Delayed keratitis after laser in situ keratomileusis.
We report 2 cases of delayed keratitis that occurred after uneventful laser in situ keratomileusis (LASIK). The first patient presented with a peripheral corneal infiltrate 3 months after a LASIK enhancement procedure. The infiltrate progressed despite treatment with topical combination tobramycin-dexamethasone. The flap was then lifted and the interface was irrigated with fortified antibiotics. The keratitis promptly resolved, and the patient recovered a best corrected visual acuity (BCVA) of 20/20. The second patient presented with decreased vision, inflammation, and a sublamellar infiltrate 1 month after primary LASIK. The flap was promptly lifted and irrigated with antibiotics. Cultures were positive for Staphylococcus epidermidis. One week later, the infiltrate had resolved and BCVA had returned to 20/20. Delayed bacterial keratitis has been described as a rare occurrence after incisional refractive surgery. To the best of our knowledge, it has not yet been reported after LASIK. It is important to consider infectious keratitis in the differential diagnosis of a patient who presents with corneal inflammation, even months after having LASIK.
Karp
K O
KO
Rush-Presbyterian-St. Luke's Medical Center, (Karp, Epstein), Chicago, Illinois 60612, USA.
Hersh
P S
PS
Epstein
R J
RJ
D000328:Adult; D000900:Anti-Bacterial Agents; D003315:Cornea / Q000382:microbiology / Q000473:pathology; D003646:Debridement; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions