Infections after PRK could have a happy ending: a series of three cases.
BACKGROUND
Infectious keratitis after PRK remains a rare but potentially devastating complication.


METHODS
Medical records of 3 male patients with infectious keratitis after uneventful PRK for myopia and astigmatism were reviewed retrospectively. PRK was performed using the Wavelight Allegretto excimer laser. Postoperative care included a bandage contact lens (BCL) for 5 days, topical antibiotics, ketorolac, and artificial tears.


RESULTS
Keratitis presented 2 - 4 days postoperatively. In one case, each culture was negative (case 1), and was positive for Streptococcus pneumoniae (case 2) and Staphylococcus aureus (case 3). Final BSCVA (best spectacle corrected visual acuity) after intensive antibiotic treatment and removal of BCL were 1.0 (case 1), 0.9 (case 2) and 0.3 correctable to 0.8 with pinhole (case 3).


CONCLUSIONS
Postoperative broad-spectrum antibiotics are mandatory after PRK to prevent infectious keratitis. However, resistant organisms are more and more common. The presence of a bandage soft contact lens after surgery is an unfavourable element that may increase risk of infection. Based on our case series, we suggest limiting soft contact lens wear during the two postoperative days even if the corneal ulceration is not healed.
Bertschinger
D R
DR
Hôpital Ophtalmique Jules-Gonin, Faculté de Médecine de Lausanne, Lausanne, Switzerland.
Hashemi
K
K
Hafezi
F
F
Majo
F
F
D000328:Adult; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008297:Male; D018903:Photorefractive Keratectomy / Q000009:adverse effects*