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Bacterial Keratitis Following Small Incision Lenticule Extraction
Jin Li1, Sheng-Wei Ren1, Li-Juan Dai1
1Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, People's Republic of China.
Infection and Drug Resistance
|August 24, 2022
Summary
Bacterial keratitis can occur after small incision lenticule extraction (SMILE). Early diagnosis and surgical intervention, including opening the corneal cap, are crucial for severe cases to preserve vision.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Infectious Diseases
Background:
- Small incision lenticule extraction (SMILE) is a popular refractive surgery for myopia.
- Postoperative infectious keratitis is a potential complication following SMILE procedures.
Observation:
- This study retrospectively analyzed five patients who developed bacterial keratitis after SMILE between 2019 and 2021.
- Four of the five patients presented with severe keratitis, requiring surgical intervention beyond topical antibiotics.
- Treatment involved scraping necrotic tissue and, in some cases, converting the corneal cap to a flap for thorough debridement and irrigation.
Findings:
- Bacterial keratitis after SMILE can manifest within 1-3 days postoperatively.
- Mild cases responded to topical antibiotics, but severe infections necessitated surgical management.
- Resolution of keratitis took 1-5 weeks, with final uncorrected visual acuity exceeding 20/32 in all patients.
Implications:
- The incidence of keratitis post-SMILE warrants attention due to the increasing popularity of this refractive surgery.
- Prompt diagnosis and appropriate, timely treatment are essential for managing post-SMILE keratitis.
- For severe cases unresponsive to topical antibiotics, surgical management by opening the corneal cap is indicated.
