title: Activation of Cytomegalovirus corneal endotheliitis following laser in situ keratomileusis.
abstract: A case of Cytomegalovirus (CMV) corneal endotheliitis following laser in-situ keratomileusis (LASIK) is presented. A 32-year-old man presented 3 weeks after uncomplicated myopic LASIK with unilateral LASIK flap oedema, interface fluid accumulation, keratic precipitates, anterior uveitis and raised intraocular pressure. Despite treatment with topical corticosteroids, he had 3 further recurrent episodes. Specular microscopy showed decreased endothelial cell density and aqueous humour. Polymerase chain reaction (PCR) testing was positive for CMV DNA. He was treated with topical ganciclovir and ketorolac, and the inflammation and oedema resolved. Repeat aqueous humour PCR testing was negative for CMV DNA, and he remained well at last follow-up (3 months after stopping all medications). CMV corneal endotheliitis can be reactivated after LASIK, and CMV DNA PCR of aqueous humour samples can help in definitive diagnosis. Early recognition and treatment of this condition is important to prevent permanent endothelial cell loss and corneal decompensation.
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Tien-En
authors.initials: TE
authors.lastname: Tan
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.|Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Chui Ming Gemmy
authors.initials: CM
authors.lastname: Cheung
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore.|Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage*; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D004279:DNA, Viral; D004728:Endothelium, Corneal / Q000473:pathology / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D020910:Ketorolac / Q000008:administration & dosage; D008297:Male; D016133:Polymerase Chain Reaction; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000628:therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir; D020910:Ketorolac