Tseng S H, Ling K C
Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
Cornea. 1995 Nov;14(6):591-4.
Infectious keratitis after penetrating keratoplasty can be devastating to the survival of the graft and its visual outcome. From November 1989 to October 1994, we treated 41 episodes of late microbial keratitis among 354 consecutive penetrating keratoplasty patients and reviewed their medical records retrospectively. The time interval between the corneal transplantation and the onset of graft infection was averaged 10.4 +/- 10.9 months (range: 1-52 months). The precipitating factors of keratitis included epithelial defect (49%), suture-related problems (41%), use of contact lenses (17%), trichiasis (17%), dry eye (12%), and lid abnormalities (10%). Gram-positive cocci and gram-negative bacilli were associated with 51 and 40%, respectively, of the infectious keratitis, with Streptococcus being the most common species. Despite fortified antibiotic treatments, major complications such as graft failure and wound dehiscence could result. The overall result was that clarity was retained in only 43% of our grafts. We conclude that to prevent infectious keratitis there is a need to implement appropriate preventive measures as well as close monitoring of the graft after operation.
穿透性角膜移植术后感染性角膜炎可严重影响植片存活及其视觉效果。1989年11月至1994年10月，我们对354例连续穿透性角膜移植患者中的41例晚期微生物性角膜炎进行了治疗，并回顾性分析了他们的病历。角膜移植与植片感染发作之间的时间间隔平均为10.4±10.9个月（范围：1 - 52个月）。角膜炎的诱发因素包括上皮缺损（49%）、缝线相关问题（41%）、使用隐形眼镜（17%）、倒睫（17%）、干眼（12%）和眼睑异常（10%）。革兰氏阳性球菌和革兰氏阴性杆菌分别与51%和40%的感染性角膜炎相关，其中链球菌是最常见的菌种。尽管采用了强化抗生素治疗，但仍可能导致诸如植片失败和伤口裂开等主要并发症。总体结果是，我们的植片中仅有43%保持了透明。我们得出结论，为预防感染性角膜炎，需要实施适当的预防措施以及术后对植片进行密切监测。
