재발성 각막미란 환자에서 뚜렷한 각막침윤 없이 생긴 전방염증 및 황반부종 1예

문수영(Su Young Moon),김용규(Yong-Kyu Kim),박성표(Sung Pyo Park) 대한검안학회 2015 Annals of optometry and contact lens Vol.14 No.4

Purpose: We introduce a case of severe anterior chamber reaction without definite corneal infiltration and cystoid macular edema associated with recurrent corneal erosion. Case summary: An 82-year-old woman visited our clinic with blurred vision and ocular pain in her left eye. She had been suffering from Sjogen disease and keratoconjunctivitis sicca for 8 years. She had been treated for recurrent corneal erosion and filamentary keratitis with bandage contact lens and topical lubrication. Slit lamp examination revealed severe anterior chamber reaction with hypopyon and corneal epithelial defect without infiltration. No organism was found in aqueous humor culture. She was treated with bandage contact lenses, topical antibiotics and steroids, and her symptoms were improved. After 18 days, cystoid macular edema developed in her left eye. Macular edema was decreased after intravitreal bevacizumab injection. Conclusions: Recurrent corneal erosion might be accompanied by severe anterior chamber reaction with hypopyon without definite corneal infiltration. This sterile inflammation can be relieved by topical antibiotics and steroids. This also harbors the risk of secondary macular edema, which can be treated with intravitreal anti-vascular endothelial growth factor injection.

반복각막진무름 환자에서 다이아몬드 연마기의 치료 효과

김현주,고재웅 대한안과학회 2018 대한안과학회지 Vol.59 No.8

Purpose: The purpose of this study is to evaluate the recurrence rate and treatment effect of conservative treatment and surgical treatment with diamond burr in reccurent corneal erosion. Methods: Between January 2010 and October 2017, 67 patients who were diagnosed with repeated corneal erosion, 55 patients underwent conservative treatment and 12 patients underwent surgical treatment with a diamond burr were evaluated for the duration of previous treatment, recurrence frequency, symptom severity, visual acuity, and the effect of treatment depending on recurrence. Surgical treatment was performed when corneal epithelial loosening occurred in more than 10% of the cases and the patient required surgical treatment. Conservative treatment was continued in patients who did not want surgical treatment. Results: There were no differences in the mean age, sex, recurrence frequency, symptom severity, and duration of treatment. All 67 patients were unilateral, and 55 patients underwent conservative treatment. Of these, 23 patients (41.8%) showed improvement, and 32 patients relapsed within 6 months. Ten eyes (83.3%) of 12 eyes treated with a diamond burr showed improvement and two eyes recurred within 6 months. The recurrence rate was lower in the diamond burr group than in the conservative group (p = 0.011). In comparison with diamond burr and conservative treatment, the visual acuity of the diamond burr group improved statistically significantly compared to the group with conservative treatment (p = 0.002). Conclusions: In patients with recurrent corneal erosion, surgical treatment with diamond bur was effective in improving visual acuity and preventing recurrence of recurrent corneal erosion than conservative treatment. 목적: 반복각막진무름 환자를 보존 치료와 다이아몬드 연마기를 사용한 수술 처치로 치료한 임상 효과를 문헌고찰과 더불어 알아보고자 한다. 대상과 방법: 2010년 1월부터 2017년 10월까지 본원 안과에서 반복각막진무름을 진단받은 환자 67명 67안을 대상으로 보존 치료를 시행한 55명과 다이아몬드 연마기를 이용한 수술 치료를 시행한 12명의 기존 치료 기간, 재발 횟수, 증상 정도, 초진 시와 6개월 후 시력, 재발 여부에 따른 치료 효과 등을 후향적으로 분석하였다. 수술 처치는 각막상피의 헐거워짐이 전체의 10% 이상을 차지하고 환자가 수술 처치를 원한 경우에 시행하였다. 수술 처치를 원하지 않았던 환자의 경우 보존 치료를 지속하였다. 결과: 환자들의 평균 나이, 성별 및 재발 횟수, 증상 정도, 기존 치료 기간에 따른 두 군의 차이는 없었다. 단안의 총 67안 중, 보존치료를 시행한 환자는 55안으로 이 중 23안(41.8%)에서 호전을 보였고, 32안에서 6개월 내에 다시 재발하였다. 다이아몬드 연마기를 이용한 12안 중 10안(83.3%)에서 호전을 보였고 2안에서 6개월 내에 재발하였다. 다이아몬드 연마기를 사용한 군에서 재발률이 보존 치료를 시행한 군에 비해 통계적으로 유의하게 더 낮았다(p=0.011). 다이아몬드 연마기를 사용한 군과 보존 치료를 시행한 군과의 비교에서는 다이아몬드 연마기를 사용한 군의 시력이 보존 치료를 시행한 군에 비해 통계적으로 유의하게 호전되었다(p=0.002). 결론: 다이아몬드 연마기를 이용한 수술 치료는 보존 치료에 비해 반복각막진무름 환자의 재발률이 낮고, 시력호전이 좋은 효과적인 치료법임을 알 수 있었다.

