角膜接触镜相关感染性角膜炎20例临床特征

doi:10.3760/cma.j.cn115909-20200609-00250

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Abstract Objective: To observe the clinical presentation and outcomes of corneal contact lens-related infectious keratitis, in order to provide a reference for clinical diagnosis and treatment. Methods: Patients who were hospitalized from July 2009 to June 2019 due to contact lens-related infectious keratitis were retrospectively reviewed. The risk factors of lens care, symptoms and signs, characteristics of corneal infection focus, results of etiological examination, treatment process and prognosis of the patients were collected and analyzed. Results: A total of 20 patients (23 eyes) were included in the study, 12 females and 8 males, with an average age of 21.4. Seventy-two percent of high-risk lens care (8/11) were wearing lenses for several days and washing the lenses in tap water. The most common clinical symptoms were foreign body sensation, pain, redness and vision loss. The ulcer in 15 eyes was located in the optic axis and paraoptic areas, and 8 eyes in the peripheral area. The positive rate of etiological examination was 35% (8/23). Acanthamoeba infection was found in 4 eyes, including 2 eyes combined with staphylococcus epidermidis infection, 3 eyes with pseudomonas aeruginosa infection and 1 eye with staphylococcus epidermidis infection. Sixteen eyes were successfully treated with drugs, and 7 eyes were successfully treated by surgery combined with drugs. Treatment outcomes were excellent in 8 eyes (35%), good in 9 eyes (39%), and poor in 6 eyes (26%). Conclusions: Wearing lenses for several days and washing them in tap water are the important risk factors of contact lens infection. Ulcers mainly occur in the optic axis and paraoptic areas. Acanthamoeba and pseudomonas aeruginosa are the most common pathogens. After timely and reasonable drug and surgical treatment, most of the patients can obtain satisfactory results.

Key words： contact lens infectious keratitis risk factors clinical characteristics treatment outcome

Received: 09 June 2020

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Fund: National Natural Science Foundation of China (81870639, 82070923); Taishan Scholars Program (20150215, 201812150); Talent Project of "Academic Promotion Program" of Shandong First Medical University (2019RC009)

Corresponding Authors: Hua Gao, Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China (Email: hgao@sdfmu.edu.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200609-00250 OR https://www.cjoovs.com/EN/Y2020/V22/I12/922

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