A Case of Keratitis Caused by Combined Infection of Multidrug-Resistant Acinetobacter Baumannii and Candida Parapsilosis

PURPOSE: To report a case of keratitis caused by Acinetobacter baumannii and Candida parapsilosis in a patient using 0.5% levofloxacin and 0.1% fluorometholone for an extended period of time. CASE SUMMARY: A 55-year-old male patient in the neurosurgery department with conjunctival injection and discharge in his left eye was consulted for ophthalmic evaluation and treatment. He was hospitalized in the state of akinetic mutism and given 0.5% levofloxacin and 0.1% fluorometholone for 2 years. On slit-lamp examination, a 3.5 x 4.5-mm dense stromal infiltrate with an overlying epithelial defect was observed. Corneal scraping culture revealed multidrug-resistant A. baumannii and C. parapsilosis. According to the susceptibility result, the patient was treated with topical 10% piperacillin/tazobactam and 0.125% amphotericin B hourly. The corneal ulcer healed gradually with corneal opacity remaining after 8 weeks of treatment. CONCLUSIONS: The authors of the present study report a case of treated multidrug-resistant A. baumannii and C. parapsilosis keratitis in a patient using topical antibiotics and steroid for an extended period of time.

Clinical Outcomes of Monovision Induced by Presbyopic Correcting Conductive Keratoplasty

PURPOSE: To evaluate the efficacy, safety, and satisfaction of patients who underwent conductive keratoplasty (CK). METHODS: CK was performed in 20 patients between April and December 2009. Surgeries were performed on the dominant eye with emmetropia as the postoperative goal and on the non-dominant eye with mild myopia as the postoperative goal. Patients' satisfaction, refractive change, and visual acuity were evaluated for at least 3 months after the surgery. RESULTS: Preoperatively, the mean manifest refraction spherical equivalent (MRSE) of the non-dominant and dominant patient eyes was 0.56 +/- 0.48 D and 0.88 +/- 0.25 D, respectively. Postoperatively, the mean MRSE of the non-dominant and dominant patient eyes was -1.65 +/- 0.56 D and -0.06 +/- 0.36D at 1 month, -1.33 +/- 0.40 D and 0.17 +/- 0.37 D at 3 months, and -1.10 +/- 0.44 D and 0.31 +/- 0.33 D at 6 months, respectively, indicating significant effect regression. Eleven out of 20 patients (55%) were disappointed with the results of CK. CONCLUSIONS: Conductive keratoplasty led to significant regression of refractive effects during follow-up. Monovision with CK is suggested to be a temporary refractive procedure in patients with presbyopia.