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Pseudomonas keratitis 4 years after laser in situ keratomileusis
Consuelo Ferrer1, Jose L Rodriguez-Prats, José L Abad
1Vissum Corporation, Instituto Oftalmológico de Alicante, Division de Oftalmología, Universidad Miguel Hernández, Alicante, Spain. consueloferrer@yahoo.com
Purpose:
To report a patient who presented an infectious keratitis 4 years after laser in situ keratomileusis (LASIK) without any other predisposing risk factor than the LASIK procedure itself.
Case Report:
We report a 32-year-old man operated by LASIK in January 2006 who presented with infectious keratitis in the OD in April 2010. Clinical examination showed a corneal abscess at 10-o'clock position in the interface and fibrin and Tyndall 4+ in the anterior chamber. Microbiological analysis identified Pseudomonas aeruginosa as the cause of infection. The patient was given ofloxacin, sulfate neomycin, polymyxin B, and prednisolone acetate to be used every 2 h. Treatment led to clinical improvement with resolution of corneal infiltrate. Keratitis with intact epithelium by Pseudomonas can occur up to 4 years after LASIK.
Conclusions:
LASIK treatment is a predisposing factor for bacterial keratitis even years after surgery. This report demonstrates the importance of continued postoperative vigilance by patient and his/her clinician.
Insights
Laser in situ keratomileusis (LASIK) surgery can predispose patients to infectious keratitis years later. This case highlights the need for ongoing monitoring after LASIK to detect late-onset bacterial eye infections.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- While generally safe, potential complications require continued monitoring.
Observation:
- A 32-year-old man developed infectious keratitis four years post-LASIK.
- Clinical presentation included a corneal abscess and anterior chamber inflammation.
- Pseudomonas aeruginosa was identified as the causative agent.
Findings:
- The patient's keratitis occurred without other identifiable risk factors besides LASIK.
- Prompt treatment with topical antibiotics and corticosteroids led to resolution.
- This case demonstrates that Pseudomonas keratitis can manifest years after LASIK.
Implications:
- LASIK itself can be a long-term predisposing factor for bacterial keratitis.
- Emphasizes the critical need for sustained postoperative vigilance in LASIK patients.
- Highlights the importance of considering LASIK as a risk factor for late-onset infectious keratitis.
