Neumaier-Ammerer B, Stolba U, Binder S, Feichtinger H
Augenabteilung, Krankenanstalt Rudolfstiftung, Wien, Osterreich.
Ophthalmologe. 2004 Jan;101(1):33-8. doi: 10.1007/s00347-003-0896-x.
In our outpatient service the number of corneal infiltrates and ulcers associated with contact lens wear in young patients increased during the last years. Therefore we evaluated all patients with keratitis regarding to the reason.
From January 1999 to August 2000 the medical charts of 210 consecutive patients and 239 eyes were reviewed. We evaluated the percentage of contact lens wearers. Patient age, localisation and number of infiltrates, bacteria and healing results were also evaluated.
In 134 of 239 eyes (56%) keratitis was caused by contact lenses, 127 eyes (53%) with soft lenses. The mean age of soft contact lens wearing patients was 28,2 +/-13,0 years. Mean age in other reasons was 46,0 +/-22,5 years. 71% (170 eyes) had single central infiltrates, 19% (45 eyes) multiple peripheral infiltrates and 10% (24 eyes) corneal ulcers. Bacteria were found in 33% (78 eyes). The most frequent isolated bacteria in non contact lens induced keratitis was staphylococcus aureus (22 eyes). In those eyes with soft contact lenses we found mostly gram negative bacteria such as serratia spp. (6 eyes), pseudomonas spp. (6 eyes), stenotrophomonas maltophilia (6 eyes) and klebsiella oxytoca (5 eyes). 20% (26 of 127 eyes) of contact lens induced corneal infection healed with a scar.
Our analysis shows, that the major part of keratitis was induced by soft contact lenses. One fifth of these very young patients retained a corneal scar. There is a higher risk to suffer a keratitis when using soft contact lenses. This should influence especially patients information regarding choice and use of soft contact lenses.
在我们的门诊中，近年来年轻患者中与隐形眼镜佩戴相关的角膜浸润和溃疡数量有所增加。因此，我们对所有角膜炎患者的病因进行了评估。
回顾了1999年1月至2000年8月期间连续210例患者和239只眼的病历。我们评估了隐形眼镜佩戴者的比例。还评估了患者年龄、浸润的部位和数量、细菌以及愈合结果。
239只眼中有134只（56%）的角膜炎由隐形眼镜引起，其中127只眼（53%）由软性隐形眼镜引起。佩戴软性隐形眼镜患者的平均年龄为28.2±13.0岁。其他原因导致角膜炎患者的平均年龄为46.0±22.5岁。71%（170只眼）有单个中央浸润，19%（45只眼）有多个周边浸润，10%（24只眼）有角膜溃疡。33%（78只眼）发现有细菌。非隐形眼镜诱发的角膜炎中最常见的分离细菌是金黄色葡萄球菌（22只眼）。在佩戴软性隐形眼镜的眼中，我们发现大多是革兰氏阴性菌，如沙雷氏菌属（6只眼）、假单胞菌属（6只眼）、嗜麦芽窄食单胞菌（6只眼）和产酸克雷伯菌（5只眼）。20%（127只眼中的26只）由隐形眼镜诱发的角膜感染愈合后留有瘢痕。
我们的分析表明，角膜炎的主要部分是由软性隐形眼镜诱发的。这些非常年轻的患者中有五分之一角膜留有瘢痕。使用软性隐形眼镜时患角膜炎的风险更高。这尤其应该影响患者在软性隐形眼镜的选择和使用方面的信息获取。
