Infectious Keratitis, Microbiological Review Over 5 Years
Published 2025 - 43rd Congress of the ESCRS
Reference: FP23.01 | Type: Free paper | DOI: 10.82333/wk5x-re37
Authors: Lucia Ibares Frias* 1 , Itziar Fernandez 2 , Alberto López-Miguel 3 , Margarita Calonge 2 , Amalia Enríquez de Salamanca 4
1Ophthalmology,Hospital General Universitario Gregorio Marañón,Madrid,Spain;Ophthalmology,Instituto Oftalmológico Fernández Vega,Madrid,Spain, 2Ophthalmology,IOBA,Valladolid,Spain;Ophthalmology,CIBER-BBN,Valladolid,Spain, 3Ophthalmology,IOBA,Valladolid,Spain, 4Ophthalmology,IOBA,Valladolid,Spain;Ophthalmology,IOBA,Valladolid,Spain
Purpose
This study aims to determine the incidence, prevalence, and frequency of long-term complications of infectious keratitis in contact lens wearers. Both therapeutic and refractive contact lens wearers are included in this study.
A comparative analysis will be conducted based on the different subtypes of contact lenses, as well as their intended purpose. Additionally, we will assess the incidence and in-hospital prevalence of the various microorganisms responsible for infectious keratitis.
Setting
A total of 259 infectious keratitis samples were recorded in the Microbiology Laboratory of Gregorio Marañón University Hospital between 2019 and 2023. Among these, 94 samples were from patients wearing either therapeutic or refractive contact lenses, including different subtypes within the latter group.
Methods
A statistical analysis of the incidence and prevalence of infectious keratitis was conducted, considering the cause of infection, the presence or absence of contact lenses, their use and subtype, the different causative microorganisms, the patient profile, the most common associated risk factors, and subsequent complications. These complications include the potential need for late-stage surgical intervention, such as corneal transplant, amniotic membrane graft, or temporary tarsorrhaphy.
Results
A positive result was obtained in 52% of the total samples and in 51% of the samples from eyes with infectious keratitis associated with contact lens use.
Microbiological analysis showed that 82% of cases were bacterial, with Gram-negative bacteria being the most prevalent group (65% of total bacteria), and Pseudomonas aeruginosa as the most frequently identified pathogen. Other infectious agents detected in smaller proportions included fungi (5%), Acanthamoeba (3.8%), and polymicrobial infections (9.2%).
Regarding complications, most patients achieved complete resolution without sequelae or with only mild sequelae. However, 14% of patients developed severe sequelae with significant visual acuity loss, and 5% required surgical intervention.
Conclusions
Infectious keratitis is a common and severe ophthalmologic emergency that all ophthalmologists should be prepared to manage.
It is also one of the most serious complications associated with contact lens use, a growing issue due to the increasing popularity of contact lenses and the lack of awareness regarding proper usage.
This study aims to determine whether specific habits or types of contact lenses contribute to a higher risk of developing infectious keratitis. Additionally, we seek to analyze the prevalence of various microorganisms involved, their associated complications, and their severity.