how many ulcer association with contact lens in taiwan william wing-fung cheng taipei medicine...
TRANSCRIPT
How Many Ulcer Association with Contact Lens in Taiwan
William Wing-Fung ChengTaipei Medicine University
Wan-Fang Hospital Center
Wing-Fung Cheng Eye Clinic
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
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
Out Patients of K Ulcer in Taiwan (2001~ 2005yrs)
Patients in Year,2001 2002 2003 2004 2005Medical Center 5130 5208 4934 4857 4384Regional Hospital 2961 3163 2834 2887 2475Local Hospital 2095 2181 2281 2438 2289Clinic 21950 22548 25043 27752 28525Total 32136 33100 35092 37934 37673
Out Patients of Cornea Ulcer
Out Patients of K Ulcer in Taiwan
Cornea Ulcer Statistic from 2001 to 2005 year (OPD)
0
5000
10000
15000
20000
25000
30000
OPDP't No.
Medical Center
Regional Hospital
Local Hospital
Clinic
Admission Patients of Cornea Ulcer in Taiwan
Patients in Year,2001 2002 2003 2004 2005Medical center 961 977 905 1018 930Regional Hospital 252 360 215 216 199Local Hospital 26 39 47 31 30Total 1239 1376 1167 1265 1159
Admission Patients of Cornea Ulcer
Admission Patients of K Ulcer in Taiwan
Cornea Ulcer Statistic from 2001 to 2005 year(Admission)
0
200
400
600
800
1000
1200
Year,2001 2002 2003 2004 2005
AdmissionP't NO.
Medical center
Regional Hospital
Local Hospital
Visiting Times of OPD for Cornea Ulcer
Patients in 2001y % 2002 % 2003 % 2004 % 2005 %Medical center 17914 28.3 17920 28.2 17403 25.9 16981 23.5 14351 21.0Regional Hospital 6207 9.8 7190 11.3 7029 10.5 7569 10.5 6153 9.0Local Hospital 4835 7.6 4682 7.4 4982 7.4 5049 7.0 4950 7.2Clinic 34262 54.2 33725 53.1 37691 56.2 42580 59.0 43005 62.8Total 63218 63517 67105 72179 68459
Times of OPD for Cornea Ulcer
Visiting Times of Admission for Cornea Ulcer
2001y % 2002 % 2003 % 2004 % 2005 %Medical center 1084 78.7 1037 71.2 995 78.5 1136 81.4 1009 80.5Regional Hospital 267 19.4 378 26.0 225 17.8 228 16.3 208 16.6Local Hospital 26 1.9 41 2.8 47 3.7 32 2.3 36 2.9Total 1377 1456 1267 1396 1253
Times of Admission for Cornea Ulcer
Visiting Times of OPD &Admission for K Ulcer
Patients in 2001y % 2002 % 2003 % 2004 % 2005 %Medical center 18998 29 18957 29 18398 27 18117 25 15360 22Regional Hospital 6474 10 7568 12 7254 11 7797 11 6361 9.1Local Hospital 4861 7.5 4723 7.3 5029 7.4 5081 6.9 4986 7.2Clinic 34262 53 33725 52 37691 55 42580 58 43005 62Total 64595 64973 68372 73575 69712
Times of OPD & Admission for Cornea Ulcer
OPD & Admission Patients of Cornea Ulcerfrom 2001 year
29%
10%8%
53%
Medical center
Regional Hospital
Local Hospital
Clinic
OPD & Admission Patients of Cornea Ulcerfrom 2002 year
29%
12%7%
52%
Medical center
Regional Hospital
Local Hospital
Clinic
OPD & Admission Patients of Cornea Ulcerfrom 2003 year
27%
11%7%
55%
Medical center
Regional Hospital
Local Hospital
Clinic
OPD & Admission Patients of Cornea Ulcerfrom 2004 year
25%
11%
7%
57%
Medical center
Regional Hospital
Local Hospital
Clinic
OPD&Admission Patients More Care in Clinic
OPD & Admission Patients of Cornea Ulcerfrom 2005 year
22%
9%
7%62%
Medical center
Regional Hospital
Local Hospital
Clinic
OPD&Admission Patients with Cornea Ulcer
OPD+Admission Patients
30000
31000
32000
33000
34000
35000
36000
37000
38000
39000
40000
2001 y 2002 2003 2004 2005
Year
No OPD+Adm.(P't)
OPD&Admission Patients with Cornea Ulcer
OPD+Admission Visiting Times
60000
62000
64000
66000
68000
70000
72000
74000
76000
2001 2002 2003 2004 2005
Year
visitingtimes
OPD+Admission
Compare OPD+Adm.P’t with Visiting No.
OPD+Admission patient and visiting No.
30000
35000
40000
45000
50000
55000
60000
65000
70000
75000
80000
2001 y 2002 2003 2004 2005
Year
No OPD+Adm.(P't)
OPD+Adm.(No)
The Year Complex Growth Rate & Year Growth Rate of Cornea Ulcer Complication
2001y 2002 2003 2004 2005OPD+Adm.(P't) 0 3.30% 5.17% 8.11% -0.94%OPD+Adm.(No) 0 0.58% 5.23% 7.61% -5.25%
2001y 2002 2003 2004 2005OPD+Adm.(P't) 0 3.30% 8.64% 17.45% 16.35%OPD+Adm.(No) 0 0.58% 5.85% 13.90% 7.92%
Year Complex Growth Rate
Year Growth Rate
The Year Complex Growth Rate of Cornea Ulcer Complication
00.58%
5.85%
13.90%
7.92%
16.35%
8.64%
17.45%
3.30%
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
0.18
0.2
2001y 2002 2003 2004 2005
OPD+Adm.(P't)OPD+Adm.(No)
The Year Growth Rate of Cornea Ulcer Complication
-0.06
-0.04
-0.02
0
0.02
0.04
0.06
0.08
0.1
2001y 2002 2003 2004 2005
OPD+Adm.(P't)
OPD+Adm.(No)
Patients in Year,2001 2002 2003 2004 2005OPD+Adm.(P't) 33375 34476 36259 39199 38832OPD+Adm.(No) 64596 64973 68372 73575 69712
OPD & Admission Patients of Cornea Ulcer
Patients numbers & Visiting timesfor Cornea Ulcer in Taiwan (2001~ 2005years)
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 rate3.68% growth for OPD visiting with cornea ulcer diagnosis1.88 times visiting OPD per one patient with ulcer
What are the risk factors for high cornea ulcer complication rate ?
Behavior ?
Environment?
Product ?
We design a questionnaire1. 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:________________
The questionnaire were done by patientsFrom Apr.2005 to Dec.2006.All patients visiting our OPDDiagnosis with contact lens wearing complication : K ulcer and Infiltrative Keratitis (IK) :47 patientsDiagnosis 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 )
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)
Discussion
MoistureLoe dysinfection solution
induce Fungus infection due to without rubbing.
Without rubbing is a key point
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