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Infectious keratitis after laser refractive surgery.

G A Kouyoumdjian1, S L Forstot, V D Durairaj

  • 1Department of Ophthalmology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.

Ophthalmology
|June 27, 2001
PubMed
Summary
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Two cases of infectious keratitis, one fungal after photorefractive keratectomy (PRK) and one bacterial after laser in situ keratomileusis (LASIK), required corneal transplants. These rare infections highlight potential risks of refractive surgery.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Surgical Complications

Background:

  • Laser refractive surgeries like photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) are common procedures.
  • While generally safe, infectious keratitis remains a potential complication following these procedures.

Observation:

  • Case 1: A male patient developed fungal keratitis (Scopulariopsis species) three weeks post-PRK, presenting with corneal ulceration.
  • Case 2: A female patient presented with interface granularity seven weeks post-LASIK, diagnosed with bacterial keratitis (Mycobacterium chelonae).

Findings:

  • Both patients ultimately required therapeutic penetrating keratoplasty (PK) due to the severity of their infections.
  • The causative agents, Scopulariopsis species and Mycobacterium chelonae, represent unusual pathogens in post-refractive surgery keratitis.

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Implications:

  • These cases underscore the importance of vigilance for atypical infectious keratitis after PRK and LASIK.
  • Prompt diagnosis and appropriate, often aggressive, treatment are crucial to manage these sight-threatening complications.
  • Further research into preventative strategies and optimized treatment protocols for post-refractive surgery infections may be warranted.