Clinical comparative analysis of bacterial keratitis according to contact lens use: a retrospective study in a tertiary referral center of South Korea.

Publisher: Kluwer Country of Publication: Netherlands NLM ID: 7904294 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2630 (Electronic) Linking ISSN: 01655701 NLM ISO Abbreviation: Int Ophthalmol Subsets: MEDLINE

Publication: Dordrecht : Kluwer
Original Publication: The Hague, Junk.

Keratitis*/diagnosis ; Keratitis*/epidemiology ; Keratitis*/drug therapy ; Eye Infections, Bacterial*/microbiology ; Contact Lenses*/adverse effects ; Contact Lenses*/microbiology ; Corneal Ulcer*/epidemiology; Humans ; Female ; Middle Aged ; Retrospective Studies ; Tertiary Care Centers ; Risk Factors ; Republic of Korea/epidemiology ; Anti-Bacterial Agents/therapeutic use

Purpose: To compare the clinical aspects and treatment outcomes of contact lens-related bacterial keratitis (CLBK) and non-CLBK patients.
Methods: Altogether 217 patients of bacterial keratitis (CLBK; 62, non-CLBK; 155) hospitalized between January 2012 and December 2020 were retrospectively analyzed for epidemiology, microbiological profiles, predisposing factors, clinical characteristics, and treatment outcomes. Poor treatment outcomes (PTO) were defined as a final BCVA < 0.3 (Snellen), a decreased visual acuity after treatment, complications, or surgical intervention. Relative importance of the initial clinical features leading to PTO was assessed using the random forest model and two-proportion Z-test.
Results: The most common predisposing factors were sleeping with wearing CL (51.6%) in the CLBK group and trauma (55.5%) in the non-CLBK group. There were significant differences between the two groups in mean age (35.1:55.1 years, p < 0.001), female sex (56.5:34.8%, p = 0.003), symptom duration (6.2:6.9 days, p = 0.019), gram-negative organisms (83.3:48.3%, p = 0.008), epithelial healing time (8.5:14.1 days, p = 0.004), final BCVA (0.15:0.46 logMAR, p = 0.015), and PTO (9.7:21.9%, p = 0.035). For the entire group, the initial BCVA < 0.1 (27.9%), symptom duration ≥ 5 days (19.4%), age ≥ 60 years (16.4%), and hypopyon (14.0%) were important initial clinical features leading to PTO in the random forest model. In CLBK group, the type of CL or CL-related history was not significantly related to PTO.
Conclusion: CLBK patients had a higher proportion of females, younger age, gram-negative bacteria, and better treatment outcomes than those of non-CLBK patients. There were no significant risk factors leading to PTO in either the type of CL or CL-related history.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

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Keywords: Bacterial keratitis; Contact lens; Corneal ulcer; Random forest model

0 (Anti-Bacterial Agents)

Date Created: 20230726 Date Completed: 20230918 Latest Revision: 20230922

20250114

10.1007/s10792-023-02756-5

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