Reiss G R, Campbell R J, Bourne W M
Surv Ophthalmol. 1986 Jul-Aug;31(1):69-72. doi: 10.1016/0039-6257(86)90053-6.
A 57-year-old white female was noted to have unusual intrastromal crystalline-like opacities in her failing right corneal graft five months after transplant surgery. Cultures grew Streptococcus viridans; since the graft was failing it was replaced and sent for pathologic examination. H&E stains revealed intrastromal pockets of basophilic material between the lamellae; there was a notable absence of inflammatory cells. Gram's stain showed the basophilic material to be gram positive and transmission electron microscopy confirmed the presence of intrastromal pockets of bacteria. The term "infectious crystalline keratopathy" was coined by Meisler for this entity, which occurs following longterm topical steroid usage. The quite clinical appearance may make its infectious etiology unapparent. Management consists of discontinuation of the steroids and the administration of antibiotics; continued infection, corneal scars, or graft failure may occur and transplantation is then required.
一名57岁的白人女性在角膜移植手术后五个月，其功能逐渐衰退的右眼角膜移植物中出现了不寻常的基质内晶体样混浊。培养物培养出草绿色链球菌；由于移植物功能逐渐衰退，遂将其更换并送去做病理检查。苏木精-伊红染色显示板层之间存在基质内嗜碱性物质的小窝；明显没有炎症细胞。革兰氏染色显示嗜碱性物质为革兰氏阳性，透射电子显微镜证实存在基质内细菌小窝。迈斯勒为这种在长期局部使用类固醇后出现的病症创造了“感染性结晶性角膜病变”这一术语。其相当独特的临床表现可能使其感染性病因不明显。治疗包括停用类固醇并使用抗生素；可能会出现持续感染、角膜瘢痕或移植物衰竭，届时则需要进行移植。