헤르페스각막염 환자에서 양막이식술의 치험 증례

문수정,이기환,김인철,Su Jung Mun,Ki Hwan Lee,In Cheol Kim 대한안과학회 2006 대한안과학회지 Vol.47 No.11

Purpose: To investigate the effect of amniotic membrane transplantation (AMT) on recurrent herpetic keratitis with unhealed corneal epithelial erosion. Methods: We performed AMT on 5 cases of herpetic keratitis from February 2004 to August 2005. We had applied two layers of fresh amniotic membrane over the corneal lesion and anchored by running suture technique with 10-0 nylon. Results: After AMT, visual acuity improved in 5 eyes of 5 herpetic keratitis patients. In all patients the persistent epithelial erosion was healed and pain was subsided after surgery. Conclusions: The AMT shortened the usage of antiviral agents and antibiotics, increased compliance, and decreased corneal opacity and neovascularization. The AMT is an effective method for managing recurrent herpetic keratitis with unhealed corneal epithelial erosion that are refractory to conventional treatment.

위아래 덧눈꺼풀 교정술을 동시에 시행한 소아에서 수술 후 시력과 난시의 변화

현동원,전찬양,진선영,하명숙,Dong Won Hyun,Chan Yang Jeon,Sun Young Jin,Myung Sook Ha 대한안과학회 2011 대한안과학회지 Vol.52 No.3

Purpose: To study the changes in vision and astigmatism in epiblepharon patients undergoing simultaneous surgery for both upper and lower eyelid epiblepharon. Methods: The study subjects consisted of 40 eyes of 20 patients who underwent surgery for both upper and lower eyelid epiblepharon from March 2007 to December 2008. The patients were divided into groups depending on the degree of corneal erosion. Uncorrected and best corrected vision, refractive error and the degree of corneal erosion were measured before and three months after the surgery. Results: The mean patient age was 7.40 years, and all but three patients showed postoperative grade 0 corneal erosion. Mean uncorrected logMAR visual acuity was 0.44 preoperatively and 0.25 three months after the operation. The mean best corrected logMAR visual acuity was 0.13 preoperatively and 0.04 three months after the operation (p = 0.02, 0.01). Mean astigmatism showed a significant decrease from 1.46 preoperatively to 1.19 three months after surgery (p = 0.03). Conclusions: After simultaneous surgery for upper and lower eyelid epiblepharon in children, uncorrected and best corrected visual acuity and corneal erosion were all improved. The astigmatism was largely with-the-rule, both before and after surgery. J Korean Ophthalmol Soc 2011;52(3):272-276

