Peculiar features of bacterial corneal ulcers caused by contact lenses

Abstract

Introduction: Myopia takes the 3-d place as a reason of adult disability in Russia (15,7%) and the 2-d among children. Contact lenses is one of the most popular way of its correction (95%). Though there are lots of advantages, this method of treatment has also a lot of disadvantages. Contact lens divides the precorneal tear film on epi- and sublens parts, making cornea more sensible for the inner and outer infection agents. It was also determined that persons, using contact lenses all the time, have three times more bacterials, among which there are those that are normally found only on the skin of eyelids.

Materials and methods: Studies were based on the ophthalmic branch of the Chelyabinsk Regional Clinic №3 in the period from 2015-2016. The study involved 101 people who were divided into two groups. The first group (46 people) contains bacterial corneal ulcer as a result of wearing contact lenses, the second (55 people) group has other reasons of ulceration. We compared such characteristics as: age, ulceration reason, ulcer location, the presence of descemetitis, hypopyon, the infiltration, time that treatment had taken. The average age of patients in the I-st group was 28 ± 2 years old, in the II-d group 47 ± 3 years. Treatment time averaged 6 ± 2 days in the first group and 9 ± 4 days in the second. Statistical analysis was performed using Statistica program 10.0 Testing Statistical Hypotheses performed at the critical significance level of p <0.05 using the Mann-Whitney test and Spearman correlation analysis.

Results: All things considering, bacterial corneal ulcers, caused not by contact lenses evolve much harder (descemetitis and hypopyon were diagnosed oftener). These ulcers are usually located in the optic zone of the eye. However, bacterial investigations of the cornea of the second group in more than half of the cases gives no results. While in the first group in 32.2% of cases seeded Klebsiella pneumoniae, a 21,4% Pseudomonas aeruginosa, as well as St. Aureus- 10.7%. Patients using one-day lenses, have a mistakes in carrying mode as the main cause of ulceration. The main reason among the people using contact lenses during the month, is a failure to observe good personal hygiene before handling lenses.

Conclusion: Patients with bacterial corneal ulcers, caused by other reasons – are people of the great age with other somatic pathologies. Contact lenses are the reason of ulceration among teenagers and young active people. The main infection agent in the first group is Klebsiella pneumonia. Nowadays 80% of its cultures have antibiotic resistance. The main reasons of ulceration in the 1-st group are mistakes in carrying mode and in personal hygiene. So we can conclude that the public education of the simple directions for use of contact lenses could significantly reduce the level of this disease.