Contact lens–related corneal ulcers in compliant patients

Najjar, Dany M.; Aktan, S.Gulderen; Rapuano, Christopher J.; Laibson, Peter R.; Cohen, Elisabeth J.

doi:10.1016/s0002-9394(03)00722-0

Cited by 21 publications

(9 citation statements)

References 2 publications

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“…While we have noted an increase in the incidence of Fusarium keratitis, the incidence of bacterial keratitis has not noticeably decreased with increased MPS use, even among apparently compliant wearers [81]. This suggests that 'convenience labeling' is not achieving its intended goals.…”

Section: Discussionmentioning

confidence: 59%

Fusariumkeratitis and contact lens wear: facts and speculations

et al. 2008

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Over the past several decades mycotic keratitis has been considered a rare sequel to hydrogel contact lens wear. In 2005--2006 an upswing in the incidence of Fusarium keratitis was associated with a disproportionate use of one multipurpose contact lens solution (MPS, ReNu with MoistureLoc, Bausch & Lomb, Rochester, NY). The MPS, as manufactured and marketed, was sterile and met regulatory guidelines for antimicrobial activity. A multivariant interaction of poor hygienic practices and the contact lens paraphernalia were associated with a mostly selective contamination in or on the lens storage case by members of the F. solani/F. oxysporum species complexes from the environment of the user. A decline of the anti-fusaria properties of the MPS in the lens case appeared related to its dissociation from drying, or dilution and the potential for sorption of antimicrobial solution components (e.g., alexidine) to various hydrogel lenses. These factors and capacities of the fusaria for rapid amplification by microcycle conidiation, production of dormant resistant cells, and potential for attachment and penetration of hydrogel lenses, were linked to the occasional selective fungal survival and growth during storage of the lens in MPS. Lack of a manual rubbing-cleaning step in the MPS disinfection process was considered a risk factor for keratitis.

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Section: Discussionmentioning

confidence: 59%

Fusariumkeratitis and contact lens wear: facts and speculations

et al. 2008

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“…In the civilian population, up to 30% of patients who develop contact lens-related keratitis contract this condition despite strict adherence to standard contact lens care hygiene 17. In a hot, dusty environment and with limited access to sanitary facilities, the risk of bacterial keratitis in deployed soldiers may be elevated.…”

Section: Discussionmentioning

confidence: 99%

Contact lens-related microbial keratitis in deployed British military personnel

Musa

Tailor²,

Gao³

et al. 2010

British Journal of Ophthalmology

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“…For many years, keratitis caused by Pseudomonas has been commonly associated with the wearing of soft contact lenses [2], and it has recently been reported that the wearing of contact lenses was the most common risk factor for keratitis and that the most commonly isolated organism was P. aeruginosa [3, 4]. Even in compliant patients [5], standard lens care hygiene precautions are probably not sufficient for preventing the development of sporadic corneal infections.…”

Section: Discussionmentioning

confidence: 99%

Severe Keratitis Caused byPseudomonas aeruginosaSuccessfully Treated with Ceftazidime Associated with Acetazolamide

Hue

Doat

Renard

et al. 2009

Journal of Ophthalmology

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Purpose. To report a case of microbial keratitis caused by Pseudomonas aeruginosa treated with a combination of acetazolamide and ceftazidime. Methods. Case report. Results. We report the case of a 17-year-old contact lens-wearing female who developed severe keratitis due to Pseudomonas aeruginosa temporarily healed with topical fortified antibiotic eye drops. After few days, the patient relapsed, and topical and intravenous ceftazidime were added. Concomitantly, oral administration of acetazolamide was prescribed. This carbonic anhydrase inhibitor was added to the antibiotic regimen in order to decrease the anterior chamber pH, and then, the ceftazidime ionization. By lowering the state of ionization of the antibiotic in the aqueous humor, its concentration was increased. This was confirmed by an improvement of the patient within few days and a rapid eradication of the infection. Conclusion. This is the first reported case of keratitis caused by P. aeruginosa successfully treated using acetazolamide as an enhancer of ceftazidime effectiveness.

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Contact lens–related corneal ulcers in compliant patients

Cited by 21 publications

References 2 publications

Fusariumkeratitis and contact lens wear: facts and speculations

Fusariumkeratitis and contact lens wear: facts and speculations

Contact lens-related microbial keratitis in deployed British military personnel

Severe Keratitis Caused byPseudomonas aeruginosaSuccessfully Treated with Ceftazidime Associated with Acetazolamide

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