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LASIK术后非结核分枝杆菌性角膜炎6例临床分析
作者:梁庆丰  …  文章来源:首都医科大学附属北京同仁医院眼科中心 北京市眼科研究所  点击数1424  更新时间:2005/6/30 10:40:07  文章录入:lqflucky  责任编辑:毛进
【摘要】目的:通过6例患者的临床分析探讨LASIK术后NTM性角膜炎的临床特点。方法:对2003年9月至2004年10月诊治的6例LASIK术后拟似NTM角膜感染患者的临床表现、治疗、危险因素及预后进行回顾分析。结果: LASIK术后NTM角膜炎6例(女性5例,男性1例),平均年龄25.2岁,平均起病时间为术后6天。角膜浅基质层的点状、片状灰白色浸润灶是该病共同临床体征。阿米卡星滴眼液联合左氧氟沙星、妥布霉素滴眼液治疗有效,必要时须联合手术治疗。睑缘炎、激素使用史及医源性感染可能是本病的危险因素。结论:LASIK术后患者角膜基质层出现点状、片状灰白色浸润灶应高度怀疑NTM角膜感染的发生,患者因素和医源性感染是其重要的危险因素,阿米卡星滴眼液是有效的治疗药物。 【Abstract】Objective: To discuss clinical feature of NTM keratitis after LASIK by retrospective analysis of 6 cases. Methods: To review 6 cases with NTM keratitis post-LASIK from September, 2003 to October, 2004 and discuss the clinical manifestations, treatments, risk factors and prognosis about this keratitis. Results: A retrospective analysis on clinical and laboratory data was performed on 6 patients with NTM keratitis after LASIK. Infiltrates appeared 6 days after surgery. The typical common clinical feature was multifocal dense superficial stromal infiltrates. Amikacin combined with Tobramycin, Levoofloxacin were effective for treatment of NTM keratitis. Surgical treatment was a useful adjunctive method in cases poorly responsive to medical therapy. Conclusion: Postoperative NTM keratitis could be suspected in a patient whose cornea appeared multifocal dense superficial stromal infiltration after LASIK. The source of infection would come from patient or hospital. Topical Amikacin appeared to be an effective treatment for these infections.
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