Clinical Analysis Of Contact Lens-Related Bacterial Keratitis According To Culture Positivity: A 25-Year Retrospective Study

The aim of this study was to investigate the microbial distribution of contact lens (CL)-related bacterial keratitis (CLBK) and to compare the clinical characteristics between culture positive (CP) and culture negative (CN) groups.

Retrospective, consecutive study. All of study case were taken by Department of Ophthalmology, Yeungnam University College of Medicine, South Korea.

We retrospectively analyzed 142 patients with CLBK (CP, 79 eyes 100 isolates; CN 63 eyes) who were hospitalized from January 1998 to December 2022. Microbiological profile was investigated in the CP group, and epidemiology, predisposing factors, clinical characteristics, and treatment outcomes were compared between CP and CN groups. Poor treatment outcome (PTO) was defined as final BCVA 0.5 or less or decreased BCVA after treatment, or surgical treatment was required. Risk factors for PTO were evaluated in total cohort using two-proportional Z-test analysis.

In the CP group, gram-negative bacteria accounted for 85%, and common isolates were Pseudomonas and Serratia species. Between the CP and CN groups, mean age (27.0 vs. 33.8 year, p=0.009) and history of therapeutic bandage CL wear (13.9 vs. 28.6%, p=0.037) were significantly different. There were no significant differences between the two groups in symptom duration, prior topical antibiotics use, sleeping with wearing CL, extended soft CL wear, epithelial defect size, hypopyon, and PTO. Significant risk factors for PTO were deep infiltration (Z=2.878), epithelial healing time ≥ 7 days (Z=2.295), initial BCVA < 0.1 (Z=2.200), and over date use of CL (Z=2.097).

In CLBK, the CP group was younger age than the CN group, had less wear of therapeutic bandage CL, and there was no significant difference in treatment outcomes.