Infectious Keratitis in Corneal Graft following Astigmatic Keratotomy: A Case Report and Literature Review

Femtosecond laser-assisted astigmatic keratotomy (FSAK) is recognized as a safe and effective therapeutic option for addressing high corneal astigmatism in corneal transplants. Although the incidence of corneal infection after FSAK in corneal transplants is very low, early detection and treatment is necessary to optimize visual outcomes and prevent devastating sequelae. This report describes a rare case of an early-onset infectious keratitis occurring in a corneal transplant after FSAK. A 38-year-old man with previous history of penetrating keratoplasty and FSAK presented to emergency department with deep corneal infiltration at the FASK incision site along with a decline in his baseline best corrected visual acuity 1 month after FSAK. Corneal scraping was performed, and topical fortified antibiotic eyedrops were started. Culture results showed no growth. Three weeks later, the corneal infiltrate resolved with residual scarring at the FSAK incision site, and the patient regained his baseline best corrected visual acuity with no sequelae.