Liu Hsin-Yu, Chu Hsiao-Sang, Chen Wei-Li, Hu Fung-Rong, Wang I-Jong
J Refract Surg. 2018 Sep 1;34(9):633-636. doi: 10.3928/1081597X-20180827-01.
To report a case of bilateral non-tuberculous mycobacterial keratitis after small incision lenticule extraction (SMILE) that was successfully treated with oral and topical fortified antibiotics.
Case report and literature review.
An otherwise healthy 21-year-old woman presented with culture-proven bilateral Mycobacterium abscessus keratitis 8 days after undergoing SMILE, showing multiple white stromal infiltrates in the interface in both eyes. Progressive, diffuse flap edema followed by pocket abscess, exudation in the anterior chamber, granulation tissue formation in the pocket, intrastromal neovascularization, and eventually partial resolution of corneal opacity were noted after topical and oral antibiotic treatment for 6 months. Her corrected distance visual acuity was 20/32 and 20/50 in the right and left eyes, respectively, 12 months after initial presentation.
This is the first report of successful medical management of bilateral non-tuberculous mycobacterial keratitis after SMILE. The manifestations are different from and even more difficult to treat than those of keratitis after LASIK. [J Refract Surg. 2018;34(9):633-636.].
报告1例小切口基质透镜切除术（SMILE）后发生双侧非结核分枝杆菌性角膜炎，经口服及局部应用强化抗生素成功治疗的病例。
病例报告及文献复习。
一名21岁健康女性在接受SMILE术后8天出现经培养证实的双侧脓肿分枝杆菌性角膜炎，双眼角膜基质层界面可见多处白色浸润灶。局部及口服抗生素治疗6个月后，出现进行性弥漫性角膜瓣水肿，随后形成袋状脓肿、前房渗出、袋内肉芽组织形成、基质内新生血管形成，最终角膜混浊部分消退。初诊12个月后，其右眼和左眼的矫正远视力分别为20/32和20/50。
本文是首例关于SMILE术后双侧非结核分枝杆菌性角膜炎成功药物治疗的报告。其表现与准分子激光原位角膜磨镶术（LASIK）后角膜炎不同，甚至更难治疗。[《屈光手术杂志》。2018；34(9):633 - 636。]
