Dart J K
Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.
Br J Ophthalmol. 1988 Dec;72(12):926-30. doi: 10.1136/bjo.72.12.926.
Fifty-three patients consecutively admitted to Moorfields Eye Hospital for treatment of suspected microbial keratitis were examined to identify predisposing factors. The principal associations were pre-existing corneal disease (22 patients (41.5%] and contact lens wear (22 patients (41.5%]. In 13 cases (25%) contact lens wear was the only factor in patients with otherwise healthy eyes using contact lenses as an alternative to spectacles. Gram-negative keratitis was more frequent in the lens wearers, with the exception of therapeutic lens users, than in other patients (p = 0.0006) and Pseudomonas aeruginosa caused keratitis in cosmetic soft lens users more frequently (p = 0.001). There was no correlation between lens handling or solution contamination in three extended wear soft-lens users. This implies that some soft-lens wearers may be infected by Gram-negative organisms from environmental sources other than contaminated lens care materials. Gram-negative keratitis is strongly associated with contact lens wear, and the diagnosis must be considered in any contact lens user with an acutely painful red eye.
对连续入住摩尔菲尔兹眼科医院治疗疑似微生物性角膜炎的53例患者进行检查，以确定诱发因素。主要相关因素为既往角膜疾病（22例患者[41.5%]）和佩戴隐形眼镜（22例患者[41.5%]）。在13例病例（25%）中，佩戴隐形眼镜是原本眼睛健康但使用隐形眼镜替代眼镜的患者的唯一因素。除治疗性隐形眼镜使用者外，革兰氏阴性菌角膜炎在隐形眼镜佩戴者中比在其他患者中更常见（p = 0.0006），铜绿假单胞菌在美容软性隐形眼镜使用者中引起角膜炎的频率更高（p = 0.001）。3例长期佩戴软性隐形眼镜的使用者中，镜片操作或护理液污染与感染之间无相关性。这意味着一些软性隐形眼镜佩戴者可能被来自被污染镜片护理材料以外的环境来源的革兰氏阴性菌感染。革兰氏阴性菌角膜炎与隐形眼镜佩戴密切相关，任何急性疼痛性红眼的隐形眼镜使用者都必须考虑该诊断。
