A Survey of Contact Lens-Related Complications in Korea: The Korean Contact Lens Study Society

Jin Hyoung Kim; Jong Suk Song; Joon Young Hyon; Sung Kun Chung; Tae Jin Kim

doi:10.3341/jkos.2014.55.1.20

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Kim, Song, Hyon, Chung, and Kim: A Survey of Contact Lens-Related Complications in Korea: The Korean Contact Lens Study Society

Original Article

J Korean Ophthalmol Soc 2014;55(1):20-31.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.1.20

A Survey of Contact Lens-Related Complications in Korea: The Korean Contact Lens Study Society

Jin Hyoung Kim, MD, PhD^1,⁶, Jong Suk Song, MD, PhD^2,⁶, Joon Young Hyon, MD, PhD^3,⁶, Sung Kun Chung, MD, PhD^4,⁶, Tae Jin Kim, MD, PhD^5,⁶

¹Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea

²Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, Seoul, Korea

³Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, Korea

⁴Department of Ophthalmology and Visual Science, Yeouido St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

⁵Department of Ophthalmology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

⁶The Korean Contact Lens Study Society, Seoul, Korea

Address reprint requests to Tae Jin Kim, MD, PhD Department of Ophthalmology, Inje University Seoul Paik Hospital, #9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea, Tel: 82-2-2270-0082, Fax: 82-2-2266-6159, E-mail: lasiklove@hanmail.net

Received 4 March 201319 June 2013 Accepted 20 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the epidemiology of contact lens (CL)-related complications in Korea.

Methods

A questionnaire regarding CL-related complications including patient’s gender, age, causative factors, and signs and symptoms was distributed to members of the Korean Ophthalmological Society by The Korean Contact Lens Study Society and the results of the questionnaire analyzed.

Results

Responses to the questionnaire written by ophthalmologists from 22 institutes and clinics were collected from 499 subjects over a 20-month period starting in October 2008 and analyzed. The mean age of respondents was 22.9 years and the male-to-female ratio was 1:8.1. The soft CL and cosmetic colored lens comprised the majority (46.6% and 42.1%, re-spectively) of the reported cases, followed by the rigid gas permeable lens (RGP lens; 10.6%) and orthokeratology lens (0.8%). In subjects using a cosmetic colored lens, 62.2% showed emmetropia and 89.1% of the lenses were prescribed by opticians. The main complications included corneal erosion, sterile corneal infiltrate, allergic disease, conjunctival injection, corneal ulcer, and dry eye syndrome. The most common causative factor of complications was excessive lens wear. Comparing main causative factors according to the RGP lens prescriber, the most common factor was poor lens fit.

Conclusions

The number of cosmetic colored lens-related complications in the emmetropic eyes of young patients is increasing rapidly. Considering opticians are the main CL prescribers in CL-related complications, Korean ophthalmologists need to pay more attention to CL fitting and constant education of patients regarding proper CL wear and care.

Keywords: Contact lens care, Contact lens fit, Contact lens related complication, Contact lens wear, Cosmetic colored lens

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Figure 1.

The distribution of lens type in reported subjects. SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens; OK = orthokeratology lens.

Figure 2.

The distribution of contact lens purchase route in total subjects (left) and respective lens type (right). SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens; OK = orthokeratology lens.

Figure 3.

The proportion of emmetropic subjects in cosmetic colored lens group according to age group. Vertical axis indicates age group & horizontal axis indicates the percentage of non-emmetropia and emmetropia. 10~19 = age from 10 to 19; 20~29 = age from 20 to 29; 30~ = older than 30 years old. ^* The proportion of emmetropic subjects was statistically significantly high in age group from 10 to 19 by Pearson chi square test (p = 0.021).

Figure 4.

The distributions of causative factors according to lens types by multiple response analysis. SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens.

Figure 5.

Comparison of causative factors according to prescribers by multiple response analysis in RGP groups. ^* Statistically significant difference was shown between group prescribed by opticians and ophthalmologist (p = 0.004, Fisher’s exact test).

Table 1.

The contents of Contact Lens-related Complications Survey

Table 2.

Regional distribution of reported subjects

Region	Number of cases	%
Seoul	194	38.9
Gyeongsang province	147	29.5
Jeolla province	116	23.3
Gyeonggi province	26	5.2
Chungcheong province	9	1.8
Gangwon province	7	1.4
Total	499	100

Table 3.

Occupational distribution of reported subjects

Occupations	Numbers	%
Student (elementary, middle and high school)	139	27.9
College student	130	26.1
Office worker	100	20.0
Housewife	27	5.4
Service or retail business	19	3.8
Health care provider	14	2.8
Educator	12	2.4
Artist or athlete	9	1.8
Unemployed	9	1.8
Soldier	8	1.6
Unrecorded	32	6.4
Total	499	100.0

Table 4.

