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- OpenAccess
Bilateral Keratitis after Lasik-Report of a Case and Review of the Domestic Literature
原位層狀角膜雷射手術後併發雙眼角膜炎：壹病例報告並回顧國內文獻
摘要
目的：報告處理一原位層狀角膜雷射近視手術(LASIK)術後併發雙眼角膜炎病例的經驗，再由已發表過的病例報告及論文討論其病因，可能之病原，及危險因子。 方法：病例報告 結果：38歲男性，經外院LASIK術後三天，併發雙眼中央角膜瓣下浸潤，雖經處理，仍然因視力持續下降故而轉診至本院。處理是將其皮瓣重新掀開，擴清併取得皮瓣下檢體進行培養，再以廣效性抗生素浸泡皮瓣下後，復位皮瓣。雖然抹片檢查及細菌培養結果並無病原產生，但發炎的情況卻得以控制。最後雙眼中央形成淡淡的結痂，並在六個月後門診追蹤時，視力進步至右眼20/25，左眼20/20。 結論：即使罕見，LASIK術後併發雙眼角膜炎的情況仍不容忽視。由於病原位於皮瓣下，宜儘早進行手術重新掀起皮瓣，取得檢體培養並以抗生素治療將有助於控制病情。
關鍵字
無資料並列摘要
Purpose: To report a case of bilateral, central interface keratitis after simultaneous LASIK procedure and discuss its etiology, pathogenesis, and risk factors by reviewing the literature in this country. Methods: The clinical presentation and course of the case was described and the clinical profiles of the published case series of infectious keratitis after LASIK in Taiwan were reviewed. Case report: A 38-year-old man presented with central interface infiltrates in both eyes on the third day after an uneventful simultaneous LASIK performed elsewhere. The flap was lifted in the left eye to obtain specimen from the interface for laboratory workup, followed by application of broad-spectrum antibiotics on both sides of the interface. Despite negative results from smears and cultures, fortified topical antibiotics were continued, and the infiltrates in both corneas resolved to form faint scars. At the latest follow-up, the patient achieved a best corrected visual acuity of 20/25 in right eye and 20/20 in left eye and without recurrence of infection. Conclusion: Although rare, the occurrence of sight-threatening bilateral keratitis following LASIK should not be overlooked. For infection within the interface, flap lifting is helpful in identification of the pathogens and antibiotics administration.
延伸閱讀
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