alone.
Citation
Suresh L, Hammoudeh Y, Ho CS, Ong ZZ, Cairns J, Gopal BP, Krstic L, Elsahn A, Lister MM, Said DG, Dua HS, Ting DSJ. Clinical features, risk factors and outcomes of contact lens-related bacterial keratitis in Nottingham, UK: a 7-year study. Eye (Lond). 2024 Sep 12. doi: 10.1038/s41433-024-03323-7. Epub ahead of print.
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Article