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Infectious keratitis after photorefractive keratectomy
Eric D Donnenfeld1, Terrence P O'Brien, Renée Solomon
1Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, USA.
Ophthalmology
|April 12, 2003
Summary
Infectious keratitis, a serious complication of photorefractive keratectomy (PRK), is most often caused by Gram-positive bacteria. Broad-spectrum antibiotic prophylaxis covering Gram-positive organisms is recommended to prevent post-PRK infections.
Area of Science:
- Ophthalmology
- Microbiology
- Surgical Complications
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery.
- Infectious keratitis is a rare but serious complication following PRK.
Observation:
- This study reviewed 12 patients (13 eyes) who developed infectious keratitis after PRK.
- Common causative organisms included Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae.
- Risk factors included contact lens manipulation and exposure to nosocomial organisms.
Findings:
- Gram-positive bacteria were the predominant pathogens identified.
- Visual acuity outcomes varied, with final best spectacle-corrected visual acuity ranging from 20/20 to 20/100.
- Treatment response to antibiotics varied among patients.
Implications:
- Infectious keratitis post-PRK necessitates prompt diagnosis and treatment.
- Broad-spectrum antibiotic prophylaxis with Gram-positive coverage is crucial for preventing post-PRK infectious keratitis.
- Understanding causative organisms and risk factors can guide preventative strategies.