외상반복각막진무름에서 치료콘택트렌즈 장기 착용과 5% NaCl 점안액 병용치료 효과

권미영,박대진 대한안과학회 2019 대한안과학회지 Vol.60 No.1

Purpose: To evaluate the clinical results of treatment with extended wear of therapeutic contact lenses and 5% NaCl eye drops for traumatic recurrent corneal erosion. Methods: From January 2015 to December 2017, 18 eyes of 18 patients who were first diagnosed with recurrent corneal erosion after trauma were analyzed. The age, sex, and causes of injury of the patients were analyzed. We retrospectively analyzed the recurrence rate, recurrence time, best-corrected visual acuity (BCVA), and complications after treatment with extended wear of therapeutic contact lenses and 5% NaCl eye drops. Results: The mean age was 50.0 ± 12.0 years (range: 27-75 years) with no significant difference in gender and the mean follow up period was 11.6 ± 7.4 months (range: 3.5-28.0 months). Three eyes (16.7%) experienced recurrences and all of them were resolved with a therapeutic contact lens and 5% NaCl eye drops. The initial mean BCVA was 0.35 ± 0.33 logarithm of minimal angle of resolution (logMAR) and the final mean BCVA was 0.09 ± 0.06 logMAR (p = 0.015). There were no significant complications such as bacterial keratitis, hypoxia or sterile infiltration from the extended wear of therapeutic contact lenses. Conclusions: The results imply that long-term combined treatment of extended therapeutic contact lens wear with 5% NaCl eye drops may be a safe and effective therapy. 목적: 외상성 반복각막진무름 환자들에서 치료콘택트렌즈의 장기 착용과 5% NaCl 점안액 유지 병용치료의 효과를 알아보고자 하였다. 대상과 방법: 2015년 1월부터 2017년 12월까지 본원 안과에서 외상에 의한 반복각막진무름을 처음 진단 받은 환자 18명 18안을 대상으로 환자들의 나이, 성별, 외상 원인을 분석하고, 치료콘택트렌즈 장기 착용과 5% NaCl 점안액을 유지 병용치료 후 반복각막진무름의 재발률, 재발 시기, 치료 후 최대교정시력, 합병증 유무에 대해 후향적 연구를 시행하였다. 결과: 환자 평균 나이는 50.0 ± 12.0세(27-75세)였고, 성별의 차이는 없었다. 평균 관찰기간은 11.6 ± 7.4개월(3.5-28.0개월)이었다. 18안 중 치료 후 재발한 환자는 3안(16.7%)이었고 3안 모두 치료콘택트렌즈 착용과 5% NaCl 점안액을 유지한 후 증상이 소실되었다. 18명 환자의 치료 전 최대교정시력은 0.35 ± 0.33 logarithm of minimal angle of resolution (logMAR)이고 치료 후 최종 최대교정시력은 0.09 ± 0.06 logMAR이었다(p=0.015). 치료콘택트렌즈의 장기 착용에 의한 세균각막염이나 저산소증, 무균침윤 등의 부작용은없었다. 결론: 외상반복각막진무름 환자에서 치료콘택트렌즈의 장기 착용과 5% NaCl 점안액 장기간 병용치료는 안전하고 효과적인 치료 방법으로 생각된다.

반복각막진무름에서 Nd:YAG Laser 치료와 보존적 치료의 비교

최문정(Moon jung Choi),정지원(Ji Won Jung),서경률(Kyoung Yul Seo),김응권(Eung Kweon Kim),김태임(Tae Im Kim) 대한안과학회 2015 대한안과학회지 Vol.56 No.5

목적: 반복각막진무름에서 Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser 치료와 보존적 치료의 효과를 비교하고자 한다. 대상과 방법: 반복각막진무름을 진단 받은 환자에서 Nd:YAG laser를 시행한 23안과 고삼투압제제를 포함한 보존적 치료를 시행한 24안을 대상으로 재발 유무, 양상, 빈도, 재발하기까지의 시간, 치료 후 최대교정시력, 합병증 유무에 대해 후향적 연구를 시행하였다. 결과: 재발률은 Nd:YAG laser를 받은 군에서 56.5%, 보존적 치료를 시행한 군에서 50.0%로 통계학적으로 유의미한 차이를 보이지 않았으나(p=0.654) 보존적 치료를 한 환자 중 재발한 12안 중 10안은 각막상피 결손을 동반한 형태로 재발하여 Nd:YAG laser군에서의 13안 중 5안보다 재발의 정도가 심함을 보여 주었다(p=0.041). 두 군 모두 시술 후 1년까지는 치료 성공률이 각각 64.1%, 60.5%였으나 시간이 지나면서 재발률이 상승하였고(p=0.649), 치료 후 최종 시력은 Nd:YAG laser를 받은 환자에서 0.05 ± 0.06 logMAR, 보존적 치료를 받은 환자에서 0.09 ± 0.08 logMAR로 유의한 차이를 보이지 않았으며(p=0.110) 두 군 모두에서 각막반흔 등의 합병증은 없었다. 결론: 반복각막진무름에서 Nd:YAG laser 치료와 보존적 치료의 재발률은 유의한 차이를 보이지 않았으나 재발 후 중증도는 Nd:YAG laser 치료가 보존적 치료보다 경미하였다. <대한안과학회지 2015;56(5):687-693> Purpose: To compare the treatment effects of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser and conservative manage-ment in treatment of recurrent corneal erosion. Methods: Twenty-three eyes that received Nd:YAG laser treatment and 24 eyes that underwent conservative management in-cluding hyperosmotic agent were retrospectively reviewed for the rate and frequency of recurrence, presentation, time to re-currence, final visual acuity and complications. Results: The rate of recurrence in eyes treated with Nd:YAG laser was 56.5% and that in eyes with conservative management was 50.0%. The difference was not statistically significant (p = 0.654). However, 10 of 12 eyes that recurred after conservative treatment presented with macroform erosion at the time of recurrence, whereas 5 of 13 eyes that recurred after Nd:YAG laser had an accompanying epithelial defect (p = 0.041). After the Nd:YAG laser treatment or conservative treatment, 64.1% and 60.5% of the eyes, respectively, remained free from recurrence 1 year after treatment, however the success rate decreased over time (p = 0.649). The final visual acuity in the group that received Nd;YAG laser treatment was 0.05 ± 0.06 log MAR and 0.09 ± 0.08 log MAR (p = 0.649) in the group that received conservative management. None of the patients in either group experienced complications of corneal scarring. Conclusions: The difference in the recurrence rates between Nd:YAG laser treatment and conservative treatment were not stat-istically different, however, the severity of recurred episodes were milder in the eyes that received Nd:YAG laser treatment. J Korean Ophthalmol Soc 2015;56(5):687-693

