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Risk Factors for Contact Lens–Related Microbial Keratitis: A Case–Control Multicenter Study

Sauer, Arnaud M.D., Ph.D.; Meyer, Nicolas M.D., Ph.D.; Bourcier, Tristan M.D., Ph.D.for the French Study Group for Contact Lens–Related Microbial Keratitis

Eye & Contact Lens: Science & Clinical Practice: May 2016 - Volume 42 - Issue 3 - p 158–162
doi: 10.1097/ICL.0000000000000180

Purpose: The most feared complication of contact lens (CL) wear is microbial keratitis (MK), even though its incidence remains low. This study aimed to identify the risk factors of CL-related MK in a large, prospective, multicenter case–control study.

Methods: A multicenter case–control study was designed. The CL-related MK subpopulation (Case) was compared with healthy CL wearers (Control) using a 52-item anonymous questionnaire designed to determine subject demographics and lens wear history. Univariate and multivariate logistic regression analyses were performed to compare both groups.

Results: The study enrolled 499 cases and 508 controls. The risk factors associated with the greatest increased odds of CL-related MK were as follows: using disinfecting solution more than 3 months (odds ratio [OR]=1.94), cosmetic CL wear and use of multipurpose disinfection solution (1.37 each), overnight wear, and soft lens use (OR=1.24 each). The protective factors associated with the greatest reduction in OR were fitting by an ophthalmologist (OR=0.73) and hyperopia versus myopia (OR=0.75).

Conclusions: The infectious determinants were linked to the type of lenses, hygiene routine, CL handling, disinfecting solution, and storage case. This study aimed to highlight the increasingly CL-related MK, which likely occurs because of lack of patient information regarding basic rules of hygiene and CL care and handling.

Service d'Ophtalmologie (A.S., T.B.), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France; and Service de Méthodologie et Biostatistiques (N.M.), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Address correspondence to Arnaud Sauer, M.D., Ph.D., Service d'Ophtalmologie, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, BP 426, 67091 Strasbourg, France; e-mail:

The authors have no funding or conflicts of interest to disclose.

The French Study Group for Contact Lens–Related Microbial Keratitis: Florence Abry (Epinal Regional Hospital), Karine Angioi, Jean-Paul Berrod, Jean-Luc Georges (Nancy University Hospital), Florent Aptel, Christophe Chiquet, Evelyne Leblond (Grenoble University Hospital), Stéphanie Baillif, Pierre Gastaud (Nice University Hospital), Laurent Ballonzoli, Martine Cros-Boidevezi, David Gaucher, Jonathan Letsch, Roland Pagot, Claude Speeg-Schatz (Strasbourg University Hospital), Vincent Borderie, Laurent Laroche (Centre Hospitalier National d'Ophtalmologie, Paris), Alain Bron, Catherine Creuzot-Garcher (Dijon University Hospital), Carole Burillon, Laurent Kodjikian (Lyon University Hospital), Guilhem Cartry (Perpignan Regional Hospital), Beatrice Cochener (Brest University Hospital), Joseph Colin, Florence Malet (Bordeaux University Hospital), Vincent Daien, Max Villain (Montpellier University Hospital), Bernard Delbosc Maher Saleh (Besançon University Hospital), Angélique Donnio, Harold Merle (Fort-de-France University Hospital), Pierre Fournie François Malecaze, Marie Malecaze-Delfour (Toulouse University Hospital), Gilles Thuret, Philippe Gain (Saint-Etienne University Hospital), Julie Gueudry, Marc Muraine (Rouen University Hospital), Louis Hoffart (Marseille University Hospital), Marc Labetoulle (Kremlin-Bicêtre, Paris), Frédéric Mouriaux (Caen University Hospital), Pierre-Yves Robert (Limoges University Hospital), and Bertrand Vabres (Nantes University Hospital).

Accepted June 23, 2015

© 2016 Contact Lens Association of Ophthalmologists, Inc.