Delayed-onset Actinomyces keratitis after laser in situ keratomileusis.
OBJECTIVE
To present a case of delayed-onset unilateral keratitis caused by Actinomyces israelii after laser in situ keratomileusis (LASIK).


METHODS
A 28-year-old woman was referred to our clinic because of foreign-body sensation and mild blurred vision in her left eye. She had bilateral simultaneous LASIK approximately 5 months ago. On slit-lamp examination, there was an area of infiltration in the corneal interface. The LASIK flap was elevated, and the involved area was scraped and irrigated with antibiotic solutions.


RESULTS
Culture and smear showed A. israelii as a causative agent, and the keratitis was successfully treated by antibiotics chosen according to antibiotic sensitivity test.


CONCLUSIONS
Actinomyces israelii must be considered in differential diagnosis of delayed-onset microbial keratitis after LASIK. Flap elevation, scraping, and irrigating the involved area can be helpful to obtain specimens for culture and smear and to control infection.
Karimian
Farid
F
Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti Medical University, Tehran, Iran. karimianf@yahoo.com
Feizi
Sepehr
S
Nazari
Roshanak
R
Zarin-Bakhsh
Parviz
P
D000190:Actinomyces / Q000302:isolation & purification; D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D019781:Corneal Topography; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008826:Microbial Sensitivity Tests; D011183:Postoperative Complications; D013524:Surgical Flaps; D013752:Tetracycline / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D013752:Tetracycline; D002437:Cefazolin; D005469:Fluorometholone