Sun Xuguang, Zhao Huiying, Deng Shijing, Zhang Yan, Wang Zhiqun, Li Ran, Luo Shiyun, Jin Xiuying
Department of Ocular Microbiology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing 100005, China.
Ophthalmic Physiol Opt. 2006 Mar;26(2):133-6. doi: 10.1111/j.1475-1313.2006.00381.x.
To report 28 cases of infectious keratitis related to orthokeratology lens overnight wear in China.
From March 2000 to August 2001, 28 cases of infectious keratitis related to overnight orthokeratology lens wear were diagnosed in Beijing Institute of Ophthalmology. These were retrospectively reviewed with regard to the pathogens isolated, duration of wear, the time since onset of symptoms, and age. Cultures of corneal scrapes for bacteria, fungus and Acanthamoeba were performed in all of the 28 cases.
All cases were students, including 10 males and 18 females, average age was 16 years (range 10-21 years). The duration of orthokeratology overnight wearing was from 2 weeks to 2 years. Uncorrected visual acuity (UCVA) on initial examination in our institute was from 20/200 to light perception. Of 28 isolates, 24 were culture positive (including 11 bacteria, 11 Acanthamoeba and two fungi), and four were culture negative. In two of the four culture negative cases, Acanthamoeba cysts were detected in the corneal stroma with the confocal microscope. Acanthamoeba and Pseudomonas aeruginosa accounted for 75% (21 of 28) of the cases of infectious keratitis.
Infectious keratitis is a severe complication associated with overnight orthokeratology lens wear. Ophthalmologists should pay more attention to this complication in practice.
报告中国28例与角膜塑形镜过夜佩戴相关的感染性角膜炎病例。
2000年3月至2001年8月，北京眼科研究所诊断出28例与角膜塑形镜过夜佩戴相关的感染性角膜炎病例。对这些病例的分离病原体、佩戴时间、症状出现后的时间以及年龄进行了回顾性分析。对所有28例病例均进行了角膜刮片的细菌、真菌和棘阿米巴培养。
所有病例均为学生，其中男性10例，女性18例，平均年龄16岁（范围10 - 21岁）。角膜塑形镜过夜佩戴时间为2周至2年。我院初诊时的裸眼视力（UCVA）为20/200至光感。28例分离物中，24例培养阳性（包括11例细菌、11例棘阿米巴和2例真菌），4例培养阴性。在4例培养阴性病例中的2例，共焦显微镜检查在角膜基质中检测到棘阿米巴包囊。棘阿米巴和铜绿假单胞菌占感染性角膜炎病例的75%（28例中的21例）。
感染性角膜炎是角膜塑形镜过夜佩戴相关的严重并发症。眼科医生在临床实践中应更多关注这一并发症。
