Delayed-onset Pseudomonas keratitis after radial keratotomy

A 62-year-old man had nonsimultaneous, four-incision radial and astigmatic keratotomy in both eyes. Both surgeries were uneventful. Twenty-one months later, the patient developed a corneal ulcer within one of the radial incisions in the left eye. Cultures were positive for Pseudomonas. Although Pseudomonas infections in post-RK eyes have been reported, late-onset Pseudomonas keratitis in a patient with four radial incisions and no history of contact lens wear is contrary to previous reports.