Microbial keratitis as a foreseeable complication of cosmetic contact lenses: a prospective study

Acta Ophthalmol. 2011 Aug;89(5):e439-42. doi: 10.1111/j.1755-3768.2011.02120.x. Epub 2011 Mar 15.


Purpose: A recent study shows that the relative risk of contact lenses (CL)-related microbial keratitis (MK) is highly increased with cosmetic contact lenses (CosCL). The aim of our study is to illustrate the implications of the CosCL on the occurence of MK and to describe the subpopulation of CosCL wearers.

Methods: A prospective multicenter study was conducted in 12 French University Hospitals on all lenses wearers presenting with MK between July 2007 and July 2009, including CosCL wearers. Patients had a complete ophthalmological examination and were interviewed by a 50 items anonymous 'questionnaire' to determine subject demographics and lenses wear history. The CosCL-related MK subpopulation (case) was described and finally compared to (noncosmetic) CL-related MK (control).

Results: Two hundred and fifty-six patients were included for contact lenses-related MK. Thirty-two of them (12.5%) were seen for MK after wearing CosCL. Compared with CL, CosCL wearers are younger (21 versus 27 years of age) and recent wearers (3 versus 9 years). CosCL were rarely dispensed by eye care professionals increasing the risk of MK (OR, 12.3). Education about lens care and handling was deficient for most of CosCL wearers (OR, 26.5). Sixty per cent of CosCL cases versus 13% of CL-related MK had a final visual acuity less than 20/200.

Conclusion: Patients who acquire CosCL are less likely to be instructed on appropriate lenses use and basic hygiene rules. Consequently, CosCL wearers are experiencing acute vision-threatening infections.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Amebiasis / epidemiology
  • Amebiasis / prevention & control
  • Case-Control Studies
  • Contact Lens Solutions / therapeutic use
  • Contact Lenses / adverse effects*
  • Contact Lenses / statistics & numerical data*
  • Cosmetic Techniques / adverse effects*
  • Cosmetic Techniques / statistics & numerical data*
  • Eye Infections, Bacterial / epidemiology
  • Eye Infections, Bacterial / prevention & control
  • France / epidemiology
  • Humans
  • Hygiene
  • Keratitis / epidemiology*
  • Keratitis / prevention & control
  • Patient Education as Topic / statistics & numerical data
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Young Adult


  • Contact Lens Solutions