TY - JOUR
T1 - Polymicrobial keratitis after a collagen cross-linking procedure with postoperative use of a contact lens
AU - Zamora, Katherine V.
AU - Males, John J.
PY - 2009/5
Y1 - 2009/5
N2 - PURPOSE: To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus. METHOD: Case report. RESULT: A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings. CONCLUSIONS: Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
AB - PURPOSE: To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus. METHOD: Case report. RESULT: A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings. CONCLUSIONS: Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
KW - Collagen cross-linking
KW - Keratitis
KW - Streptococcus oralis
KW - Streptococcus salivarius
KW - UV-A
UR - http://www.scopus.com/inward/record.url?scp=67650616270&partnerID=8YFLogxK
U2 - 10.1097/ICO.0b013e31818d381a
DO - 10.1097/ICO.0b013e31818d381a
M3 - Article
C2 - 19411973
AN - SCOPUS:67650616270
SN - 0277-3740
VL - 28
SP - 474
EP - 476
JO - Cornea
JF - Cornea
IS - 4
ER -