García de Oteyza Gonzalo, Laiseca Andrea, Sauvageot Paola, Álvarez de Toledo Juan
Department of Cornea and Ocular Surface, Centro de Oftalmología Barraquer, Barcelona, Spain.
Ophthalmol Ther. 2017 Dec;6(2):367-371. doi: 10.1007/s40123-017-0103-9. Epub 2017 Aug 14.
The purpose of this study was to report the first case of acute bacterial keratitis produced by methicillin-resistant Staphylococcus aureus after the implantation of two intracorneal ring segments during an uneventful procedure for treating keratoconus in a 13-year-old child.
A patient with grade III keratoconus underwent an implantation of intracorneal ring segments with no complications during the procedure. Three days later, a whitish corneal infiltrate appeared in between the union of both corneal rings. Sample cultures were positive for methicillin-resistant S. aureus (MRSA). Corneal infiltrate did not improve despite intensive topical and systemic antibiotics. Melting appeared even after the explantation of both corneal rings. Keratoplasty à chaud had to be performed to preserve the eye integrity.
MRSA keratitis following intracorneal ring segment implantation is a rare but severe complication that can lead to a therapeutic penetrating keratoplasty to definitely cure the process.
本研究的目的是报告首例在一名13岁儿童治疗圆锥角膜的手术过程顺利、植入两枚角膜内环后发生的耐甲氧西林金黄色葡萄球菌所致急性细菌性角膜炎病例。
一名患有III级圆锥角膜的患者在手术过程中植入角膜内环，未出现并发症。三天后，在两枚角膜环结合处之间出现白色角膜浸润。样本培养显示耐甲氧西林金黄色葡萄球菌（MRSA）呈阳性。尽管使用了强化的局部和全身抗生素，角膜浸润仍未改善。即使在两枚角膜环取出后仍出现角膜溶解。必须进行热角膜移植以维持眼球完整性。
角膜内环植入后发生的MRSA角膜炎是一种罕见但严重的并发症，可导致治疗性穿透性角膜移植以彻底治愈该病症。
