Peripheral keratitis following laser in situ keratomileusis.
OBJECTIVE
To report two different cases of sterile, peripheral keratitis following laser in situ keratomileusis (LASIK).


METHODS
A report of two cases (two eyes of two patients).


RESULTS
In two patients, peripheral infiltrates appeared 1 day after LASIK. One patient had a history of rheumatoid arthritis and both had peripheral corneal changes that may have represented prior inflammatory events. The presentations were quite different, with one occurring in association with an epithelial defect at the edge of the flap and the other occurring without an epithelial defect peripheral to the microkeratome cut. In the second case a similar infiltrate showed up in the unoperated fellow eye. Both patients were treated with aggressive antibiotic and corticosteroid therapy. Both patients recovered well with no loss of best spectacle-corrected visual acuity.


CONCLUSIONS
Peripheral keratitis can occur in patients following LASIK; preoperative evidence of previous inflammation may be a marker for patients at higher risk. Rheumatoid arthritis patients may be at increased risk for this complication. With careful and aggressive management excellent visual outcomes are still possible.
Lahners
William J
WJ
Center For Sight, Sarasota, FL 34238, USA. wjlahners@centerforsight.net
Hardten
David R
DR
Lindstrom
Richard L
RL
D000328:Adult; D000900:Anti-Bacterial Agents; D001172:Arthritis, Rheumatoid / Q000150:complications; D003315:Cornea / Q000473:pathology*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008875:Middle Aged; D009216:Myopia / Q000601:surgery
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids