Mycobacterium chelonae Keratitis After Excimer Laser Photorefractive Keratectomy

Brancato, Rosario

doi:10.1001/archopht.1997.01100160486019

Cited by 39 publications

(19 citation statements)

References 6 publications

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“…[5][6][7][8] We are aware of 1 case of Mycobacterium keratitis after photorefractive keratectomy (PRK). 4 Our patient presented approximately 4 weeks after uneventful laser-assisted subepithelial keratectomy (LASEK) surgery, a similar timeframe for presentation in LASIK cases. 3,[6][7][8] Our laboratory was able to identify presumed mycobacterial species from the Gram stain, facilitating prompt treatment.…”

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confidence: 70%

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Mycobacterium chelonae keratitis after laser-assisted subepithelial keratectomy

Rodriguez

Holzinger

et al. 2006

Journal of Cataract and Refractive Surgery

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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.

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“…We know of 1 case after PRK. 4 As LASEK has become an increasingly popular form of refractive surgery, it is possible that more cases of mycobacterial infection will be seen.…”

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confidence: 99%

Mycobacterium chelonae keratitis after laser-assisted subepithelial keratectomy

Rodriguez

Holzinger

et al. 2006

Journal of Cataract and Refractive Surgery

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“…1 In theory, the risk for infection during photorefractive keratectomy (PRK) is higher than during laser in situ keratomileusis because the former technique produces an epithelial defect of 8.0 to 9.0 mm that takes approximately 4 days to heal. 2 In addition, therapeutic contact lenses, which are routinely used as adjuvant treatment to reduce pain and facilitate corneal reepithelialization, may increase the risk for microbial keratitis.…”

Section: Serratia Marcescens Keratitis After Photorefractive Keratectomymentioning

confidence: 99%

Serratia marcescens keratitis after photorefractive keratectomy

Rahimi¹,

Hashemian²,

Khodabande³

2009

Journal of Cataract and Refractive Surgery

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discussion by RA Morgan, 378 16. Cooper BA, Holekamp NM, Bohigian G, Thompson PA. Casecontrol study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds. Am J Ophthalmol 2003; 136:300-305 17. Yu-Wai-Man P, Morgan SJ, Hildreth AJ, Steel DH, Allen D. Efficacy of intracameral and subconjunctival cefuroxime in preventing endophthalmitis after cataract surgery. J Cataract Refract Surg 2008; 34:447-451 18. Li J, Morlet N, Semmens J, Gavin A, Ng J. Coding accuracy for endophthalmitis diagnosis and cataract procedures in Western Australia; the Endophthalmitis Population Study of Western Australia (EPSWA): second report; on behalf of the EPSWA team.Infection following keratorefractive surgery is a rare complication, but it can lead to decreased visual acuity and may necessitate a corneal graft. 1 In theory, the risk for infection during photorefractive keratectomy (PRK) is higher than during laser in situ keratomileusis because the former technique produces an epithelial defect of 8.0 to 9.0 mm that takes approximately 4 days to heal. 2 In addition, therapeutic contact lenses, which are routinely used as adjuvant treatment to reduce pain and facilitate corneal reepithelialization, may increase the risk for microbial keratitis.The organisms most commonly responsible for infection are those present in the normal flora of the eye such as Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae, 1 but growth of other bacteria, 2-5 parasites, fungi, or viruses have been reported. To our knowledge, this is the first reported case of Serratia corneal ulcer following PRK in a patient who wore soft contact lenses. The same microorganism was isolated from the case of the contact lens worn before PRK for myopia correction. CASE REPORTA 25-year-old woman with a history of soft contact lens use had uneventful bilateral PRK with mitomycin for myopic correction. The preoperative refraction was À7.00 À0.5 Â 40 in the right eye and À7.25 in the left eye.The patient was advised to stop wearing contact lenses for at least 7 days before surgery, but she continued to wear them until 3 days before PRK. She had complained of mild ocular irritation in the left eye starting a few weeks before surgery that subsided with application of steroid eyedrops (betamethasone 0.1%). Culture from the case of this lens showed serratia. After PRK the patient used only one BCL.The routine postoperative regimen included a bandage contact lens, betamethasone 0.1% eyedrops 3 times a day, chloramphenicol 0.5% eyedrops drops 4 times a day, and diclofenac 0.1% eyedrops 3 times a day for 3 days. Two days after the bandage contact lens was removed, the patient developed severe pain and redness in the left eye and was referred to our clinic.On examination, the uncorrected distance visual acuity (UDVA) was 20/20 in the right eye and 20/200 in the left eye. A paracentral corneal ulcer was evident on slitlamp examination. Smear and culture were obtained from the ulcer, and aggressive medical therapy was started ...

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Mycobacterium species are widely found in soil, water, and the environment and may colonize body surfaces and fluids such as the skin, sputum, and gastric contents of healthy individuals. [21][22][23] Mycobacterium chelonae is resistant to chemical disinfectants such as chlorine, which is responsible for their occurrence in keratitis after various office surgical procedures.…”

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confidence: 99%