Abstract

SA.18.10

Infectious serious keratitis and contact lenses in Bordeaux University Hospital

Nicolas Mesplié
Bordeaux, France (sannico@aliceadsl.fr)

Objective: To study clinical and microbiological characteristics of patients affected by serious infectious keratitis under contact lens wear in Bordeaux.
Methods: A retrospective study of 112 patients presenting serious infectious keratitis was conducted over 20 months. Risk factors, initial description, positive bacteriological cultures of corneal smears, bacteria and antibiogram were listed. Infectious serious keratitis under contact lens were selected.
Results: 112 patients were hospitalized. Bacteriological and mycosis cultures of corneal smears isolated an organism in 67 of cases. Risk factors were contact lens wear in 28%. On one hand, pseudomonas aeruginosa (10), staphylocoque coagulase negative (6) were the most frequent species with contact lens smear. In the pseudomonas aeruginosa keratitis, there were an anterior chamber inflammation in 66% of cases, with hypopion in 53% of cases and stromal defect in 30% of cases, leading to a corneal graft in 13% of cases.
Pseudomonas aeruginosa and coagulase negative staphylococcus were sensitive in 100% of cases to ciprofloxacin. On the other hand, we noted 6 cases of amoebic keratitis and 4 cases of mycotic (fusarium) keratitis concomitant to the use of Renu Moisture Loc. Various clinical forms were noted, fulminant, subacute and chronic. Corneal graft were made in all fulminant forms, nevertheless infection was not controlled.
Conclusions: In this study, pseudomonas aeruginosa keratitis can perforate cornea and may impose immediate corneal graft. Ciprofloxacin was effective against some species responsible of bacterial keratitis. Amoebic and fusarium keratitis have a more reserved prognosis, depending on the clinical forms of the infection.

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