Su Chuan-Yi, Tsai Jih-Jin, Chang Yo-Chen, Lin Chang-Ping
Department of Ophthalmology, Kaohsiung Medical University, Koahsiung, Taiwan.
Cornea. 2006 Jul;25(6):663-6. doi: 10.1097/01.ico.0000214228.44109.0f.
To present the immunologic status and clinical manifestations of patients who had infectious scleritis after pterygium excision.
This prospective noncomparative study of immunologic status and clinical manifestations involved 18 eyes of 18 patients with infectious scleritis (16 bacterial and 2 fungal infections) with a history of pterygium excision from 1999 to 2001.
The period between pterygium excision and scleritis ranged from 1 to 36 years. None of the 18 patients had any history of systemic autoimmune disease. Elevated erythrocyte sedimentation rates were found in 9 (50%) of 18 patients. Elevated serum C-reactive protein levels were found in 9 (75%) of 12 patients. Other serologic tests were all negative. The most common pathogen of infectious scleritis, Pseudomonas aeruginosa, was present in 13 patients (72.2%), significantly higher than any others (P < 0.05). All of the eyeballs were salvaged, and 9 (50%) of 18 patients had final vision better than 2/20.
There was no underlying autoimmune disease associated with infectious scleritis in this study. Early diagnosis and aggressive medical and surgical treatment might have saved the eyes.
阐述翼状胬肉切除术后发生感染性巩膜炎患者的免疫状态及临床表现。
这项关于免疫状态和临床表现的前瞻性非对照研究纳入了1999年至2001年间18例有翼状胬肉切除病史且发生感染性巩膜炎（16例细菌感染和2例真菌感染）患者的18只眼。
翼状胬肉切除至巩膜炎发作的间隔时间为1至36年。18例患者均无全身性自身免疫性疾病病史。18例患者中有9例（50%）红细胞沉降率升高。12例患者中有9例（75%）血清C反应蛋白水平升高。其他血清学检查均为阴性。感染性巩膜炎最常见的病原体铜绿假单胞菌存在于13例患者中（72.2%），显著高于其他任何病原体（P<0.05）。所有眼球均得以挽救，18例患者中有9例（50%）最终视力优于2/20。
本研究中感染性巩膜炎无潜在自身免疫性疾病。早期诊断以及积极的药物和手术治疗可能挽救了这些眼睛。
