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Microbial keratitis after laser in situ keratomileusis
Neelam Pushker1, Tanuj Dada, Parul Sony
1R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Purpose And Method:
To review the literature on microbial keratitis reported after laser in situ keratomileusis (LASIK).
Results:
Forty-one eyes have been reported to have microbial keratitis after LASIK. The causative organisms vary from gram positive bacteria to atypical mycobacteria, fungal, and viral pathogens. The infection is usually acquired intraoperatively, but may also be caused by postoperative contamination. A majority of the patients present within 72 hours of the surgery with an acute onset of symptoms. Management of microbial keratitis after LASIK includes aggressive topical fortified antibiotic therapy, irrigation of stromal bed with antibiotic solution after lifting the flap, and sending the scraping of the infiltrate for microbiological evaluation. The keratitis heals with scarring and a best spectacle-corrected visual acuity of 20/40 or better can be obtained in the majority of the patients.
Conclusion:
Microbial keratitis is a sight-threatening complication of LASIK.
Insights
Microbial keratitis is a serious complication following laser in situ keratomileusis (LASIK) surgery. Early detection and aggressive treatment are crucial for managing this sight-threatening condition after LASIK.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Microbial keratitis is a potential complication following LASIK.
Purpose of the Study:
- To review the existing literature on microbial keratitis after LASIK.
- To understand the causative agents, presentation, and management of post-LASIK microbial keratitis.
Main Methods:
- Literature review of reported cases of microbial keratitis post-LASIK.
- Analysis of causative organisms, timing of onset, and treatment strategies.
Main Results:
- Forty-one cases of microbial keratitis post-LASIK were reported.
- Infectious agents included bacteria, atypical mycobacteria, fungi, and viruses.
- Most infections were acquired intraoperatively or via postoperative contamination, presenting within 72 hours.
Conclusions:
- Microbial keratitis is a sight-threatening complication of LASIK.
- Aggressive management, including fortified antibiotics and flap irrigation, is essential.
- Most patients achieve good visual outcomes with prompt treatment.