Both contact lens use and LASIK laser eye surgery can be associated with infection. A new study suggests the rate of infection with contact lens use actually is going up, despite improvements in contact lens technology and materials.
Laser vision correction, both LASIK and PRK laser eye surgery, are alternatives to both glasses and contact lens use. While of course the surgical options of LASIK and PRK are not without infection risk, it is interesting to note that the rate of contact lens infection seems to actually be increasing each year — at least according to a new study published in Cornea, the Journal of Cornea and External Disease.
Probably the most dreaded complication of contact lens use is infection. Infection can lead to the need for corneal transplantation and even to blindness in rare cases. While infections remain relatively rare with properly worn soft contact lenses, a new study at one of the country’s premiere eye hospitals suggests that the occurrence of contact lens infection is increasing year after year — and has been doing so for quite some time.
In this study, the medical records of all patients diagnosed at the Wills Eye Institute in Philadelphia with bacterial infections of the corneas (“bacterial corneal ulcers”) between January 1, 2004 and December 31, 2007 were reviewed. Results showed that there was a significant increase in contact lens related ulcers over the period from 2004 to 2007. The most common type of contact associated with infections were daily wear soft frequent replacement lenses. 58.7% of the cases were in men. Of total cases, 54.3% involved overnight contact lens wear with the vast majority of contact lenses approved for overnight use! The most common type of bacteria was the dreaded Psuedomonas aeruginosa organism, which tends to create rapidly growing and devastating corneal infections. While it is common in contact lens infections, it is quite rare in LASIK or PRK infections, which tend to have more slow growing organisms.
This increase in the rate of contact lens infections from 2004 to 2007 at the Wills Eye Institute is significant. The Wills Eye Institute is one of the most prestigious eye care facilities in the United States and has cases referred to it from across the Northeastern US and beyond. Interestingly, this increase in the rate of contact lens infections continues a longer term trend in this regard noted first in a 1996-1999 study and then again in a 1999-2002 study, both conducted at the Wills Eye Institute.
While LASIK and PRK also can be associated with infection from the laser eye surgery itself, the rates of infection appear to be lower and the types of infection tend to be less aggressive than seen with contact lens use. Both laser vision correction surgery and contact lens wear, however, obviously carry a degree of infection risk. It is surprising to many to see the rate of contact lens infections going up instead of down given the improvement in contact lens materials and technology over the past several years, including materials that are much more oxygen permeable such as silicone hydrogel lenses (e.g. Acuvue Oasys or PureVision contact lenses) as well as the long term trend toward daily wear disposable contact lenses and frequent replacement contact lenses.
See Also
Trends in Contact Lens -Related Corneal Ulcers at a Tertiary Referral Center
Study of long term contact lens infection trends at the Will Eye Hospital in Philadelphia
Study finds increase in number of contact lens-related corneal ulcers
A review of the Wills Eye Hospital Study of long term contact lens infection rates
Acuvue Oasis Contact Lenses
Acuvue Oasis are a high oxygen permeability contact lens design
Silicone hydrogel contact lens guide
All About Vision discussion of various silicone hydrogel contact lenses
Risk of Eye Infection Not Diminished by New Types of Contact Lenses
Study shows the development of disposable contact lenses and silicone hydrogel contact lenses have not lowered the rate of contact lens related corneal infections
Proper Care of Contact Lenses
Proper Care of Contact Lenses (American Academy of Ophthalmology)
Contact Lens Risks (FDA)
FDA website about risks of contact lens use
The Wills Eye Institute
Website for the Wills Eye Institute where the contact lens study was conducted
Disposable Contacts: A Healthy Choice
All About Vision discussion of disposable and frequent replacement contact lenses
Complications and Symptoms with Disposable Daily Wear Contact Lenses and Conventional Soft Daily Wear Contact Lenses
Disposable Daily Wear Soft Contact Lenses are Compared to Conventional Soft Contact Lenses
The Risk of LASIK and PRK Infection Compared to Contact Lenses
LASIK and PRK infection rates appear to be lower than that seen with contact lens use (Shapiro)