The comparison of patient’s age according to the lens type

	Mean	SD	Range
SCL	24.9	7.4	13-51
CCL^*	20.6	4.9	12-40
RGP	23.9	8.0	11-55
Total	22.9	6.8	11-55

SD = standard deviation; SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens.

^* CCL group was statistically significantly younger than SCL group or RGP group by p < 0.001, p-value was determined by Scheffe test after ANOVA test.

Table 5.

Distribution of subjects according to lens type and age group

Age	SCL (%)	CCL (%)	RGP (%)	Total (%)
10-19	45 (19.4)	99 (47.2)^*	17 (32.1)	161 (32.5)
	(28.0)	(61.5)	(10.6)	(100)
20-29	143 (61.6)	103 (49.0)	26 (49.0)	272 (54.9)
	(52.6)	(37.9)	(9.6)	(100)
≥30	44 (19.0)	8 (3.8)^†	10 (18.9)	62 (12.6)
	(71.0)	(12.9)	(16.1)	(100)
Total	232 (100)	210 (100)	53 (100)	495 (100)
	(46.9)	(42.4)	(10.7)	(100)

Number of patients (% of age group in same lens type), (% of lens type in same age group). Statistically significantly different distribution of age group according to lens types.

SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens.

^* p < 0.001

^† p < 0.001 by Pearson chi square test respectively.

Table 6.

Comparision of factors associated with lens wear and care among groups with different lens types

	Total subjects	SCL	CCL	RGP	p-value
Daily wear time (hours)	10.2 ± 3.0	9.8 ± 2.5	9.6 ± 3.0	10.4 ± 2.6	0.124
Daily wear time (hours)	(4-20)	(3-24)	(1-20)	(5-15)
Overnight wearing days (days/month)	8.4 ± 7.6	9.7 ± 7.8	5.3 ± 2.8	16 ± 13.9	0.002^*
Overnight wearing days (days/month)	(0-28)	(0-28)	(0-12)	(0-28)
Reused period after purchase (months)	4.6 ± 5.2	4.5 ± 5.1	3.9 ± 4.1	8.2 ± 8.2	<0.001^†
Reused period after purchase (months)	(1 day-60)	(1 day-60)	(1 day-36)	(1 day-40)

Values are presented as mean ± SD.

^* Statistically significant difference was shown by ANOVA test. There was significant difference in overnight wearing days between CCL-RGP group (p = 0.044 by Tukey test)

^† Reused period after purchase was significantly longer in RGP group. p < 0.001 between RGP-CCL group & RGP-SCL group by Scheffe test respectively.

Table 7.

The Distribution of complications in contact lens related patients

Complications	SCL	CCL	RGP	OK	Total	%
Corneal erosion	54	45	31	1	131	26.3
Sterile infiltration	39	53	4	0	96	19.2
Allergic disorder^* (Giant papillary conjunctivitis)	38	22	4	0	64	12.8
Allergic disorder^* (Giant papillary conjunctivitis)	(6)	(2)			(8)	(1.6)
Conjunctival injection	29	28	3	2	62	12.4
Infectious ulcer	25	19	3	0	47	9.4
Dry eye syndrome	22	16	7	1	46	9.2
Tight lens syndrome	12	21	0	0	33	6.6
Corneal neovascularization	4	5	0	0	9	1.8
Unclassified	6	1	1	0	8	1.6
Superior limbic keratitis	2	0	0	0	2	0.4
Conjunctival hemorrhage	1	0	0	0	1	0.2
Total	232	210	53	4	499	100

SCL = soft contact lens; CCL = cosmetic colored lens; RGP = rigid gas permeable lens; OK = orthokeratology lens.

^* The number of subjects diagnosed as allergic disorder includes that of giant papillary conjunctivitis.

Table 8.

Statistically significant factors related with complication type in each lens group

Lens type	Complication type	Factor	p-value^*	Odd ratio (95% CI)
SCL	Corneal ulcer	Age^†	0.04	1.076 (1.024-1.130)
	Sterile infiltration	Age^†	0.002	0.887 (0.822-0.957)
		Female	0.049	0.419 (0.176-0.997)
	Allergic disorder	Female	0.029	9.662 (1.254-74.434)
		Reused period after purchase^‡	0.030	0.848 (0.730-0.984)
	Tight lens syndrome	Daily wear time^§	0.012	1.338 (1.065-1.681)
CCL	Dry eye syndrome	Age^†	0.004	1.152 (1.047-1.268)
		Reused period after purchase^‡	0.035	1.102 (1.007-1.207)

SCL = soft contact lens; CCL = cosmetic colored lens; CI = confidential interval.

^* Statistically significant difference was shown by multiple logistic regression analysis

^† Age (years old)

^‡ Reused period after purchase (months)

^§ Daily wear time (hours).

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