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목적 : To determine the bacteriological spectrum of the removed therapeutic soft contact lenses(TSCLs), and to establish the efficacy of prophylactic antibiotics on TSCLs used for 2 weeks in the treatment of recurrent corneal erosion syndrome(RCES) patients.
방법 : This study included idiopathic RCES treated using highly oxygen-permeable silicone hydrogel contact lenses(CLs), and treated four times a day with topical tobramycin 3% for 2 weeks. After the TSCLs were applied for 2 weeks, the lenses were removed with sterile forceps under the speculum was inserted and placed on blood agar with the inner face down. The TSCLs were analyzed for bacterial colonization and antibiotic susceptibility tests were performed for the isolates, by using disk diffusion.
결과 : Of the 40 lenses analyzed, 9(22.5%) yielded positive cultures. Staphylococcus epidermidis was the most commonly isolated microorganism. Furthermore, we found two lenses that were colonized by Enterobacter gergoviae and Citrobacter freundii. All cultured bacteria showed intermediate or complete sensitivity to Ciprofloxacin, Tigecycline, and Tobramycin. Despite bacterial colonization in 9 contact lenses, no clinical signs of infectious keratitis were found in any of the patients with prophylactic topical tobramycin 3%.
결론 : Despite their hyperoxygen-transmissibility, TSCLs cannot prevent bacterial colonization, and the risk of microbial keratitis is still high in RCES patients. Thus, in case of long-term usage with TCLS, it should be added topical tobramycin 3% as the prophylactic antibiotics for preventing secondary corneal infections.
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