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多模态方法治疗小切口微透镜取出术后无并发症的感染性角膜炎：病例报告。

Management of infectious keratitis following uneventful small-incision lenticule extraction using a multimodal approach - A case report.

机构信息

Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India.

出版信息

Indian J Ophthalmol. 2020 Dec;68(12):3064-3066. doi: 10.4103/ijo.IJO_2418_19.

DOI:10.4103/ijo.IJO_2418_19
PMID:33229708
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7856942/
Abstract

A 42-year-old female presented with pain, photophobia, and superficial corneal infiltrates in mid-periphery in the left eye, after 2 days of uneventful bilateral SMILE procedure. Inspite of the medical treatment with fortified antibiotics, the infection spread to the interface, close to visual axis reducing UDVA from 20/16 to 20/80. Immediate surgical intervention in the form of scraping of interface lesions with 26G needle, interface wash with antibiotics and photoactivated chromophore for keratitis (PACK-CXL) was performed. After 24 h of bacterial culture Staphylococcus aureus was yielded. Interface wash and PACK-CXL was repeated after 48 h by which infiltrates reduced and early scarring was observed by 10 post-op day. Subsequent topical steroids helped in limiting scar formation and UDVA improved to 20/30 at the final visit. Combined approach of interface wash with antibiotics and PACK-CXL may be a safe and effective modality in treating early onset infectious keratitis following SMILE surgery.

摘要

一位 42 岁女性在双眼 SMILE 手术后 2 天出现左眼中部周边疼痛、畏光和浅层角膜浸润。尽管使用强化抗生素进行了治疗，但感染仍扩散至角膜界面，接近视轴，导致最佳矫正视力（UDVA）从 20/16 下降至 20/80。立即进行了手术干预，用 26G 针头刮除界面病变，并用抗生素和光激活角膜染色质（PACK-CXL）冲洗界面。24 小时后细菌培养出金黄色葡萄球菌。48 小时后再次进行界面冲洗和 PACK-CXL，浸润减轻，并在术后 10 天观察到早期瘢痕形成。随后局部应用皮质类固醇有助于限制瘢痕形成，最终随访时 UDVA 提高至 20/30。联合应用抗生素冲洗和 PACK-CXL 可能是治疗 SMILE 手术后早期发生感染性角膜炎的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/c7560c3df80b/IJO-68-3064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/a39508ef15ba/IJO-68-3064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/ac8e50984eb1/IJO-68-3064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/28b60777c46b/IJO-68-3064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/c7560c3df80b/IJO-68-3064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/a39508ef15ba/IJO-68-3064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/ac8e50984eb1/IJO-68-3064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/28b60777c46b/IJO-68-3064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b7/7856942/c7560c3df80b/IJO-68-3064-g004.jpg

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