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Mycobacterium interface keratitis after laser in situ keratomileusis
A Solomon1, C L Karp, D Miller
1Department of Ophthalmology, Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, USA.
Ophthalmology
|December 6, 2001
Summary
Mycobacterial keratitis, a serious LASIK complication, presents with delayed diagnosis and prolonged treatment. Early detection and aggressive management, including flap removal and specific antibiotics, are crucial for better visual outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Surgical Complications
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Infectious keratitis can occur post-LASIK, posing a risk to vision.
- Mycobacterium species are uncommon but serious causes of post-LASIK keratitis.
Observation:
- A case series of five eyes in four patients with post-LASIK mycobacterial keratitis was analyzed.
- Symptoms appeared a mean of 20 days post-LASIK, with diagnosis delayed by a mean of 4.5 weeks.
- Four out of five eyes required LASIK flap amputation.
Findings:
- Treatment with fortified clarithromycin and amikacin led to resolution in a mean of 8.4 weeks.
- Corticosteroid use was associated with worsening and prolonged infection.
- Aggressive management, including flap removal and specific antibiotics, is vital.
Implications:
- Mycobacterial keratitis post-LASIK requires prompt diagnosis and specific treatment protocols.
- Early identification of mycobacteria and avoidance of corticosteroids are key to successful management.
- Optimized treatment strategies can improve visual outcomes in these challenging cases.