Baum J, Dabezies O H
Boston Eye Associates, Chestnut Hill, Massachusetts 02167-2115, USA.
Cornea. 2000 Nov;19(6):777-81. doi: 10.1097/00003226-200011000-00003.
To demonstrate the sterile nature of presumed sterile midperipheral corneal infiltrates associated with soft contact lens (SCL) use and to show that withholding antibiotics or the occasional use of a topical corticosteroid alone may, with strict guidelines, have a role in the treatment of this entity.
Nine consecutive patients presenting with typical midperipheral corneal infiltrates after SCL wear were seen in the office (O.H.D.) during a 2-year period, 1996-1998. All patients were initially placed on topical fluorometholone as the only treatment.
Eight of the nine patients experienced a rapid relief of symptoms and the infiltrates were noted to be smaller and less dense in 3-4 days. Therapy was discontinued after 7 days, by which time the lesions had cleared. The ninth patient developed a microbial keratitis from which Pseudomonas aeruginosa was cultured. With appropriate therapy, visual acuity returned to 20/25. Two different algorithms are offered for the treatment of a putative sterile infiltrate associated with SCL use.
The use of a topical corticosteroid alone may have a role in the treatment of presumed sterile midperipheral corneal infiltrates associated with SCLs when strict guidelines are followed. Such therapy suggests that the infiltrates are not the result of infection.
证明与软性角膜接触镜（SCL）使用相关的假定无菌性角膜中周部浸润的无菌性质，并表明在严格的指导原则下，停用抗生素或偶尔单独使用局部皮质类固醇可能在该病症的治疗中发挥作用。
在1996年至1998年的两年期间，在办公室（O.H.D.）对9例佩戴SCL后出现典型角膜中周部浸润的连续患者进行了观察。所有患者最初仅接受局部氟米龙治疗。
9例患者中有8例症状迅速缓解，3 - 4天后浸润变小且密度降低。7天后停止治疗，此时病变已消退。第9例患者发生了微生物性角膜炎，培养出铜绿假单胞菌。经过适当治疗，视力恢复到20/25。针对与SCL使用相关的假定无菌性浸润提供了两种不同的治疗方案。
当遵循严格的指导原则时，单独使用局部皮质类固醇可能在治疗与SCL相关的假定无菌性角膜中周部浸润中发挥作用。这种治疗表明浸润不是感染的结果。
