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Treatment of Pseudomonas Keratitis by Continuous Infusion of Topical Antibiotics With the Morgan Lens

Wang, Mingwu MD, PhD; Smith, Whitney A. MD; Duncan, Joshua K. DO; Miller, Joseph M. MD, MPH

doi: 10.1097/ICO.0000000000001128
Case Report

Purpose: Despite following standard treatment, Pseudomonas keratitis can continue to progress and result in loss of vision or of the eye. Our cases demonstrate that the Morgan Lens can be an effective topical antibiotic delivery vehicle in advanced keratitis.

Methods: Two patients (3 eyes) with Pseudomonas keratitis were included in this report after failing to respond to intense inpatient topical treatment. Because loss of the eyes was imminent, the Morgan Lenses were used for continuous lavage with ceftazidime (50 mg/mL), in conjunction with other conventional treatment.

Results: Three days after lavage, corneal cultures became negative in all eyes. Infusion was continued for at least a week to ensure sterilization of the infection before switching to standard topical therapy. The infection in both cases was promptly eradicated and the eyes were rescued.

Conclusions: The Morgan Lens can be a viable alternative in treating severe and aggressive infectious keratitis or sclerokeratitis. Application of the Morgan Lens is noninvasive and requires minimal training. Intravenous tubing connectors allow for easy swapping between medications, simultaneous administration of multiple medications, and titration of dosing. Additionally, it is cost-effective as the low demand for nursing care essentially eliminates the need for intensive care unit admission.

*NeuVision Medical Institute, Tucson, AZ;

Department of Ophthalmology and Visual Science, College of Medicine, University of Arizona, Tucson, AZ;

Updegraff Laser Vision, St Petersburg, FL; and

§Department of Ophthalmology, Baylor College of Medicine, Houston, TX.

Reprints: Mingwu Wang, MD, PhD, Cornea Associates, 6422 E. Speedway Boulevard, Suite 100, Tucson, AZ 85710 (e-mail: mingwuwang@hotmail.com).

The authors have no funding or conflicts of interest to disclose.

Received September 22, 2016

Received in revised form November 13, 2016

Accepted November 16, 2016

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