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准分子原位角膜磨镶术后单侧近平滑念珠菌性界面角膜炎:病例报告及文献复习

Unilateral Candida parapsilosis interface keratitis after laser in situ keratomileusis: case report and review of the literature.

作者信息

Chen Wen-Lu, Tsai Yi-Yu, Lin Jane-Ming, Chiang Chun-Chi

机构信息

Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan.

出版信息

Cornea. 2009 Jan;28(1):105-7. doi: 10.1097/ICO.0b013e318184e69b.

Abstract

PURPOSE

To describe a rare case of early-onset Candida parapsilosis infection after laser in situ keratomileusis (LASIK) and review the published reports of post-LASIK fungal infections.

METHODS

A 32-year-old woman presented with interface infiltration in the central interface in the right eye 2 days after LASIK surgery. The right eye flap was lifted, and the opacities were scraped. Two days later, a 3- x 3-mm-dense oval opacity and diffuse hazes were noted. Surgical intervention was arranged because of suspicion of interface infectious keratitis.

RESULTS

After an apparent post-LASIK keratitis with related interface inflammation failed to respond to medical therapy, corneal culture results were positive for C. parapsilosis 2 weeks 6 days after presentation. The patient was started on topical drops of amphotericin B 0.15% every hour after the smear showed the presence of yeast. The opacities decreased, and the topical antifungal drops were tapered. One month later, her uncorrected visual acuity recovered to 20/20.

CONCLUSIONS

Candida parapsilosis interface keratitis after LASIK may occur in the early phase. Early diagnosis and proper treatment can result in good outcome.

摘要

目的

描述一例准分子原位角膜磨镶术(LASIK)后早期发生近平滑念珠菌感染的罕见病例,并回顾已发表的LASIK术后真菌感染报告。

方法

一名32岁女性在LASIK手术后2天,右眼中央界面出现界面浸润。掀开右眼瓣,刮除混浊物。两天后,发现一个3×3毫米的致密椭圆形混浊物和弥漫性 haze。因怀疑界面感染性角膜炎而安排手术干预。

结果

在明显的LASIK术后角膜炎及相关界面炎症对药物治疗无反应后,就诊2周6天后角膜培养结果显示近平滑念珠菌阳性。涂片显示有酵母存在后,患者开始每小时使用0.15%两性霉素B滴眼液。混浊物减少,局部抗真菌滴眼液逐渐减量。1个月后,她的未矫正视力恢复到20/20。

结论

LASIK术后近平滑念珠菌界面角膜炎可能在早期发生。早期诊断和适当治疗可取得良好效果。

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