Infectious keratitis and cosmetic lenses: A five-case retrospective study

Purpose. - To determine the characteristics of infectious keratitis related to piano cosmetic lenses. Methods. - Retrospective case study of a series of infectious keratitis among piano cosmetic lenses wearers. The main parameters were demographic data, medical history, risk factors for infectious complications and keratitis severity criteria, microbiological results, clinical course, and final visual acuity. Results. - Five patients were included, all females, ranging from 15 to 50 years of age. Four were emmetropic. One patient had undergone refractive photokeratectomy a few months before. All had risk factors for infectious complications. The fundamental causes of infections were diverse: bacterial abscesses, keratomycosis, and amoebic keratitis. All presented severity criteria. In two cases, the keratitis led to severe consequences with legal blindness requiring penetrating keratoplasty in one case. Discussion. - Infectious keratitis in piano cosmetic lenses wearers is not rare and may have dramatic consequences. Sales are specifically regulated and the lenses are considered cosmetic products, not medical devices. The sales regulations for piano cosmetic lenses should be updated, as several countries have already done after encountering many serious incidents. (C) 2010 Elsevier Masson SAS. All rights reserved.