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2例患者使用妥布霉素—地塞米松滴眼液后出现角膜溃疡。例1男,54岁,因右眼新生血管性青光眼、右眼中央静脉阻塞行青光眼阀植入术。术后给予妥布霉素—地塞米松滴眼液滴眼,1滴/h。第7天,患者右眼颞侧角膜缘出现一椭圆形浅溃疡,深达1/3角膜厚度,溃疡边缘呈灰色水肿。角膜刮片检查及细菌、真菌培养均呈阴性。考虑角膜溃疡与妥布霉素—地塞米松滴眼液有关。停用该滴眼液,给予重组牛碱性成纤维细胞生长因子滴眼液和羧甲基纤维素钠滴眼液,并口服维生素C和维生素B2。停药第2天,角膜溃疡完全愈合。例2女,28岁,因左眼外伤性白内障、左眼晶状体半脱位行左眼白内障摘除和人工晶体植入术。术后给予妥布霉素—地塞米松滴眼液滴眼治疗,1滴/h。第3天患者左眼颞侧角膜缘出现一条带状溃疡,深达2/3角膜厚度,溃疡边缘呈灰色水肿。角膜刮片检查及细菌、真菌培养均为阴性。考虑角膜溃疡与托布霉素—地塞米松滴眼液有关。停用该滴眼液,给予重组牛碱性成纤维细胞生长因子滴眼液和羧甲基纤维素钠滴眼液,并口服维生素C和维生素B2。停药第3天,角膜溃疡完全愈合。
Corneal ulcers occurred in 2 patients using tobramycin-dexamethasone eye drops. Example 1 Male, 54 years old, because of right eye neovascular glaucoma, right eye central vein obstruction of glaucoma valve implantation. Postoperative tobramycin - dexamethasone eye drops, 1 drop / h. On day 7, an oval shallow ulceration appeared on the temporal corneal edge of the right eye with a depth of 1/3 of the corneal thickness and a gray edema at the edge of the ulcer. Corneal scraper examination and bacterial and fungal cultures were negative. Consider corneal ulcer and tobramycin - dexamethasone eye drops. The ophthalmic solution was discontinued and reconstituted bovine basic fibroblast growth factor eye drops and sodium carboxymethylcellulose eye drops were administered, and vitamin C and vitamin B2 were orally administered. On the second day after stopping, corneal ulcer completely healed. Case 2 female, 28 years old, left eye traumatic cataract, left lens subluxation left eye cataract extraction and intraocular lens implantation. Postoperative administration of tobramycin - dexamethasone eye drops treatment, 1 drop / h. On the third day, a strip-shaped ulceration appeared on the temporal corneal edge of the left eye, with a depth of 2/3 of the cornea and a gray edema on the edge of the ulcer. Corneal scraping examination and bacterial and fungal culture were negative. Consider corneal ulcer and tobramycin - dexamethasone eye drops. The ophthalmic solution was discontinued and reconstituted bovine basic fibroblast growth factor eye drops and sodium carboxymethylcellulose eye drops were administered, and vitamin C and vitamin B2 were orally administered. On the third day after stopping, corneal ulcer completely healed.