How Many Ulcer Association with Contact Lens in Taiwan

1. 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

2. 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

3. 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

4. Out Patients of K Ulcer in Taiwan (2001~ 2005yrs)

5. Out Patients of K Ulcer in Taiwan

6. Admission Patients of Cornea Ulcer in Taiwan

7. Admission Patients of K Ulcer in Taiwan

8. Visiting Times of OPD for Cornea Ulcer

9. Visiting Times of Admission for Cornea Ulcer

10. Visiting Times of OPD &Admission for K Ulcer

12. OPD&Admission Patients More Care in Clinic

13. OPD&Admission Patients with Cornea Ulcer

14. OPD&Admission Patients with Cornea Ulcer

15. Compare OPD+Adm.P’t with Visiting No.

16. The Year Complex Growth Rate & Year Growth Rate of Cornea Ulcer Complication Year Complex Growth Rate Year Growth Rate

17. The Year Complex Growth Rate of Cornea Ulcer Complication

18. The Year Growth Rate of Cornea Ulcer Complication

19. Patients numbers & Visiting times for Cornea Ulcer in Taiwan (2001~ 2005years)

20. 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

21. What are the risk factors for high cornea ulcer complication rate ? Behavior ? Environment? Product ?

22. 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:________________

23. The questionnaire were done by patients • From Apr.2005 to Dec.2006. • 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 )

24. 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)

25. Discussion • MoistureLoe dysinfection solution induce Fungus infection due to without rubbing. • Without rubbing is a key point

26. 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

27. Thank you very much William Wing-Fung Cheng