使用多年的夜戴型角膜塑形片之角膜綠膿桿菌感染－個案報告

Pseudomonas Corneal Ulcer Related to Nocturnal Orthokeratology-Lens Used for Years-A Case Report

許伯熙(Po-His Hsu) ； 劉智誠(Jyh-Cheng Liou) ； 彭美玲(Mei-Lin Peng) ； 詹秋忠(Chiu-Chung Tsan)

《中華民國眼科醫學會雜誌》 43卷3期 (2004/09) Pp. 204-208

https://doi.org/10.30048/ACTASOS.200409.0010

摘要

目的：本篇報告一位已使用四年的夜戴型角膜塑形片的病患所引起的角膜綠膿桿菌感染。
方法：單一病例報告。
結果：本文報告感染病例為一11歲男性，已使用四年夜戴型角膜塑形片，在泡溫泉後左眼紅痛轉診至本院。門診初診時，左眼視力矯正0.2，角膜潰瘍2×3mm，前房清澈；住院當晚，左眼視力快速降至指數20公分，且出現前房蓄膿。經細菌培養後為綠膿桿菌，以Vancomycin合併使用Ceftazidine點眼治療，並加Amikacin結膜下注射，其前房蓄膿則快速消退；病患在七日後角膜癒合結疤，一個月後左眼最佳矯正視力為0.7，留下3×4角膜疤痕。
結論：夜戴型角膜塑形片即便使用多年，仍是角膜感染的高危險因子，需密切追蹤。

並列摘要

Purpose: To report a case of pseudomonas corneal ulcer related to nocturnal orthokeratology-lens used for 4years
Method: case report
Result: A 11-year-old boy who had myopia and received nocturnal orthokeratology treatment for 4 years. He got the left eye redness with pain after hot spring bathing two days before visiting our hospital. The best corrected visual acuity was 4/20 at out patient department, and the ulcer was 2×3 mm in size, anterior chamber was clear. The visual acuity decreased rapidly to counting finger at 20cm, and hypopyon was noted at the night of admission. Topical ceftazidine and vancomycin were given hourly, subconjuntival injection with Amikacin was administed. Anterior chamber hypopyon decreased rapidly. The ulcer healed with a scar after 7 days. The culture of the scraped corneal tissue grew P.aeruginosa. The best corrected visual acuity was 14/20 with a scar 3×4 mm in size after one month.
Conclusion: Nocturnal orthokeratology-lens wearing is a potential risk factor for conical ulcer even used for several years.

並列關鍵字

Nocturnal Orthokeratology ； Pseudomonas aeruginosa ； Corneal ulcer