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Methicillin-Resistant Staphylococcus aureus Ocular Infection after Corneal Cross-Linking for Keratoconus: Potential

Romina Fasciani1, Antonio Agresta1, Alice Caristia1

  • 1Department of Head and Neck Surgery, Ophthalmology Unit, Catholic University of the Sacred Heart "A. Gemelli", Largo "A. Gemelli" 8, 00168 Rome, Italy.

Case Reports in Ophthalmological Medicine
|April 14, 2015
PubMed

Insights

A case study highlights the risk of methicillin-resistant Staphylococcus aureus (MRSA) ocular infection following UVA-riboflavin corneal cross-linking in a patient with atopic dermatitis, emphasizing careful preoperative assessment and hygiene.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Dermatology

Background:

  • Keratoconus is a progressive corneal condition often managed with corneal collagen cross-linking.
  • Atopic dermatitis is associated with an increased risk of Staphylococcus aureus colonization.
  • Ocular infections, including those caused by MRSA, are potential complications of ophthalmic procedures.

Purpose of the Study:

  • To report a case of methicillin-resistant Staphylococcus aureus (MRSA) ocular infection after UVA-riboflavin corneal collagen cross-linking.
  • To investigate the potential link between atopic dermatitis and postoperative MRSA infection in this context.

Main Methods:

  • A case report detailing a 22-year-old male patient with keratoconus and atopic dermatitis.
  • The patient underwent UVA-riboflavin corneal cross-linking and subsequently developed a severe ocular infection.
  • Microbiological cultures identified MRSA, and treatment involved targeted antibiotic therapy.

Main Results:

  • The patient developed a rapidly progressive corneal abscess and cyclitis five days post-surgery.
  • Cultures confirmed MRSA with significant antibiotic resistance.
  • Despite aggressive treatment, severe ocular damage was unavoidable.

Conclusions:

  • While UVA-riboflavin corneal cross-linking is effective for keratoconus, infectious complications can occur.
  • Atopic dermatitis may be a risk factor for postoperative MRSA infection due to S. aureus colonization.
  • Thorough clinical assessment for comorbidities and strict postoperative hygiene are crucial.

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