title: Recalcitrant Pseudomonas keratitis after epipolis laser-assisted in situ keratomileusis: case report and review of the literature.
abstract: We report a case of recalcitrant microbial keratitis after epipolis laser-assisted in situ keratomileusis (epi-LASIK) surgery caused by Pseudomonas aeruginosa and review the literature on resistant Pseudomonas keratitis after excimer laser surgery. Microbial keratitis occurred two weeks after epi-LASIK surgery and was resistant to fluoroquinolones, aminoglycosides and macrolides but sensitive to meropenem. The patient had total corneal melting and required therapeutic penetrating keratoplasty. The globe could be salvaged and the distance visual acuity was 6/60 in the right eye. Recalcitrant Pseudomonas keratitis might require a therapeutic graft and necessitate the use of intravenous meropenem to prevent recurrence of infection.
authors.affiliation: Cornea and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. namrata.sharma@gmail.com
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Animesh
authors.initials: A
authors.lastname: Jindal
authors.forename: Shveta J
authors.initials: SJ
authors.lastname: Bali
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007634:Keratitis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000209:etiology*