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[使用软性隐形眼镜后发生棘阿米巴角膜炎——病例报告]

[Acanthamoeba keratitis after use of soft contact lenses--case report].

作者信息

Ziak P, Ondriska F, Mrva M

机构信息

Ocná klinika JLF UK a MFN, Martin.

出版信息

Cesk Slov Oftalmol. 2003 Sep;59(5):352-8.

Abstract

The case history of a 39-year patient suffering from a deep inflammation of cornea and not responding to conventional antibiotic treatment is presented. The patient was using soft contact lenses during the period of initial symptoms; moreover, he was bathing in thermal bathing pool. A cultivation examination of smears from the area of corneal defect revealed the presence of Acanthamoeba lugdunensis in combination with bacterial infection by Pseudomonas aeruginosa. The available data indicate that it is the first case of acanthamoeba karatitis (AK) after the application of contact lenses in Slovakia. A long-term local treatment with propamidin isethionate (Brolene gtt, ung.) resulted in healing up. The subsequent vision after 16 months since the initial symptoms proved to be 6/12 (0.5). The healing of the centrally localized defect changed the curvature of cornea with consequent hypermetropic shift. The defect completely corrected the patient's myopia (-8.5). The paper describes present possibilities of AK therapy.

摘要

本文介绍了一名39岁患者的病例史,该患者患有角膜深层炎症,对传统抗生素治疗无反应。患者在出现初始症状期间一直佩戴软性隐形眼镜;此外,他还在热水浴池洗澡。对角膜缺损部位的涂片进行培养检查发现,存在罗旦氏棘阿米巴,并伴有铜绿假单胞菌的细菌感染。现有数据表明,这是斯洛伐克首例因佩戴隐形眼镜后发生棘阿米巴角膜炎(AK)的病例。长期局部使用依西酸丙脒腙(Brolene滴眼液、软膏)治疗后病情痊愈。自出现初始症状16个月后的后续视力为6/12(0.5)。中央局限性缺损的愈合改变了角膜曲率,导致远视性移位。该缺损完全矫正了患者的近视(-8.5)。本文描述了目前AK治疗的可能性。

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