Zamora Katherine V, Males John J
Corneal Unit, Sydney Eye Hospital, New South Wales, Australia.
Cornea. 2009 May;28(4):474-6. doi: 10.1097/ICO.0b013e31818d381a.
: To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus.
: Case report.
: A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings.
: Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
报告一例圆锥角膜患者在接受胶原交联治疗后，由唾液链球菌、口腔链球菌和凝固酶阴性葡萄球菌引起的混合微生物性角膜炎病例。
病例报告。
一名32岁男性，在左眼接受核黄素和紫外线A胶原交联治疗圆锥角膜3天后，出现疼痛性红眼1天。他承认在重新佩戴绷带式隐形眼镜前，将其从眼中取出并在口中清洗过。就诊时，发现严重角膜炎，有8毫米的上皮缺损和360度环形浸润。其隐形眼镜培养结果显示唾液链球菌和口腔链球菌呈阳性，角膜刮片培养出凝固酶阴性葡萄球菌。
胶原交联是一种有前景的治疗进行性圆锥角膜的方法，报告的副作用最小。然而，由于患者接受了上皮清创术并佩戴软性隐形眼镜，术后存在继发感染的可能性。紫外线对角膜免疫机制的作用及其对角膜伤口愈合的影响值得进一步研究。
