[Flap Amputation in Mycobacterium chelonae Keratitis after Laser-in-situ Keratomileusis (LASIK)].
BACKGROUND
Keratitis due to Mycobacterium chelonae after laser-in-situ keratomileusis (LASIK) is a rare, but severe complication. In the following report, we present clinical findings, microbiological investigation, treatment and outcome of the first case of Mycobacterium chelonae reported in Europe.


METHODS
A 52-year old woman presented with atypical unilateral keratitis after LASIK. Mycobacterium chelonae keratitis was diagnosed by microbiological investigation. Interface irrigation and treatment with topical and oral antibiotics was performed.


RESULTS
Despite intensive treatment, flap removal was necessary to control the infection. Best-corrected visual acuity dropped from preoperatively 1.0 to postoperatively 0.2.


CONCLUSIONS
The diagnosis of mycobacterial keratitis after laser-in-situ keratomileusis is often delayed due to atypical clinical appearance. Therefore consideration of atypical pathogens and rapid microbiological diagnosis is necessary to provide adequate treatment.
Kohnen
Thomas
T
Klinik für Augenheilkunde, Johann-Wolfgang-Goethe-Universität Frankfurt, Frankfurt am Main. Kohnen@em.uni-frankfurt.de
Schöpfer
Dörte
D
Bühren
Jens
J
Hunfeld
Klaus-Peter
KP
D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D003320:Corneal Ulcer / Q000175:diagnosis / Q000601:surgery*; D004269:DNA, Bacterial / Q000032:analysis; D003907:Dexamethasone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000601:surgery*; D016926:Mycobacterium chelonae / Q000235:genetics; D016133:Polymerase Chain Reaction; D012086:Reoperation; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000601:surgery*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D003907:Dexamethasone