Traumatic late flap dehiscence and Enterobacter keratitis following LASIK

J Refract Surg. 2006 Apr;22(4):402-4.

Abstract

Purpose: To report a case of traumatic flap dehiscence and Enterobacter keratitis 34 months after LASIK.

Methods: A 36-year-old man sustained a flap dehiscence following traumatic right eye gouging by a seagull claw. He presented the following day with uncorrected visual acuity (UCVA) in the affected eye of 3/200 and organic foreign body deposits underneath the flap. Systemic and topical antibiotics were administered and urgent surgical debridement and replacement of the LASIK flap was performed. An Enterobacter species was cultured from an intraoperative swab.

Results: After a prolonged postoperative course, including administration of topical ofloxacin, tobramycin, chloramphenicol, and dexamethasone, UCVA returned to 20/20.

Conclusions: Good visual outcome after early debridement and appropriate antibiotics was achieved. Patients should be injury advised to seek prompt ophthalmic consultation after LASIK.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Cornea / microbiology
  • Cornea / surgery
  • Corneal Injuries
  • Enterobacter / isolation & purification
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Follow-Up Studies
  • Humans
  • Keratitis / drug therapy
  • Keratitis / microbiology*
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Ophthalmic Solutions
  • Surgical Flaps*
  • Surgical Wound Dehiscence / drug therapy
  • Surgical Wound Dehiscence / etiology*

Substances

  • Anti-Bacterial Agents
  • Ophthalmic Solutions