Lu Y, Snibson G R
University of Melbourne Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Aust N Z J Ophthalmol. 1997 Aug;25(3):231-2. doi: 10.1111/j.1442-9071.1997.tb01398.x.
We report on the case of a 46-year-old female who presented with delayed microbial keratitis 10 years after uncomplicated radial keratotomy.
The pre- and postoperative clinical record was reviewed following her presentation to the Corneal Clinic. Slit-lamp examination revealed a stromal inflammatory infiltrate at the site of an earlier radial keratotomy incision. The lesion was scraped and a coagulase-negative Staphylococcus aureus was cultured in enrichment broth.
The keratitis was treated successfully with combination fortified topical antibiotics without loss of vision.
Although microbial keratitis is a well documented complication of incisional refractive procedures, it is rarely encountered as late as one decade after surgery. Patients should be warned of this possibility and the need for prompt treatment.
我们报告了一例46岁女性患者，她在进行无并发症的放射状角膜切开术10年后出现了迟发性微生物性角膜炎。
在她就诊于角膜门诊后，回顾了术前和术后的临床记录。裂隙灯检查显示在先前放射状角膜切开术切口部位有基质炎性浸润。刮取病变组织，在增菌肉汤中培养出凝固酶阴性金黄色葡萄球菌。
联合强化局部抗生素成功治疗了角膜炎，未出现视力丧失。
虽然微生物性角膜炎是切口屈光手术的一种有充分记录的并发症，但在手术后十年这么晚才出现却很少见。应告知患者有这种可能性以及及时治疗的必要性。
