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Risk Factors for Contact Lens–RelatedFusarium Keratitis—Reply

Seang-Mei Saw, PhD, MPH; Peng-Lim Ooi, MBBS, MPH, MSc; Donald T. H. Tan, FRCS(Glasg); Wei-Boon Khor, MBBS; Chee-Weng Fong, MSc, MSocSc; Jayne Lim, BSc(Hons); Howard Y. Cajucom-Uy, MD; Derrick Heng, MBBS, MRCP, MPhil; Suok-Kai Chew, MBBS, MSc, DLSHTM; Tin Aung, PhD, FRCS(Edin); Ai-Ling Tan, FCRPA; Cheng-Leng Chan, BSc(Pharm)(Hons); Steven Ting, MSc(Stats); Paul A. Tambyah, MBBS; Tien-Yin Wong, PhD, FRCS(Edin)
Arch Ophthalmol. 2007;125(12):1716. doi:10.1001/archopht.125.12.1716-a.
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In reply

Our study showed significant increased risks (odds ratio, 21.5; 95% confidence interval, 4.0-115.5; P < .001) of contact lens–related Fusarium keratitis with the use of ReNu MultiPlus. We have not, however, inferred a causal relationship. The criteria for a cause and effect relationship include biological plausibility, a strong association, temporality of the association, a dose-response trend, lowering of risks with the removal of exposure, and consistency of findings across different studies.1 Our findings were not consistently replicated in Hong Kong or the United States.24


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