Infectious keratitis after corneal crosslinking: systematic review.
Infectious keratitis after corneal crosslinking: systematic review.
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DOI：
10.1097/j.jcrs.0000000000000620
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发表时间：
2021-08-01
影响因子：
2.8
通讯作者：
Robertson DM
中科院分区：
文献类型：
--
作者：
Murchison CE;Petroll WM;Robertson DM
角膜交联是FDA批准的治疗方法，用于治疗圆锥角膜患者的角膜并预防角膜扩张的进展。标准程序包括在治疗前去除角膜上皮（上皮脱落）。标准程序的变化包括加速交联和经上皮程序。本研究回顾了已知的关于上皮脱落交联后感染的风险、病原体谱和临床结局。确定了26份出版物。术后配戴绷带型接触透镜。现有数据表明，上皮脱落交联后感染性角膜炎的总体发生率较低。细菌感染是最常见的，平均在手术后4.8天出现。术后即刻使用类固醇和绷带角膜接触镜和/或有特应性或疱疹性疾病史与感染相关。这些患者需要严格的术后护理，并在适当时进行预防性抗病毒治疗。
Corneal crosslinking is an FDA approved therapy to stiffen the cornea and prevent progression of corneal ectasia in patients with keratoconus. The standard procedure involves removal of the corneal epithelium (epithelial-off) prior to treatment. Variations to the standard procedure include accelerated crosslinking and transepithelial procedures. This study reviewed what is known regarding the risk for infection following epithelial-off crosslinking, the spectrum of pathogens, and clinical outcomes. Twenty-six publications were identified. All eyes were fit with a bandage contact lens post-operatively. Available data indicate that the overall frequency of infectious keratitis after epithelium-off crosslinking is low. Bacterial infections are the most common, presenting an average of 4.8 days after surgery. The use of steroids and bandage contact lenses in the immediate postoperative period and/or a history of atopic or herpetic disease were associated with infection. These patients require intense post-operative care with prophylactic anti-viral therapy when appropriate.
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