Delayed sterile keratitis following radial keratotomy requiring corneal transplantation for visual rehabilitation

Delayed keratitis is an unusual complication of radial keratotomy surgery. A case of documented sterile keratitis involving four adjacent nasal incisions occurred 34 months following a 16-incision radial keratotomy procedure. Multiple cultures and biopsies failed to show a pathogen. The keratitis was confined to the incisional area without involvement of the intervening stroma. A penetrating keratoplasty was necessary to restore useful vision. Clinical and pathological studies documented delayed corneal wound healing.