, Volume 45, Issue 6, pp 727–735 | Cite as

Infectious keratitis and orthokeratology lens use: a systematic review

  • Ka Wai Kam
  • Wing Yung
  • Gabriel Ka Hin Li
  • Li Jia Chen
  • Alvin L. YoungEmail author



Myopia is a prevalent condition among Asians. Orthokeratology lens has gained popularity as a method of myopia control. This systematic review is to summarize the clinical profile of infectious keratitis in association with orthokeratology lens wear.


We searched in the PubMed and EMBASE for articles adopting the search strategy “(orthokeratology lens OR orthokeratology) AND (bacterial eye infection OR keratitis OR cornea ulcer OR microbial keratitis OR bacterial keratitis)”, from the start date of the databases to August 23, 2016. Articles reporting infectious keratitis in orthokeratology lens users with data of individual cases were considered eligible for this systematic review. We recorded the outcome measures including method of diagnosis, etiological agents, duration and mode of treatment and treatment outcomes.


Our literature search yielded 172 papers. After removing duplicated and irrelevant reports, we included 29 articles for data analysis, involving 173 eyes. Among all reported cases, the mean age at presentation was 15.4 ± 6.2 years, with a female preponderance (male-to-female ratio 1:1.7). Positive microbiological cultures were reported in 69.4% of cases, with Pseudomonas aeruginosa and Acanthamoeba being the most common etiological agents. The mean duration of hospitalization was 7.7 ± 6.7 days. Mean LogMAR visual acuity at presentation was 1.17 ± 0.78, increased to 0.33 ± 0.41 at final visit (p < 0.001).


Despite early intervention and treatment, the majority of infections resulted in the formation of corneal scars and almost 10% of eyes needed surgical treatment. Timely awareness and treatment of keratitis should be emphasized to the users.


Orthokeratology Myopia Contact lens Infectious keratitis Complications 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Ka Wai Kam
    • 1
    • 2
  • Wing Yung
    • 2
  • Gabriel Ka Hin Li
    • 1
    • 2
  • Li Jia Chen
    • 1
    • 2
  • Alvin L. Young
    • 1
    • 2
    Email author
  1. 1.Department of Ophthalmology and Visual SciencesPrince of Wales HospitalNew TerritoriesHong Kong
  2. 2.Department of Ophthalmology and Visual SciencesThe Chinese University of Hong KongNew TerritoriesHong Kong

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