Photorefractive Keratectomy Treatment for Myopia and Concomitant Corneal Scar after Fungal Keratitis

施行雷射屈光性角膜切削術以治療近視和黴菌性角膜炎後相伴隨之角膜結痂

莊雅鈞(Ya-Chun Chuang) ； 黃奕修(Yih-Shiou Hwang) ； 馬惠康(David Hui-Kang Ma) ； 林耕國(Ken-Kuo Lin) ； 陳宏吉(Hung-Chi Jesse Chen)

《中華民國眼科醫學會雜誌》 49卷4期 (2010/12) Pp. 616-622

https://doi.org/10.30048/ACTASOS.201012.0015

摘要

目的：報告一病患經過藥物治療而自黴菌性角膜炎(fungal keratitis)恢復15個月後，成功施行雷射屈光性角膜切削術(PRK)矯正雙眼近視(myopia)，並去除右眼相伴隨之角膜瘢痕(corneal scar)。
方法：一30歲配戴隱形眼鏡之男性，罹患右眼黴菌性角膜炎（茄形鐮胞菌）。經抗黴菌眼藥水治療兩個月後，結果產生基質瘢痕，再經15個月後施行雙眼之雷射屈光性角膜切削術。
結果：病患成功施行雙眼雷射屈光性角膜切削術，術中並發現無併發症。術後四年角膜仍維持清澈且無菌，且最佳矯正視力達到1.0。
結論：雷翱茁光性角膜切削術在黴菌性角膜炎治癒後施行，可以同時去除角膜瘢痕以及矯治屈光不正，且無黴菌性角膜炎之復發。

並列摘要

Purpose: To report a patient who recovered clinically from fungal keratitis underwent photorefractive keratectomy (PRK) successfully to correct bilateral myopia and to remove concomitant corneal scar in the right eye 15 months after anti-fungal treatment. Method: A 30-year-old man with a history of contact lens wearing had fungal keratitis (Fusarium solani ) in the right eye. The keratitis was treated by topical anti-fungal treatment for two months with resultant stromal scar. Later PRK was performed in both eyes after 15 months.
Result: The patient underwent a smooth procedure of PRK in both eyes. No complications were observed intraoperatively. Four years after PRK, the right cornea remained both transparent and sterile, with best-corrected visual acuity (BCVA) of 20/20.
Conclusion: PRK surgery can be conducted in patients with cured fungal keratitis to both remove the corneal scar and to correct the refractive error simultaneously without recurrence of fungal keratitis.

並列關鍵字

corneal scar ； fungal keratitis ； myopia ； photorefractive keratectomy PRK