Infectious Keratitis After Keratorefractive Surgery: Update and Review of the Literature

Abstract

Objectives:To summarize the clinical manifestations, microbiological profile, treatment, and prognosis of corneal infections after different keratorefractive surgery.Methods:To obtain relevant studies, English-language databases, including PubMed, Ovid Embase, Web of Science, and CLNAHL, were searched from January 1979 to March 2022. The fundamentals of the literature, clinical characteristics, pathogens, and treatments were retrieved for each included article.Results:Eighty-four studies involving 306 infectious eyes were included in this review. Risk factors of potential infection included a history of blepharitis, contact lens usage, and contaminated surgical instruments. The mean onset time was 22.9±38.7 days (range: 1 day to 3 years). The most common organism isolated from infectious keratitis after keratorefractive surgery were Staphylococcus aureus, followed by Mycobacterium and coagulase-negative Staphylococcus. Most of the infections after refractive procedures were sensitive to medical treatment alone, and the ultimate best-corrected visual acuity after medical treatment was as follows: 20/20 or better in 82 cases (37.0%), 20/40 or better in 170 cases (76.5%), and worse than 20/40 in 52 cases (23.5%). Surgical interventions including flap lift, flap amputation, ring removal, and keratoplasty were performed in 120 eyes (44.5%).Conclusions:Most infections after keratorefractive surgery occur within a week, whereas more than half of the cases after laser-assisted in situ keratomileusis happen after about a month. Gram-positive cocci and mycobacterium are the most common isolates. Infections after LASIK, intracorneal ring (ICR) implantation, and small incision lenticule extraction, which primarily occur between the cornea layers, require irrigation of the tunnels or pocket with antibiotics.

Fusarium keratitis in a Brazilian tropical semi‐arid area: Clinical–epidemiological features, molecular identification and antifungal susceptibility

“…Amplification was performed using an Eppendorf Mastercycler Nexus GX2 (Merck, Germany) thermocycler as follows: an initial denaturation step of 4 min at 95°C, followed by for 35 hybridization/extension cycles, including 60 s at 94°C, 60 s at 60°C and 120 s at 72°C, with final extension 15 min step at 72°C, before the unlimited cooling step at 4°C. DNA concentration was estimated using NanoDrop 2000 spectrophotometer (Thermo Fisher Scientific®, USA) and then stored at 4°C 11,30 . PCR products were visualized by electrophoresis on a 1.2% (w/v) agarose gel.…”

“…DNA concentration was estimated using NanoDrop 2000 spectrophotometer (Thermo Fisher Scientific®, USA) and then stored at 4°C. 11,30 PCR products were visualized by electrophoresis on a 1.2% (w/v) agarose gel. Hybridizaton reaction was performed with the Sequencing kit BygDye v3.0 (Thermo Fisher Scientific®, USA), according to manufacturer's recommendations.…”

“…7 An increasing incidence in FK has been detected globally, mainly associated with contact lenses [8][9][10] and trauma. 5,11,12 While a climateassociated pattern is recognized-in which Fusarium spp. are seen as prevalent fungal pathogens in tropical climates-FK has become an important issue even in temperate and cold regions.…”

“…An increasing incidence in FK has been detected globally, mainly associated with contact lenses 8–10 and trauma 5,11,12 . While a climate‐associated pattern is recognized—in which Fusarium spp.…”