ĐẶC ĐIỂM LÂM SÀNG, VI SINH VÀ KẾT QUẢ ĐIỀU TRỊ VIÊM LOÉT GIÁC MẠC SAU CHẤN THƯƠNG

Abstract

Background: Infectious keratitis is one of the leading causes of blindness/ severe vision impairment. That is triggered by an imbalance between ocular surface defense system and microbial overgrowth, in which trauma is the most common risk factor. Due to the disparity between geographical location and socio-economic status, pathologic microorganisms would develop differently. Besides, people’ limited awareness about the severity of disease would partly induce to complications. Thus, prompt diagnosis and right treatment at the beginning is obviously critical related to the efficiency of treatment. As time goes on, clinical and microbiological characteristics may change along with the development of the socio-economic status and pathologic microorganisms. We conduct this research to update the current issues and contribute to prompt diagnosis, improved clinical outcomes. Purpose: To investigate the clinical and microbiological characteristics and correlation between these factors with clinical outcomes of post-traumatic infectious keratitis. Method: An observational prospective study was performed on patients diagnosed with post-traumatic infectious keratitis from May 2023 to November 2023 at the corneal department of Ho Chi Minh city Eye Hospital. A data collection form was used to document patient demographics, risk factors, microbiological diagnosis, pretreatment and posttreatment ocular characteristics. Any contact lens-induced keratitis was excluded from the study. Results: IK was diagnosed in 60 eyes, the mean age was 47 ± 11,1y. significantly more were male (71,7%) than female. The majority of patients (67%) had sustained domestic injury, in which dust is the most common factor (36,7%). The median time between onset of symptoms and presentation to the hospital was 10d. Smear-positive corneal scrapings were 62,7%, culture-positive results were 37,5%. Monomicrobial fungus was the most common (45%), followed by polymicrobial (16,7%). Methicillin – resistant coagulase negative Staphylococci was predominant isolates (86,6%). 98,3% patients had visual acuity less than 3/10 at presentation. 58% patients required surgery, in which 46,7% cases got complications: impending/corneal perforation, persistent corneal epithelial defects. Gluing and wearing contact lens is the most selected method (65,7%). Visual acuity at 6 months was significantly improved than that at presentation (p < 0,05). Conclusion: Post-traumatic keratitis is mainly secondary from domestic injury, dust, blindness is predominant. Fungus is the most common pathologic microorganism.