Ortho-K-Associated Infectious Keratitis: Not Uncommon, Not Insignificant

Christopher J. Rapuano, MD


March 03, 2015

Orthokeratology-Associated Infectious Keratitis in a Tertiary Care Eye Hospital in Hong Kong

Chan TC, Li EY, Wong VW, Jhanji V
Am J Ophthalmol. 2014;158:1130-1135

Study Summary

Chan and colleagues report a retrospective review of infectious keratitis owing to orthokeratology (ortho-K) lenses requiring inpatient treatment at a tertiary care hospital in Hong Kong from 2003 to 2013.

Twenty-three patients were identified with a mean age of 15 years (range, 9-23 years). Combining the results of corneal scrapings, contact lenses, and storage media cultures, there were eight cases of Pseudomonas, six cases of Acanthamoeba, and five cases of coagulase-negative Staphylococcus.

The average time from symptom onset to hospitalization was 2.9 days (range, 1-8 days) for Pseudomonas and 15.7 days (range, 2-31 days) for Acanthamoeba (P=.008). The mean disease duration was 13 days (range, 6-28 days) for Pseudomonas and 35 days (range, 19-62 days) for Acanthamoeba (P=.005). The mean duration of hospitalization was 15 days (range, 5-31 days).

All cases responded to medical therapy over a mean of 32 days (range, 6-131 days). Six culture-negative infections were considered to be caused by Acanthamoeba, making this pathogen responsible for 12 of the 23 ortho-K–related cases in the study (52%). Over the 11-year period of the study, ortho-K lenses were responsible for 19% (23/121) of all contact lens-related infections but 37.5% (12/32) of all contact lens-related Acanthamoeba infections admitted to the hospital.


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