PSEUDOMONAL KERATITIS IN SOFT CONTACT LENS WEARER : ABOUT TWO CASES

Published 2022 - 26th ESCRS Winter Meeting

Reference: P163 | Type: Abstracts | DOI: 10.82333/hzwf-qm45

Authors: Moctar Issiaka* ¹ , Soukaina Bahti ² , jihane Ait El Haj ³ , Adil Mchachi ⁴ , Leila Benhmidoune ² , Rayad Rachid ² , Mohamed El Belhadji ²

¹ophtalmologie Adultes ,hopital 20 Aout 1953, CHU Ibn Rochd ,casablanca,Morocco, ²ophtalmologie Adultes,Hopital 20 Aout 1953, Chu Ibn Rochd,casablanca,Morocco, ³ophtalmologie Adultes,hopital 20 Aout 1953, Chu Ibn Rochd,casablanca,Morocco, ⁴ophtalmologie Adultes,Hopital 20 Aout 1953, Chu ibn Rochd,casablanca,Morocco

Purpose

Report of two cases of unusual pseudomonal keratitis associated with the use of daily silicone hydrogel contact lenses.

Setting

Microbial keratitis is potentially sight-threatening and has long been strongly associated with contact lens wear. Even with fully comply with care and wearing. Studies and laboratories had linked overnight wear to an increased risk of microbial keratitis,also the use of low-Dk hydrogel contact lenses by creating significant corneal hypoxia.

Methods

Two cases who developed culture-positive keratitis linked to pseudomonas aeroginosa, despite consistent daily wear of hydrogen silicone lenses.

Results

The 2 patients had no significant risk factors. The first case involving a 31-year-old woman who reported consistent and infrequent use of daily silicone hydrogel contact lenses presented with a rapid onset after just 2 months. The culture was positive for pseudomonas aeruginosa. The corneal ulcer was successfully treated with a fortified antibiotic, the best corrected visual acuity of 14/20 was reached after 6 weeks, despite the persistence of sequellar stromal opacity. The 2nd case is a 29-year-old woman who had been using conventional soft contact lenses, before switching to daily disposable silicone hydrogel contact lenses, for a maximum daily wear of 8-10 hours, developed severe keratitis in his left eye after 4 months of wearing. The evolution was marked by the extension of the abscess and a corneal perforation despite the maximum treatment from the outset. She obtained a transfixing keratoplasty allowing to obtain a better final visual acuity corrected to 8/20.

Conclusion

Even rare, microbial keratitis remains a serious and potentially blinding complication of contact lens wear. P. aeruginosa is the most frequent organism implicated in contact lens-related keratitis,requiring rapid,intensive ,and adequate treatement. The clinical performance and advenced materials of silicone hydrogel lenses used on a daily-wear had reduced many hypoxic complications.