RESUMO
PURPOSE: To review bacterial culture results in infectious keratitis at a tertiary referral center. DESIGN: Retrospective case series. METHODS: Analysis of Gram stain, bacterial culture, and targeted antibiotic sensitivities of all cases of presumed infectious keratitis at Duke University Eye Center from 1997 to 2004 (n = 453). RESULTS: Cultures were positive in 307 cases (68%); 21% demonstrated polymicrobial growth. Among 388 isolates, 81% were Gram-positive. Gram stain results were available in 334 cases, demonstrating 18% sensitivity and 94% specificity. Antibiotic sensitivities revealed 24% resistance of tested S. aureus isolates to cefazolin, and <5% resistance of tested gram-negative isolates to various antibiotics, with no statistically significant increase from 1997 to 2004. CONCLUSIONS: In this study, the microbial profile has remained stable from 1997 to 2004. Gram stain studies were of poor sensitivity, while culture yields were significantly higher and demonstrated a relatively high polymicrobial infection rate. Increasing antibiotic resistance was not clearly demonstrated.
Assuntos
Infecções Oculares Bacterianas/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Ceratite/microbiologia , Antibacterianos/farmacologia , Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Estudos RetrospectivosRESUMO
PURPOSE: To describe a case of a traumatic late dislocation of a laser-assisted in situ keratomileusis (LASIK) flap complicated by epithelial ingrowth. DESIGN: Interventional case report. METHODS: A 50-year-old woman presented 21 months after uncomplicated LASIK with painful vision loss in the right eye after minor trauma. RESULTS: A dislocation of the LASIK flap was noted at examination and was repositioned. One week later, epithelial ingrowth was detected in the flap interface. The ingrowth was treated with flap lifting, debridement, and sealing of the flap with fibrin glue. Visual acuity returned to baseline, and there was no recurrence after 20 months of follow-up. CONCLUSIONS: Traumatic dislocations of LASIK flaps may occur many months after uncomplicated surgery and may be associated with epithelial ingrowth after successful repositioning. The additional use of fibrin glue in conjunction with thorough debridement may be helpful in preventing the recurrence of epithelial ingrowth.