반복각막진무름에서 전안부빛간섭단층촬영으로 관찰되는 비정상 소견에 대한 임상분석

김유민,엄희동,윤동희,김홍균 대한안과학회 2019 대한안과학회지 Vol.60 No.12

Purpose: To evaluate the correlation between abnormal findings seen in anterior segment optical coherent tomography and the recurrence rate in patients with recurrent corneal erosion syndrome. Methods: Between January 2015 and August 2018, 53 eyes of 52 patients who had been diagnosed with recurrent corneal erosion syndrome were included in the study. Follow-up was performed for 12 months. To confirm the recurrence, we questioned the subjects on their symptoms and performed slit lamp examinations. At the first visit, the second week, and the first month, we performed anterior segment optical coherent tomography to identify pathologic findings for recurrent corneal erosion syndrome. Results: In 12 months, 29 eyes (54.7%) had a recurrence of corneal erosion and 24 eyes (45.3%) had no recurrence. There was no significant difference in age, sex, trauma, diabetes mellitus, or meibomian gland dysfunction between the recurrent and non-recurrent groups. Among the anterior segment optical coherent tomography findings, anterior stromal hyper-reflectivity, undetected epithelial basement membrane, intraepithelial basement membrane, intraepithelial inclusions were not significantly different between the two groups. In the first month, corneal epithelial edema was 82.8% in the recurrent group, but 33.3% in the non-recurrent group. It was significantly different (p = 0.000). Corneal epithelial thickness lowered significantly in the non-recurrent group, but not in the recurrent group in the first month. In other words, epithelial edema improved in the non-recurrent group, whereas epithelial edema did not improve in the recurrent group. Conclusions: If corneal epithelial edema is not treated in patients with recurrent corneal erosion syndrome, high possibility of a recurrence should be considered. 목적: 반복각막진무름환자들에서 전안부빛간섭단층촬영으로 확인되는 비정상 소견에 대한 분석과 재발률 사이의 상관관계를 알아보고자 하였다. 대상과 방법: 2015년 1월부터 2018년 8월 사이에 본원 안과에서 반복각막진무름을 진단받은 52명, 53안을 대상으로 하였다. 경과 관찰은 12개월 동안 이루어졌으며 재발 여부를 확인하기 위해 문진 및 세극등현미경검사를 시행하였다. 첫 방문, 2주째, 1개월째 전안부빛간섭단층촬영을 시행하여 반복각막진무름의 비정상 소견을 확인하였다. 결과: 12개월의 경과 관찰기간 동안 각막진무름이 재발한 경우는 29안(54.7%), 재발하지 않은 경우는 24안(45.3%)이었다. 재발한 군과 재발하지 않은 군 간의 나이, 성별, 외상력, 당뇨, 마이봄샘기능부전 유무는 유의한 차이가 없었다. 전안부빛간섭단층촬영 시 나타나는 반복각막진무름의 비정상 소견 중 전측실질의 고반사성, 각막상피바닥막의 소실, 상피내 바닥막, 상피내 내포물은 재발한 군과 재발하지 않은 군에서 유의한 차이를 보이지 않았으나, 상피부종은 1개월째 재발한 군에서는 82.8%, 재발하지 않은 군에서는 33.3%로 두 군 간의 유의한 차이를 보였다(p=0.000). 경과 관찰 1개월 동안 재발하지 않은 군에서는 각막상피두께가 유의하게 감소하였으나, 재발한 군에서는 유의하게 감소하지 않았다. 다시 말해 재발하지 않은 군에서는 각막상피부종이 호전되었으나, 재발한 군에서는 각막상피부종이 지속되었다. 결론: 반복각막진무름환자에서 각막상피부종이 지속되는 경우 높은 재발 가능성을 고려하여 주의 깊은 관찰과 치료가 필요하다.

