Bates A K, Kirkness C M, Ficker L A, Steele A D, Rice N S
Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London.
Eye (Lond). 1990;4 ( Pt 1):74-8. doi: 10.1038/eye.1990.8.
Thirty cases of microbial keratitis after penetrating keratoplasty were reviewed to examine the associated risk factors, the spectrum of pathogens and the prognosis for graft survival and visual outcome. The indications for keratoplasty in this group differed markedly from those for all corneal grafts performed with a much higher incidence of previous microbial keratitis and of herpes simplex keratitis. A positive culture was obtained in 93% of cases and in contrast to microbial keratitis overall, Gram positive organisms predominated particularly streptococcus pneumoniae and staphylococcus aureus. Risk factors identified were loose or broken sutures, graft decompensation and a poor ocular surface environment. There was a poor prognosis for graft survival with only 23% of cases retaining a clear graft. Overall 53% of cases were regrafted.
回顾了30例穿透性角膜移植术后发生微生物性角膜炎的病例，以研究相关危险因素、病原体谱以及移植片存活和视觉预后情况。该组角膜移植的适应证与所有角膜移植的适应证明显不同，既往微生物性角膜炎和单纯疱疹性角膜炎的发病率要高得多。93%的病例培养呈阳性，与总体微生物性角膜炎不同的是，革兰氏阳性菌占主导，尤其是肺炎链球菌和金黄色葡萄球菌。确定的危险因素包括缝线松动或断裂、移植片失代偿和眼表环境差。移植片存活预后不佳，只有23%的病例移植片保持透明。总体而言，53%的病例进行了再次移植。
