Donshik P C, Suchecki J K, Ehlers W H
University of Connecticut Health Center, Division of Ophthalmology, Farmington, USA.
Trans Am Ophthalmol Soc. 1995;93:49-60; discussion 60-4.
A retrospective study was performed to review the clinical characteristics of peripheral corneal infiltrates in contact lens wearers.
The charts of all contact lens patients with peripheral corneal infiltrates 1.5 mm or less in size who presented to the office from 1987 to 1994 were reviewed.
The epidemiological and clinical characteristics of peripheral corneal infiltrates associated with contact lens wear were reviewed in 52 patients (64 infiltrates). Forty-four patients presented with a single infiltrate, while the remaining 8 patients had multiple infiltrates. While there was no predilection for a specific quadrant of the cornea, when a subgroup of patients who wore extended wear lenses was analyzed, 19 of the 40 infiltrates were located in the superior quadrant. Forty percent of the patients were wearing disposable extended wear contact lenses, 21% were wearing conventional extended wear lenses, 33% were wearing conventional or frequent replacement/disposable daily wear contact lenses and 6% were wearing rigid gas permeable lenses. The majority of patients had minimal conjunctival inflammation, an anterior stromal cellular reaction and minimal anterior chamber activity. A subgroup of 16 patients had corneal cultures of their infiltrates. In this group, 8 of the 16 had positive cultures. All patients had a resolution of the infiltrates without complications and the majority were refitted to daily wear soft or rigid contact lenses.
Peripheral corneal infiltrates in contact lens wearers appears to be more common in patients wearing extended wear soft contact lenses. While often considered "sterile" in the literature, a significant number have been shown to be culture-positive. The organisms that have been associated with peripheral infiltrates appear to be less "pathogenic" than those that have been reported to be associated with central corneal ulcer. However, it is probably advisable that patients with peripheral corneal ulcers secondary to contact lens wear should be initially treated with topical antibiotics.
进行一项回顾性研究，以评估佩戴隐形眼镜者周边角膜浸润的临床特征。
回顾了1987年至1994年期间到诊所就诊的所有周边角膜浸润大小在1.5毫米及以下的隐形眼镜患者的病历。
对52例患者（64处浸润）佩戴隐形眼镜相关的周边角膜浸润的流行病学和临床特征进行了评估。44例患者表现为单个浸润，其余8例患者有多个浸润。虽然角膜的特定象限没有偏好，但在分析佩戴长戴型隐形眼镜的患者亚组时，40处浸润中有19处位于上象限。40%的患者佩戴一次性长戴型隐形眼镜，21%佩戴传统长戴型隐形眼镜，33%佩戴传统型或频繁更换/一次性日戴型隐形眼镜，6%佩戴硬性透气性隐形眼镜。大多数患者结膜炎症轻微，前基质有细胞反应，前房活动轻微。16例患者的浸润处进行了角膜培养。在该组中，16例中有8例培养结果为阳性。所有患者的浸润均消退且无并发症，大多数患者重新佩戴日戴型软性或硬性隐形眼镜。
佩戴隐形眼镜者的周边角膜浸润在佩戴长戴型软性隐形眼镜的患者中似乎更为常见。虽然在文献中通常被认为是“无菌的”，但已显示相当一部分培养结果为阳性。与周边浸润相关的微生物似乎比与中央角膜溃疡相关的微生物“致病性”更低。然而，对于因佩戴隐形眼镜继发周边角膜溃疡的患者，最初可能建议使用局部抗生素治疗。