각막굴절수술 전후 각막 염색 디지털 사진과 정량적 테스트를 이용한 각막미란 및 안구건조증의 평가: 라식과 라섹의 임상 양상 비교

김유진,두하영,마기중 대한시과학회 2007 대한시과학회지 Vol.9 No.3

각막 굴절교정수술 전후 각막미란 및 안구건조증에 대한 변화양상을 비교하기 위해 정량적 검사지표와 Diagnostic corneal surface digital photography를 이용한 Oxford corneal stain grading scheme을 사용하여 이들 검사지표의 변화와 유용성을 분석하고, LASIK 과 LASEK 시술군의 차이를 비교하고자 하였다. 굴절교정수술을 위해 내원한 환자 134명 (267안)을 대상으로 한 명의 술자가 LASIK(110안)과 LASEK(157안)을 시행하였고, 수술 방법에 따라 두 군으로 나누어, 술 전과 술 후 7일, 1개월, 3개월 및 6개월에 각각 Tear break-up time(TBUT), Fluorescein stained corneal surface digital photography를 시행하였고, 또한 술 전과 술 후 1개월 3개월에 Schirmer test를 시행하여, 술 후 각막미란 및 안구건조증 검사지표의 변화양상을 관찰하였다. Digital photography 에서 Corneal staining은 Oxford scheme을 이용하여 하였다. 안구건조증에 대한 정량적 검사 지표는 두 군 모두 수술 초기에 건조증이 심하였다가 시간이 경과할수록 회복되는 양상을 보였다. TBUT와 Schirmer test는 추적 관찰기간 내내 술전 보다 낮았고(p The purpose of this study is to assess the clinical applicability of Oxford corneal stain grading using diagnostic corneal surface digital photography in corneal erosion and dry eye syndrome after corneal refractive surgery. Two hundred and sixty seven eyes of 134 patients were enrolled in this study. LASIK was performed in 110 eyes and LASEK was performed in 157 eyes. All the surgery was done by a single surgeon. Tear beak-up time(TBUT) and fluorescein stained corneal surface digital photography were performed preoperatively and on postoperative day 7, 1 month, 3 months, and 6 months. Schirmer test was performed preoperatively and on postoperative 1 month and 3 months in order to evaluate the clinical aspects of dry eye syndrome. Dry eye syndrome which was assessed using TBUT and Schirmer test, was aggravated at early postoperative period but improved after time in both LASIK and LASEK group. Postoperative TBUT and Schirmer test were significantly lower than that of the preoperative in all follow-up periods(p < 0.05) and LASIK group showed significantly lower postoperative TBUT and Schirmer test values than LASEK group(p < 0.05). Fluorescein staining grading showed aggravating corneal erosion until the postoperative 3 months but showed improvement to the preoperative level at postoperative 6 months. Although the LASEK group had more corneal erosion until postoperative day 7, the LASIK group had more corneal erosion on postoperative 1 month and afterwards. In conclusion, the corneal surface digital photography using fluorescein staining grading is an effective and objective method in assessing the corneal erosion and dry eye syndrome since it can show directly the true morphologic corneal damage and reflect the severity of the disease. Moreover, it showed that LASIK could induce more severe corneal erosion and dry eye syndrome than LASEK.

