title: Acute hydrops with secondary bacterial keratitis: sequelae of paediatric refractive surgery.
abstract: A 24-year-old male patient with bilateral high myopia presented to our outpatient department with sudden onset of pain and diminution of vision in his right eye. He had sequentially undergone bilateral trabeculectomy and photorefractive keratectomy at the age of 6 years in both eyes. This was followed by radial keratotomy in right eye at the age of 8 years. The slit lamp examination demonstrated the presence of infiltrates in central cornea with an underlying fluid cleft, along with 14 radial keratotomy scars. Anterior segment optical coherence tomography confirmed the presence of intrastromal cleft in communication with anterior chamber. Bacterial culture revealed coagulase-negative Staphylococcus. The patient was successfully treated with fortified antibiotics in conjunction with the sensitivity report. This case underlines the need for a cautious approach towards refractive surgery in paediatric age group and highlights the long-term sequelae of retreatments in these cases.
authors.affiliation: Cornea & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Bandivadekar
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Ganesh
authors.initials: G
authors.lastname: Pillai
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
mesh_terms: D000208:Acute Disease; D002648:Child; D015818:Eye Infections, Bacterial / Q000209:etiology*; D006801:Humans; D007634:Keratitis / Q000382:microbiology*; D007646:Keratotomy, Radial / Q000009:adverse effects; D008297:Male; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000209:etiology*; D014130:Trabeculectomy / Q000009:adverse effects*; D055815:Young Adult