title: Peripheral sterile corneal infiltrates after refractive surgery.
abstract: OBJECTIVE
  To report 5 eyes of peripheral sterile corneal infiltrates after refractive surgery.
  
  
  METHODS
  Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel, and Enaim Ophthalmological Center, Jerusalem, Israel.
  
  
  METHODS
  Three patients had bilateral refractive procedures for correcting myopia. The procedures included laser epithelial keratectomy in 2 eyes, laser in situ keratomileusis (LASIK) in 2 eyes using a keratome, and LASIK in 1 eye using femtosecond laser.
  
  
  RESULTS
  All the patients complained of ocular pain between 1 and 3 days after the procedure. A ring stromal infiltrate peripheral to the flap edge with intact epithelium and an intervening clear zone between the peripheral corneal infiltrates and the limbus was observed in 5 eyes without anterior chamber reaction. All cases improved after several days of topical steroid and antibiotic treatment and systemic steroid. Final visual acuity was 20/25 or better in all cases.
  
  
  CONCLUSIONS
  The exact mechanism of this complication is still unknown, which can be confused with infectious keratitis. It is important to maintain a high degree of suspicion for infectious keratitis because the management is very different. The potential outcome can be much worse if the keratitis is due to an infectious etiology which can appear after all types of refractive laser procedures.
authors.affiliation: Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Tova
authors.initials: T
authors.lastname: Lifshitz
authors.forename: Jaime
authors.initials: J
authors.lastname: Levy
authors.forename: Ori
authors.initials: O
authors.lastname: Mahler
authors.forename: Shmuel
authors.initials: S
authors.lastname: Levinger
mesh_terms: D000328:Adult; D003315:Cornea / Q000473:pathology*; D005260:Female; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted; D007634:Keratitis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D014792:Visual Acuity