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Acanthamoeba keratitis after photorefractive keratectomy
Roger M Kaldawy1, John E Sutphin, Michael D Wagoner
1Cornea and External Disease Division, Department of Ophthalmology, Boston University Medical Center, Boston, Massachusetts, USA. Rogerkaldawy@bmc.org
Journal of Cataract and Refractive Surgery
|February 1, 2002
Summary
Acanthamoeba keratitis can occur after photorefractive keratectomy. Patients with corneal epithelial defects should avoid freshwater exposure to prevent serious infections like this case of severe keratitis.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery.
- Postoperative keratitis is a rare but serious complication.
- Early diagnosis and appropriate treatment are crucial for visual outcomes.
Observation:
- A 37-year-old woman presented with severe suppurative keratitis post-PRK.
- The keratitis was refractory to antibiotics and steroids.
- Confocal microscopy and histopathology confirmed Acanthamoeba keratitis.
Findings:
- Acanthamoeba keratitis developed despite intensive treatment.
- Contaminated freshwater exposure was the likely source of infection.
- The deepithelialized cornea was susceptible to amebic invasion.
Implications:
- This case highlights the risk of Acanthamoeba keratitis after PRK.
- Patient education is vital: avoid freshwater with epithelial defects and contact lenses.
- Prompt recognition and tailored treatment are essential for managing microbial keratitis.