Kim Eun Chul, Kim Man Soo
Department of Ophthalmology and Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.
Cornea. 2009 Apr;28(3):348-50. doi: 10.1097/ICO.0b013e31816b6a0b.
To report bilateral Acanthamoeba keratitis after wearing an overnight reverse geometric contact lens for 5 days.
Case report and review of the medical literature
A 22-year-old woman developed bilateral corneal ulcers during orthokeratology. A slit-lamp examination showed round epithelial abrasion, radial infiltration, and disciform keratitis in both corneas. Visual acuity OD was hand motion and OS was counting fingers. Bilateral Acanthamoeba keratitis was diagnosed by culture by using non-nutrient agar overlaid with viable Escherichia coli. Small, round, and double-walled cysts were observed in non-nutrient agar under an inverted phase contrast microscope. Topical 0.02% polyhexamethylene biguanide, Cravit (0.5% levofloxacin), and Tobra (0.5% tobramycin) were administered. After 1 month of treatment, the corneal ulcer had healed, and the patient's best-corrected visual acuity was 20/100 OD and 20/25 OS.
Acanthamoeba keratitis can simultaneously affect both eyes during overnight orthokeratology.
报告佩戴过夜型反转几何角膜接触镜5天后发生的双侧棘阿米巴角膜炎。
病例报告及医学文献回顾
一名22岁女性在角膜塑形术期间发生双侧角膜溃疡。裂隙灯检查显示双眼角膜有圆形上皮擦伤、放射状浸润及盘状角膜炎。右眼视力为手动，左眼视力为指数。通过使用覆盖有活大肠杆菌的无营养琼脂进行培养，诊断为双侧棘阿米巴角膜炎。在倒置相差显微镜下于无营养琼脂中观察到小的、圆形的双壁囊肿。给予0.02%聚六亚甲基双胍、可乐必妥（0.5%左氧氟沙星）和托百士（0.5%妥布霉素）局部用药。治疗1个月后，角膜溃疡愈合，患者最佳矫正视力右眼为20/100，左眼为20/25。
在过夜角膜塑形术期间，棘阿米巴角膜炎可同时累及双眼。
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