Therapeutic keratectomy for Mycobacterium abscessus keratitis after LASIK

We report successful treatment of a case of Mycobacterium abscessus keratitis after laser in situ keratomileusis (LASIK) with therapeutic lamellar keratectomy. A 34-year-old woman developed a 2 x 2 mm feathery infiltration within the interface inferior to the pupil margin with mild inflammation of the conjunctiva in her left eye 40 days after LASIK surgery. Bacterial culture from the infiltrates of the interface of the stromal bed revealed Mycobacterium abscessus. After combination antibiotic therapy including amikacin and ciprofoxacin was given for 6 weeks, infiltration persisted despite the development of necrosis in the flap tissue. Therapeutic lamellar keratectomy combined with flap removal was performed. No recurrence was found 1 year after the surgery. Therapeutic lamellar keratectomy with flap removal can provide an effective treatment modality for the management of post-LASIK Mycobacterium abscessus keratitis that is unresponsive to medical treatment.