A 24-year-old man with myopic astigmatism had uncomplicated laser-assisted subepithelial keratectomy (LASEK) in October 2004. Approximately 4 weeks later, a foreign-body sensation and redness developed in the left eye. A paracentral anterior stromal infiltrate was observed, and Gram stain on the day of presentation showed branching filamentous gram-positive rods. Cultures subsequently grew Mycobacterium chelonae. Topical tobramycin 15 mg/mL, azithromycin 2 mg/mL, amikacin 25 mg/mL, and cefazolin 50 mg/mL were initiated based on Gram stain results. We believe this is the first documented case of M chelonae keratitis after LASEK.
A 41-year-old man with myopic astigmatism had laser in situ keratomileusis (LASIK) in each eye in April 2002. Ten months later, he sustained a central perforating corneal injury to the right eye. One day following repair of the corneal wound, he presented with diffuse corneal epithelial microcystic edema, lamellar interface fluid accumulation, and 20/400 visual acuity. Additional sutures were placed to close a presumed posterior wound gape with complete resolution of the corneal edema and lamellar interface fluid collection. One year later, his best corrected visual acuity measured 20/20+ in the right eye. This case is the first to document lamellar interface fluid accumulation following LASIK owing to traumatic disruption of the corneal endothelium.
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