title: Bilateral infectious keratitis after implantation of intrastromal corneal ring segments.
abstract: OBJECTIVE
  To report the development of bilateral infectious keratitis after implantation of intrastromal corneal ring segments (ICRSs).
  
  
  METHODS
  Retrospective case report.
  
  
  METHODS
  A 20-year-old woman presented with photophobia, decreased vision, and pain 11 days after uncomplicated implantation of ICRSs for keratoconus in both eyes. Bilateral corneal stromal infiltrates were noted at the site of ICRSs implantation.
  
  
  METHODS
  The patient was started on frequent topical fortified antibiotics in both eyes. Despite aggressive medical management, stromal infiltrates progressed, necessitating removal of ICRSs from both corneas to control infectious keratitis and melting of cornea.
  
  
  METHODS
  Retrospective case report of a 20-year-old woman who developed bilateral severe infectious keratitis 11 days after uncomplicated implantation of ICRSs for keratoconus.
  
  
  RESULTS
  Cultures obtained at the time of initial presentation yielded Streptococcus viridans. Patient responded well to the treatment and was left with stromal scars in both corneas.
  
  
  CONCLUSIONS
  Although rare, simultaneous implantation of ICRSs may carry a risk of severe bilateral infectious keratitis. Early recognition of infection, aggressive treatment with antibiotics, and, in some cases, removal of ICRSs may be necessary to prevent serious sight-threatening complication of this refractive procedure.
authors.affiliation: Oculoplastic and Orbit Division, Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. orbitdr@yahoo.com
authors.forename: Imtiaz A
authors.initials: IA
authors.lastname: Chaudhry
authors.forename: Ali A
authors.initials: AA
authors.lastname: Al-Ghamdi
authors.forename: Omar
authors.initials: O
authors.lastname: Kirat
authors.forename: Farhan
authors.initials: F
authors.lastname: Al-Swelmi
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-Rashed
authors.forename: Farrukh A
authors.initials: FA
authors.lastname: Shamsi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D020878:Device Removal; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D034363:Viridans Streptococci / Q000302:isolation & purification*; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents