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史蒂文斯-约翰逊综合征患者波士顿人工角膜眼内炎

Endophthalmitis in Boston Keratoprosthesis in a Patient with Steven-Johnson Syndrome.

作者信息

Al-Otaibi Humoud M, Talea Mohammed, Kirat Omar, Stone Donald U, May William N, Kozak Igor

机构信息

King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Middle East Afr J Ophthalmol. 2016 Oct-Dec;23(4):329-331. doi: 10.4103/0974-9233.194095.

Abstract

A 25-year-old Syrian male with a previous episode of Stevens-Johnson syndrome with bilateral corneal cicatrization previously underwent surgery for Type 1 Boston Keratoprosthesis (K-Pro). Sixteen months after the K-Pro surgery, the patient presented with decreased vision to hand motion and microbial keratitis of the graft around the K-Pro with purulent discharge. Corneal scrapings were nonrevealing. B-scan in 3 days showed increased debris in the vitreous cavity and thickened retinochoroidal layer. Intravitreal tap and injections of vancomycin and ceftazidime were performed. The vitreous culture revealed β-hemolytic ; fungal cultures were negative. Repeat B-scan 3 days later demonstrated decreased vitreous opacity, and the patient felt more comfortable and was without pain. His visual acuity improved to 20/70, ocular findings have been stable for 9 months, and the patient continues to be monitored.

摘要

一名25岁的叙利亚男性,曾患史蒂文斯-约翰逊综合征并伴有双侧角膜瘢痕形成,此前接受了1型波士顿人工角膜(K-Pro)植入手术。K-Pro手术后16个月,患者出现视力下降至仅能感知手动,且人工角膜周围的移植片发生微生物性角膜炎并伴有脓性分泌物。角膜刮片检查未发现异常。3天后的B超显示玻璃体腔碎屑增多,视网膜脉络膜层增厚。进行了玻璃体穿刺并注射万古霉素和头孢他啶。玻璃体培养显示β-溶血性;真菌培养为阴性。3天后复查B超显示玻璃体混浊减轻,患者感觉更舒适且无疼痛。其视力提高到20/70,眼部情况已稳定9个月,患者仍在继续接受监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3955/5141631/fd3f4a3b527d/MEAJO-23-329-g001.jpg

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