Kim E K, Lee D H, Lee K, Lim S J, Yoon I S, Lee Y G
Institute of Vision Research and Department of Ophthalmology, Brain Korea 21, Yonsei University College of Medicine, Seoul.
J Refract Surg. 2000 Jul-Aug;16(4):467-9. doi: 10.3928/1081-597X-20000701-11.
Nocardia are gram-positive bacteria existing ubiquitously in the environment; they can cause keratitis. Nocardia asteroides keratitis occurred in the interface between the stromal bed and flap after traumatic detachment of the flap 4 months after an initially uncomplicated laser in situ keratomileusis (LASIK) procedure.
Nocardia asteroides keratitis was confirmed by culture. Therapy included topical and oral trimethoprim-sulfamethoxazole.
Thirteen months after the trauma, the patient's spectacle-corrected visual acuity was 20/20 with a manifest refraction of -2.25 -1.00 x 30 degrees.
The immediate steps of management consisting of surgically lifting the corneal flap, rapid microbial identification, and proper treatment with specific antibiotics resulted in the successful treatment of Nocardia asteroides keratitis in a traumatized eye after LASIK.
诺卡菌是环境中普遍存在的革兰氏阳性菌，可引起角膜炎。在最初无并发症的准分子原位角膜磨镶术（LASIK）术后4个月，瓣片外伤性脱离后，星型诺卡菌角膜炎发生于基质床与瓣片之间的界面。
通过培养确诊为星型诺卡菌角膜炎。治疗包括局部和口服甲氧苄啶 - 磺胺甲恶唑。
外伤后13个月，患者经眼镜矫正的视力为20/20，明显屈光不正为 -2.25 -1.00×30度。
包括手术掀起角膜瓣、快速微生物鉴定以及用特定抗生素进行适当治疗在内的立即处理步骤，成功治疗了LASIK术后受外伤眼中的星型诺卡菌角膜炎。
