How Many Ulcer Association with Contact Lens in Taiwan William Wing-Fung Cheng Taipei Medicine University Wan-Fang Hospital Center Wing-Fung Cheng Eye Clinic
Database from National Health Research Institutes National Health Insurance Research Institutes Database Institute of Health Policy and management,College of Public Health, National Taiwan University
Contact Lens About over 2 million users in Taiwan Including Soft contact lens,mainly. hard contact lens Orthok lens Presblyopia contact lens Toric contact lens
Out Patients of K Ulcer in Taiwan (2001~ 2005yrs)
Out Patients of K Ulcer in Taiwan
Admission Patients of Cornea Ulcer in Taiwan
Admission Patients of K Ulcer in Taiwan
Visiting Times of OPD for Cornea Ulcer
Visiting Times of Admission for Cornea Ulcer
Visiting Times of OPD &Admission for K Ulcer
OPD&Admission Patients More Care in Clinic
OPD&Admission Patients with Cornea Ulcer
Compare OPD+Adm.P’t with Visiting No.
The Year Complex Growth Rate & Year Growth Rate of Cornea Ulcer Complication Year Complex Growth Rate Year Growth Rate
The Year Complex Growth Rate of Cornea Ulcer Complication
The Year Growth Rate of Cornea Ulcer Complication
Patients numbers & Visiting times for Cornea Ulcer in Taiwan (2001~ 2005years)
Percentage of Cornea Ulcer Complication of Contact Lens in Taiwan, 2004 year. 1.96% for patients with cornea ulcer per year ( 39,199¯/2,000,000+ users, users no.estimated from C.L.company) Very high cornea ulcer complication rate 3.68% growth for OPD visiting with cornea ulcer diagnosis 1.88 times visiting OPD per one patient with ulcer
What are the risk factors for high cornea ulcer complication rate ? Behavior ? Environment? Product ?
We design a questionnaire 1. Name:_______________ 2. Birth day:_______________ 3. Contact Lens Styles: □ Daily disposable □ Weekly disposable □ Two week disposable □ Long term normal styles 4. Extended wear: Daily □ over one day □ over two days □ over one week Two week □ over two weeks □ over three week □ over one mouth Long term □ over night wearing 5. Dysinfection Method: Cleaning every day □ yes □ no Cleaning solution □ normal saline only □ using dysinfection solution Cleaning method with rubbing □ yes □ no 6. Wearing Period per Day: □ less than 8hrs □ 8~12hrs □ over 12hrs 7. Diagnosis:________________
The questionnaire were done by patients From Apr.2005 to Dec All patients visiting our OPD Diagnosis with contact lens wearing complication : K ulcer and Infiltrative Keratitis (IK) :47 patients Diagnosis with cornea ulcer due to contact lens wearing: 30/47 patients (64%) Diagnosis with IK due to contact lens wearing: 17/47 patients (36%) M/F:14/33 (1 : 2.4) Age: 14~52 years old ( below20:13, 20-30:23, 30-40:9, upper40:2 )
Result from questionnaires : Extended wear : 47% (22/47) mainly in disposable C L : 73% (16/22) mainly in 2-weeks disposable C L : 95% Cleaning without dysinfection solution : 49% (23/47) mainly in disposable C L : 70% (16/23) Cleaning without rubbing: 75% (35/47) mainly in long term C L : 57% (20/35)
Discussion MoistureLoe dysinfection solution induce Fungus infection due to without rubbing. Without rubbing is a key point
Conclusion: The high complication rate nearly 2% and the rapid 3 years complex growth rate 17.5% of cornea ulcer in contact lens users in Taiwan (2001~2004) due to wrong contact lens wearing behaviors : (1) Extended wear (2) Cleaning without dysinfection solution (3) Esp. Cleaning without rubbing
Thank you very much William Wing-Fung Cheng