데스메막박리 자동각막내피층판이식술 후 발생한 난치성 반복각막진무름의 치료

김민정(Minjeong Kim),오자영(Ja Young Oh),김경우(Kyoung Woo Kim) 대한안과학회 2022 대한안과학회지 Vol.63 No.1

목적: 홍채각막내피증후군에서 데스메막박리 자동각막내피층판이식술 후 발생한 난치성 반복각막진무름의 치료 증례에 대해 보고하고자 한다. 증례요약: 좌안 홍채각막내피증후군을 동반한 62세 남자 환자에서 데스메막박리 자동각막내피층판이식술을 시행하였다. 수술 중 시야 확보를 위해 각막상피를 15번 블레이드로 제거했고, 내피 이식편을 전방 내 삽입하기 전 3군데 각막 통기 절개를 시행하였다. 술 후 1주째 각막상피는 재생되었으나 2주째 상피가 분리되어 느슨한 상피를 제거한 후 치료콘택트렌즈를 착용하였다. 이후 반복적 상피 제거, 치료콘택트렌즈 착용, 5% 염화나트륨 및 자가혈청안약 점안, 독시사이클린, 스테로이드, 발라시클로버 복용에도 불구하고 호전되지 않았고, 이후 3차례의 전부 각막기질천자를 시행하여 8주째 각막상피가 유착되었다. 10주째 각막진무름은 더 이상 관찰되지 않았으나 급성 거부 반응이 발생하여 면역억제치료 후 호전되었다. 술 후 1년째 백내장수술 시행 후 교정 시력은 0.8이었다. 결론: 데스메막박리 자동각막내피층판이식술 후 난치성 반복각막진무름이 발생할 수 있으며 반복적인 전부 각막기질천자를 통한 적극적인 치료가 도움이 될 수 있겠다. Purpose: To report a case of refractory recurrent corneal erosion that occurred after Descemet’s stripping automated endothelial keratoplasty (DSAEK) in iridocorneal endothelial syndrome. Case summary: A 62-year-old male patient with iridocorneal endothelial syndrome planned to undergo ultrathin DSAEK. At the surgery, corneal epithelial debridement was performed using a No. 15 blade to enhance the surgical field visibility. Three corneal venting incisions were made before graft insertion in the recipient eye. The corneal epithelium was healed at postoperative 1 week. However, the epithelium detached at 2 weeks postoperatively. The loosened epithelium was peeled off, and a therapeutic bandage contact lens was applied. Thereafter, the corneal epithelial detachment did not improve, despite repeated corneal epithelial debridement, prolonged therapeutic bandage contact lens wear, applications of 5% sodium chloride eyedrops and autoserum eyedrops, and intake of doxycycline, steroids, and valaciclovir. Anterior stromal puncture was performed three times, and the corneal epithelium eventually attached at postoperative 8 weeks. Although recurrent corneal erosion was not observed at postoperative 10 weeks, acute graft rejection occurred but improved with immunosuppressive treatment. The corrected visual acuity was 0.8 after cataract surgery, which was performed at 1 year after DSAEK. Conclusions: Refractory recurrent corneal erosion may occur after DSAEK surgery. In such a case, an aggressive treatment including the repeated anterior stromal puncture technique may be helpful.

반복각막진무름 후 혼합 세균각막염 1례

이상협,김태임,정소향,정재림,정성근,김응권,Sang Hyup Lee,Tae-im Kim,So Hyang Chung,Jae Lim Chung,Sung Kun Chung,Eung Kweon Kim 대한안과학회 2007 대한안과학회지 Vol.48 No.3

Purpose: We report a case of keratitis of Stenotrophomonas maltophilia and Coagulase negative Staphylococcus in a recurrent corneal erosion patient. Methods: A 29-year-old female patient was referred to our clinic for an intractable corneal ulcer in her left eye. Results: Her best corrected visual acuity in her left eye was 10/400 and the cornea showed a 2×2 mm corneal infiltration at the 6 o’clock position along with endothelial plaque. Initially, 5% cefazolin, 1.4% tobramycin, 3.3% vancomycin, and 0.125% amphotericin were administered every 2 hours, and Natacyn? was administered every 4 hours, but corneal infiltration was still aggravated. After nine days of medical treatment, the advancement of the conjunctival flap was performed. The lesion had not improved, and corneal scrape and culture were repeated. Stenotrophomonas maltophilia and Coagulase negative Staphylococcus were identified. Treatment with clindamycin and Cravit?, to which isolated organisms are susceptible, was started, and the lesion improved. During the treatment, her right eye showed a painful epithelial defect in the morning, and a few days later recurrent corneal epithelial bullae developed in her left eye. She was diagnosed with recurrent corneal erosion in both eyes. The infection lesion improved by using 2% clindamycin and Cravit?, but the corneal bullae were not controlled, and therefore all eyedrops gradually tapered. After the cessation of eyedrops, corneal epithelial bullae disappeared. When she visited our clinic 12 days after discharge, her vision was 20/30 and her corneal lesion had improved completely.