Infectious keratitis after photorefractive keratectomy in a comanaged setting

J Cataract Refract Surg. 2000 Jan;26(1):140-1. doi: 10.1016/s0886-3350(99)00336-3.

Abstract

A 48-year-old man had simultaneous bilateral photorefractive keratectomy (PRK). The surgeon who performed the PRK did not see the patient in follow-up, and there was confusion regarding the comanaging doctor. Therefore, the patient was not examined immediately postoperatively. Several days later, he was hospitalized for an unrelated, painful orthopedic problem and heavily sedated. Seven days after the PRK, an ophthalmologist was consulted for ocular irritation and discharge. Examination showed bilateral, purulent conjunctivitis and severe infectious keratitis in the left eye. The patient was treated with periocular and topical antibiotics. Corneal cultures yielded Staphylococcus aureus. The keratitis resolved slowly, leaving the patient with hand motion visual acuity. A corneal transplant and cataract extraction was performed 15 months later, resulting in a best corrected visual acuity of 20/400 because of glaucomatous optic nerve damage. Severe infectious keratitis may occur after PRK. Poor communication between the surgeon, comanaging doctor, and patient may result in treatment delay.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents
  • Cataract Extraction
  • Conjunctivitis, Bacterial / microbiology
  • Conjunctivitis, Bacterial / pathology
  • Conjunctivitis, Bacterial / therapy
  • Cornea / microbiology
  • Cornea / pathology
  • Cornea / surgery
  • Corneal Transplantation
  • Corneal Ulcer / microbiology*
  • Corneal Ulcer / pathology
  • Corneal Ulcer / therapy
  • Drug Therapy, Combination / administration & dosage
  • Eye Infections, Bacterial* / microbiology
  • Eye Infections, Bacterial* / pathology
  • Eye Infections, Bacterial* / therapy
  • Humans
  • Lasers, Excimer
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Photorefractive Keratectomy / adverse effects*
  • Staphylococcal Infections* / microbiology
  • Staphylococcal Infections* / pathology
  • Staphylococcal Infections* / therapy
  • Staphylococcus aureus / isolation & purification*
  • Surgical Wound Infection / microbiology*
  • Surgical Wound Infection / pathology
  • Surgical Wound Infection / therapy
  • Visual Acuity

Substances

  • Anti-Bacterial Agents
  • Ophthalmic Solutions