Cavanaugh T B, Gottsch J D
Cornea Service, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Am J Ophthalmol. 1991 Apr 15;111(4):466-72. doi: 10.1016/s0002-9394(14)72382-7.
We studied three patients with infectious keratitis that occurred after cyanoacrylate gluing despite prophylactic antibiotic therapy. Two patients developed culture-positive bacterial ulcers, one caused by a methicillin-resistant Staphylococcus aureus and the other by Haemophilus influenzae. The third patient developed a fungal keratitis. Two patients required penetrating keratoplasty. Each infection and perforation was concealed by the opaqueness of the glue. The pain of the infectious ulcers may have been obscured by the ocular surface irritation and drying induced by glue. Tissue toxicity, microbial colonization, use of bandage lenses, and long-term broad-spectrum antibiotics may precipitate glue-related corneal infections. Masking of underlying infection and the development of resistant organisms should be considered when using this mode of therapy.
我们研究了3例尽管接受了预防性抗生素治疗但在使用氰基丙烯酸酯胶水后仍发生感染性角膜炎的患者。2例患者发生了培养阳性的细菌性溃疡，1例由耐甲氧西林金黄色葡萄球菌引起，另1例由流感嗜血杆菌引起。第3例患者发生了真菌性角膜炎。2例患者需要进行穿透性角膜移植术。每次感染和穿孔都被胶水的不透明性掩盖。感染性溃疡的疼痛可能被胶水引起的眼表刺激和干燥所掩盖。组织毒性、微生物定植、使用绷带镜和长期使用广谱抗生素可能会引发与胶水相关的角膜感染。使用这种治疗方式时应考虑掩盖潜在感染和耐药菌的产生。
