Microbiological study of disposable soft contact lenses after photorefractive keratectomy.

P E Dantas, M C Nishiwaki-Dantas, V H Ojeda, N Holzchuh, L J Mimica
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Abstract

Purpose: To evaluate the bacterial contamination of bandage disposable soft contact lenses used in patients following photorefractive keratectomy (PRK) and to correlate our findings with clinical data.

Methods: Forty-six patients (81 eyes) underwent PRK. Immediately after each procedure, disposable soft contact lenses were positioned with sterile forceps. After 3 days, the lenses were removed in a sterile manner, placed in sterile Eppendorf pipettes containing 8 mL of enriched brain heart infusion broth, and analyzed for microbial contamination.

Results: Seven positive cultures were found: six gram positive cocci (7.4%) and one gram negative bacillus (1.2%). There was no clinical correlation with these findings.

Conclusion: Isolated microorganisms were similar to those described in the literature as agents of bacterial keratitis and are components of the normal ocular flora. Klebsiela pneumoniae--considered an occasional or transient flora--was the exception. All isolated microorganisms but K. pneumoniae were sensitive to most of the antibiotics tested. Our findings suggest that the risk of infectious keratitis after PRK related to soft contact lens wear for 3 days seems to be low, which may be because lenses were not manipulated by the patient during the wearing period, and the postoperative antibiotic regimen was strictly followed by patients. However, care should be taken to instruct patients in proper lens care practices to reduce the risk of bacterial keratitis in contact lens wear following PRK.

光屈光性角膜切除术后一次性软性隐形眼镜的微生物学研究。
目的:评估光屈光性角膜切除术(PRK)患者使用的一次性软性隐形眼镜的细菌污染情况,并将我们的研究结果与临床数据相关联。方法:46例(81眼)行PRK手术。每次手术后,一次性软性隐形眼镜立即用无菌钳定位。3天后,无菌摘除晶体,置于装有8ml浓缩脑心输注液的无菌埃本多夫移液管中,分析微生物污染情况。结果:阳性培养7例,革兰氏阳性球菌6例(7.4%),革兰氏阴性杆菌1例(1.2%)。这些发现与临床无相关性。结论:分离的微生物与文献中描述的细菌性角膜炎病原体相似,是正常眼部菌群的组成部分。肺炎克雷伯菌——被认为是偶然或短暂的菌群——是例外。除肺炎克雷伯菌外,所有分离的微生物对大多数抗生素均敏感。我们的研究结果提示,软性隐形眼镜配戴3 d后PRK发生感染性角膜炎的风险较低,这可能与配戴期间患者未操作隐形眼镜,术后患者严格遵守抗生素治疗方案有关。然而,应注意指导患者进行适当的晶状体护理,以减少PRK后佩戴隐形眼镜发生细菌性角膜炎的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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