Dantas P E, Nishiwaki-Dantas M C, Ojeda V H, Holzchuh N, Mimica L J
Department of Ophthalmology, Santa Casa, SP, Brazil.
CLAO J. 2000 Jan;26(1):26-9.
To evaluate the bacterial contamination of bandage disposable soft contact lenses used in patients following photorefractive keratectomy (PRK) and to correlate our findings with clinical data.
Forty-six patients (81 eyes) underwent PRK. Immediately after each procedure, disposable soft contact lenses were positioned with sterile forceps. After 3 days, the lenses were removed in a sterile manner, placed in sterile Eppendorf pipettes containing 8 mL of enriched brain heart infusion broth, and analyzed for microbial contamination.
Seven positive cultures were found: six gram positive cocci (7.4%) and one gram negative bacillus (1.2%). There was no clinical correlation with these findings.
Isolated microorganisms were similar to those described in the literature as agents of bacterial keratitis and are components of the normal ocular flora. Klebsiela pneumoniae--considered an occasional or transient flora--was the exception. All isolated microorganisms but K. pneumoniae were sensitive to most of the antibiotics tested. Our findings suggest that the risk of infectious keratitis after PRK related to soft contact lens wear for 3 days seems to be low, which may be because lenses were not manipulated by the patient during the wearing period, and the postoperative antibiotic regimen was strictly followed by patients. However, care should be taken to instruct patients in proper lens care practices to reduce the risk of bacterial keratitis in contact lens wear following PRK.
评估准分子激光角膜切削术(PRK)后患者使用的一次性软性角膜接触镜的细菌污染情况,并将我们的研究结果与临床数据相关联。
46例患者(81只眼)接受了PRK手术。每次手术后立即用无菌镊子放置一次性软性角膜接触镜。3天后,以无菌方式取出镜片,放入含有8 mL强化脑心浸液肉汤的无菌艾本德移液器中,并分析微生物污染情况。
发现7份阳性培养物:6份革兰氏阳性球菌(7.4%)和1份革兰氏阴性杆菌(1.2%)。这些结果与临床情况无相关性。
分离出的微生物与文献中描述的作为细菌性角膜炎病原体的微生物相似,并且是正常眼内菌群的组成部分。肺炎克雷伯菌——被认为是偶尔或短暂存在的菌群——是个例外。除肺炎克雷伯菌外,所有分离出的微生物对大多数测试抗生素敏感。我们的研究结果表明,PRK后佩戴软性角膜接触镜3天导致感染性角膜炎的风险似乎较低,这可能是因为患者在佩戴期间未对镜片进行操作,并且患者严格遵循了术后抗生素治疗方案。然而,应注意指导患者正确护理镜片,以降低PRK后佩戴角膜接触镜时发生细菌性角膜炎的风险。