Delayed-onset multifocal polymicrobial keratitis after laser in situ keratomileusis

J Cataract Refract Surg. 2002 May;28(5):898-9. doi: 10.1016/s0886-3350(01)01015-x.


We report a case of mixed Aspergillus fumigatus and coagulase-negative Staphylococcus stromal keratitis in a 43-year-old man who developed discomfort and swelling in his right eye 20 days after uneventful bilateral laser in situ keratomileusis (LASIK). Clinical examination revealed 2 distinct corneal infiltrates beneath the LASIK flap. Corneal scrapings were taken for microscopic examination and culture. Both infiltrates initially improved on topical antibiotic therapy, but over the next 18 days, 1 infiltrate worsened and repeat cultures were performed, which demonstrated A fumigatus. Natamycin 5% and amphotericin 0.1% were started and continued for 8 weeks with resolution of the infiltrate and return of the best corrected visual acuity. Delayed-onset multifocal keratitis is a rare complication of LASIK. Fungal entities should be considered in the differential diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Aspergillosis / drug therapy
  • Aspergillosis / etiology*
  • Aspergillus fumigatus / isolation & purification*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / etiology*
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / etiology*
  • Humans
  • Keratitis / drug therapy
  • Keratitis / microbiology*
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Natamycin / therapeutic use
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology*
  • Staphylococcus / isolation & purification*


  • Anti-Bacterial Agents
  • Antifungal Agents
  • Amphotericin B
  • Natamycin