白内障和虹膜萎缩是棘阿米巴角膜炎药物治疗的毒性并发症吗？
Are cataract and iris atrophy toxic complications of medical treatment of acanthamoeba keratitis?
作者信息
Ehlers Niels, Hjortdal Jesper
机构信息
Department of Ophthalmology, Arhus University Hospital, Arhus, Denmark.
出版信息
Acta Ophthalmol Scand. 2004 Apr;82(2):228-31. doi: 10.1111/j.1600-0420.2004.00237.x.
PURPOSE
Two cases of acanthamoeba keratitis with almost identical clinical courses developed mature cataract and iris atrophy after prolonged treatment with chlorhexidine 0.02% and propamidine isethionate 0.1%. It is suggested that these complications were caused by the chemicals, rather than resulting from the amoebae-induced inflammation.
METHODS
Penetrating keratoplasty was performed in both cases when perforation from peripheral ulceration was threatening.
RESULTS AND CONCLUSIONS
The immediate results were good. From these two cases it seems possible that there is a maximum level of intensity of the medical treatment and also that surgery should be considered at an earlier stage, before intraocular complications develop.
目的
两例棘阿米巴角膜炎患者临床病程几乎相同，在用0.02%洗必泰和0.1%依西酸丙脒长时间治疗后出现了成熟白内障和虹膜萎缩。提示这些并发症是由化学药物引起的，而非阿米巴诱导的炎症所致。
方法
当周边溃疡穿孔有威胁时，对两例患者均实施了穿透性角膜移植术。
结果与结论
近期效果良好。从这两例病例来看，似乎药物治疗存在一个最大强度水平，并且在眼内并发症发生之前应更早考虑手术治疗。
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