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Surgeon advocates refractive surgery over contact lens wear to minimize infection risk
 Minas T. Coroneo |
WAILEA, Hawaii — In a presentation here on bacterial keratitis, one speaker advocated refractive surgery for contact lens wearers to minimize the higher risk of infection from contact lens wear.
Showing results from a study by Mathers et al, Minas T. Coroneo, MD, said at Hawaiian Eye 2009 that he would recommend refractive surgery for all chronic contact lens wearers.
There is one case of bacterial keratitis from daily contact lens wear in every 100 patients, with a loss of visual acuity greater than 20/70 in one out of 2,000 patients, Dr. Coroneo said. The refractive surgery infection rate is one in 800, with a vision loss greater than one line occurring once in 1,250 to 3,200 patients, and two lines in one out of 10,000.
"When you look at it, over a lifetime, it's safer to have refractive surgery than using contact lenses, since prevention is better than a cure," he said.
Dr. Coroneo’s presentation suggests that, from a public health perspective, contact lens wear carries a risk of serious adverse events about four times higher than LASIK. Therefore, he suggests that all contact lens wearers should at least consider LASIK as a safer alternative.
Naturally, other considerations such as refractive stability, corneal thickness and topography, etc., must rule out the non-candidates for laser correction, but the worldwide incidence of corneal ulcers and severe scarring would be significantly diminished if the majority of ametropes were treated with laser correction rather than contact lenses.
– John A. Hovanesian, MD, FACS
OSN Cornea/External Disease Board Member