Late-onset laser in situ keratomileusis-related corneal ulcer--a case series.
OBJECTIVE
To report 4 cases of flap margin-related corneal ulcer that developed 5 years after laser in situ keratomileusis (LASIK) procedures.


METHODS
We retrospectively documented the clinical and laboratory characteristics of all patients between 2004 and 2008 who presented with LASIK-related corneal ulcer that appeared >5 years postoperatively. The 4 patients who had this condition were 25-, 33-, 61-, and 62-year-old males.


RESULTS
Two patients had cultures positive to Staphylococcus aureus and Streptococcus epidermidis. Two ulcers healed after standard fortified topical antibiotic regimen, 1 ulcer healed after treatment with moxifloxacin, and the fourth healed after treatment with lomefloxacin. All cases presented 5 years after the LASIK procedure.


CONCLUSIONS
LASIK procedures can be associated with the risk of corneal infection even years later. The mechanism may be flap margin instability causing epithelial defense barrier disturbance.
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
David
D
Varssano
Michael
M
Waisbourd
Lior
L
Berkner
Michael
M
Regenbogen
Rossen
R
Hazarbassanov
Adi
A
Michaeli
D000287:Administration, Topical; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000209:etiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D011804:Quinolines / Q000627:therapeutic use; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D013524:Surgical Flaps / Q000009:adverse effects*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; C053091:lomefloxacin; D000077266:Moxifloxacin