Optical Coherence Tomography in Infectious Keratitis After Femtosecond Keratorefractive Surgery.

Area of Science:

• Ophthalmology
• Medical Imaging
• Corneal Surgery

Background:

• Infectious keratitis post-refractive surgery presents unique challenges due to the surgical interface.
• Anterior Segment Optical Coherence Tomography (AS-OCT) has not been extensively studied in these specific cases.
• Understanding AS-OCT patterns is crucial for accurate diagnosis and management.

Purpose of the Study:

• To evaluate the utility of AS-OCT in diagnosing and managing infectious keratitis following femtosecond laser in situ keratomileusis (FS-LASIK) and keratorefractive lenticule extraction (KLEx).
• To characterize the AS-OCT findings in post-refractive surgery infectious keratitis.
• To assess AS-OCT's role in guiding treatment and monitoring healing.

Main Methods:

• Retrospective review of 22,756 eyes from 13,564 patients undergoing FS-LASIK and KLEx.
• Analysis of AS-OCT findings in four confirmed cases of post-refractive surgery infectious keratitis.
• Documentation of infection progression, interface changes, and healing.

Main Results:

• AS-OCT identified initial infiltrates and inflammation within the surgical interface in all cases.
• Specific findings included interface fluid accumulation and stromal remodeling.
• AS-OCT effectively documented the dynamic changes during infection and healing.

Conclusions:

• AS-OCT is a valuable tool for evaluating corneal infections after refractive surgery.
• It aids in diagnosis, treatment guidance, and assessment of healing and scarring.
• AS-OCT provides critical insights into the unique presentation of keratitis in the surgical interface.