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Published on: July 6, 2015
Infectious keratitis in 18,651 laser surface ablation procedures
Victoria de Rojas1, Fernando Llovet, Mercedes Martínez
1Clinica Baviera, Instituto Oftalmológico Europeo, Spain. derojas.v@gmail.com
Purpose:
To evaluate the incidence, culture results, risk factors, treatment strategies, and visual outcomes of infectious keratitis after surface ablation.
Setting:
Multicenter study in Spain.
Design:
Case series.
Methods:
The medical records of patients who had surface ablation between January 2003 and December 2009 were reviewed to identify cases of infectious keratitis. The incidence, risk factors, clinical course, days to diagnosis, medical and surgical treatment, and visual outcome were recorded. Main outcome measures were incidence of infectious keratitis after surface ablation, culture results, response to treatment, and visual outcomes.
Results:
The study reviewed the records of 9794 patients (18,651 eyes). Infectious keratitis after surface ablation was diagnosed in 39 eyes of 38 patients. The onset of infection was early (within 7 days after surgery) in 28 cases (71.79%). Cultures were positive in 13 of 27 cases in which samples were taken. The most frequently isolated microorganism was Staphylococcus species (9 cases). The final corrected distance visual acuity (CDVA) was 20/20 or better in 23 cases (58.97%), 20/40 or better in 36 cases (92.30%), and worse than 20/40 in 3 cases (7.69%).
Conclusions:
The incidence of infectious keratitis after surface ablation was 0.20%. Infectious keratitis is a potentially vision-threatening complication. Prompt and aggressive management with an intensive regimen of fortified antibiotic agents is strongly recommended. Proper management can preserve useful vision in most cases.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
Insights
Infectious keratitis after surface ablation occurred in 0.20% of patients. Prompt treatment with antibiotics preserved useful vision in most cases, highlighting the importance of aggressive management for this vision-threatening complication.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Infectious Diseases
Background:
- Surface ablation is a common refractive surgical procedure.
- Infectious keratitis is a rare but serious complication following ocular surgery.
- Understanding the incidence and outcomes of infectious keratitis post-surface ablation is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of infectious keratitis after surface ablation.
- To identify risk factors, culture results, and treatment strategies for this complication.
- To evaluate the visual outcomes in patients who developed infectious keratitis post-surface ablation.
Main Methods:
- A multicenter case series study was conducted in Spain.
- Medical records of 9794 patients (18,651 eyes) who underwent surface ablation between 2003 and 2009 were reviewed.
- Data collected included incidence, risk factors, clinical course, diagnosis time, treatment, and visual acuity.
Main Results:
- Infectious keratitis was diagnosed in 39 eyes (0.20% incidence).
- Most infections (71.79%) occurred within 7 days post-surgery, with Staphylococcus species being the most common pathogen.
- Final corrected distance visual acuity was 20/40 or better in 92.30% of affected eyes.
Conclusions:
- The incidence of infectious keratitis after surface ablation is low but significant.
- Early diagnosis and aggressive management with fortified antibiotics are essential.
- Effective treatment can preserve useful vision in the majority of patients.
