A prospective study of contact lens complications in a managed care setting.
BACKGROUND: Understanding the rate of contact lensrelated complications and the factors that affect their occurrence can facilitate better prescribing decisions. METHODS: In a managed care setting, 1496 patient visits were evaluated using a common protocol by 11 optometrists to determine the prevalence of all contact lens-related complications. RESULTS: Over one-half (61%) of the visits were normal, with the remainder showing some type of complication. The more prevalent complications included superficial punctate staining (17.3%) and neovascularization (11.4%). Total complications were less prevalent with rigid gas permeable (RGP) and disposable lens types. Planned replacement soft lenses, used on a daily wear schedule, had the lowest prevalence of more serious complications when compared to conventional soft and disposable lenses. Patients on an extended wear schedule greater than 3 days were more likely to experience complications. The use of nonapproved care systems showed more complications, with serious complications reduced when a one-step care system was used. CONCLUSION: Choice of lens type, wearing schedule, and care system does affect the prevalence of complications, which underlines the importance of the recommendations of the prescriber.