Characteristics of Infectious Keratitis in Bandage Contact Lens Wear Patients

OBJECTIVE: The aim of this study was to determine the characteristics of infectious keratitis in patients wearing bandage contact lenses (BCLs). METHODS: The BCL-related infectious keratitis cases were reviewed at the eye center of the Second Affiliated Hospital at the Zhejiang University School of Medicine from January 2015 to August 2018. Detailed information about the patients with infectious keratitis was collected, including the age, gender, clinical characteristics, culture results, and other measures. All the data analyses were performed using IBM SPSS Statistics for Windows version 24.0. RESULTS: From January 2015 until August 2018, 6,385 eyes of 6,188 patients, including 3,410 males and 2,778 females, received BCLs at our hospital. The mean age of these patients was 48.10±20.81 years (range=15-78 years). The mean BCL wearing time was 18.98±23.72 days (range=1-58 days). Eight patients (0.13%) with infectious keratitis were identified, and the mean age of these patients was 54.33±28.14 years (range=16-75 years). Seven of the infectious keratitis patients were older than 50 years, and one patient was 16 years old. The infectious keratitis incidence rate of the older patients (≥50 years) was significantly higher than that of the young patients (<50 years) (χ=9.647, P=0.002). There was a higher postkeratoplasty risk of BCL-related infectious keratitis than that in the corneal epithelial defect (χ=21.371, P=0.000) and pterygium surgery (χ=16.037, P=0.000) cases, but not in the corneal collagen cross-linking cases (χ=1.792, P=0.181). The mean onset time of BCL-related infectious keratitis was 22.63±18.72 days (range=3-58 days) after wearing the BCLs. Among these 8 infected patients, 3 were noncompliant with their eye drop use and 2 extended their BCL wearing time past 30 days. CONCLUSION: Bandage CL-related infectious keratitis is more likely to occur in older patients. The most common risk factor for BCL-related infectious keratitis was postkeratoplasty use. Overall, appropriate indications, good compliance, and close follow-up attention are required for BCL wearers.