准分子激光上皮下角膜磨镶术（Epi-LASIK）后发生两例耐甲氧西林金黄色葡萄球菌性角膜炎
Two cases of methicillin-resistant Staphylococcus aureus keratitis after Epi-LASIK.
作者信息
Nomi Norimasa, Morishige Naoyuki, Yamada Naoyuki, Chikama Tai-Ichiro, Nishida Teruo
机构信息
Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Department of Ocular Pathophysiology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
出版信息
Jpn J Ophthalmol. 2008 Nov-Dec;52(6):440-443. doi: 10.1007/s10384-008-0537-7. Epub 2008 Dec 17.
BACKGROUND
We describe two severe cases of methicillin-resistant Staphylococcus aureus (MRSA) keratitis following Epi-LASIK surgery.
CASES
One patient was a 23-year-old man who underwent Epi-LASIK surgery in both eyes. He developed an infectious corneal ulcer in one eye 2 days after surgery and was referred to us 7 days post-surgery with corneal perforation, for which we performed therapeutic penetrating keratoplasty. The other patient was a 32-year-old man who developed infectious keratitis in one eye 4 days after bilateral Epi-LASIK and was referred to us 2 days later.
OBSERVATIONS
Microbial testing revealed MRSA infection as the cause of the keratitis in both patients which was successfully treated with vancomycin eyedrops.
CONCLUSION
Infectious keratitis after refractive surgery is uncommon; it is important to diagnose this condition, identify the causative agent, and initiate treatment with appropriate antibiotics as soon as possible.
背景
我们描述了两例准分子激光上皮瓣下角膜磨镶术（Epi-LASIK）术后耐甲氧西林金黄色葡萄球菌（MRSA）角膜炎的严重病例。
病例
一名23岁男性双眼接受了Epi-LASIK手术。术后2天，他一只眼睛出现感染性角膜溃疡，术后7天因角膜穿孔被转诊至我们医院，我们为其实施了治疗性穿透性角膜移植术。另一名患者是一名32岁男性，双眼Epi-LASIK术后4天，一只眼睛出现感染性角膜炎，2天后被转诊至我们医院。
观察结果
微生物检测显示，两名患者的角膜炎病因均为MRSA感染，用万古霉素滴眼液治疗成功。
结论
屈光手术后感染性角膜炎并不常见；尽早诊断这种情况、确定病原体并开始使用适当的抗生素进行治疗很重要。
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