Non-tuberculous mycobacterial keratitis at the interface after laser in situ keratomileusis.
OBJECTIVE
To describe two cases of bacterial keratitis with atypical mycobacteria after laser in situ keratomileusis (LASIK).


METHODS
Two cases of non-tuberculous mycobacterial keratitis occurred in the interface between the stromal bed and flap, 20 days and 14 days after LASIK. The keratitis progressed slowly and worsened after attempts were made to remove the colonies. Mycobacterium fortuitum was confirmed 2 months after initial presentation following culture of the excised flap tissue in one case, and Mycobacterium chelonae was identified by culture of removed material and by RT-PCR with primers in the other case. The patients were treated medically and by surgical flap removal.


RESULTS
In the first case, the keratitis was controlled only after removal of the partially melted flap and intensive medical treatment. In the second case, the lesion cleared after 2 months of antibiotics, but after tapering of antibiotics, the infiltrate progressed. Eventually, the keratitis was controlled after removal of the flap.


CONCLUSIONS
Non-tuberculous Mycobacterium should be considered as one of the causes of keratitis when presenting as white colonies in the lamellar bed after LASIK. Treatment for 2 months may not be enough to eradicate the infection and excision of the flap may be necessary.
Seo
Kyoung Y
KY
Institute of Vision Research and Dept. of Ophthalmology, Division of Medical Science, Yonsei University College of Medicine, Seodaemoongu Shinchondong 134, C.P.O. Box 8044, Seoul, Korea.
Lee
Jae B
JB
Lee
Kyungwon
K
Kim
Moon J
MJ
Choi
Kyu Ryong
KR
Kim
Eung Kweon
EK
D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016926:Mycobacterium chelonae; D019907:Mycobacterium fortuitum