Peripheral Keratitis Following Laser in situ Keratomileusis

Abstract

PURPOSE: To report two different cases of sterile, peripheral keratitis following laser in situ keratomileusis (LASIK). METHODS: A report of two cases (two eyes of two patients). RESULTS: In two patients, peripheral infiltrates appeared 1 day after LASIK. One patient had a history of rheumatoid arthritis and both had peripheral corneal changes that may have represented prior inflammatory events. The presentations were quite different, with one occurring in association with an epithelial defect at the edge of the flap and the other occurring without an epithelial defect peripheral to the microkeratome cut. In the second case a similar infiltrate showed up in the unoperated fellow eye. Both patients were treated with aggressive antibiotic and corticosteroid therapy. Both patients recovered well with no loss of best spectacle-corrected visual acuity. CONCLUSION: Peripheral keratitis can occur in patients following LASBK; preoperative evidence of previous inflammation may be a marker for patients at higher risk. Rheumatoid arthritis patients may be at increased risk for this complication. With careful and aggressive management excellent visual outcomes are still possible. [J Refract Surg 2003;19:671-675]

Surgical outcomes of laser in situ keratomileusis (LASIK) in patients with stable systemic disease

“…One limitation of our study is the short follow-up period of only three months, which may not have been sufficient to detect all possible complications. Although most complications tend to occur within the first few weeks or months [ 14 , 15 ], it is possible that some complications may have arisen beyond this period. Additionally, the small size of patient groups with different systemic diseases may limit the generalizability of the study’s findings to larger populations.…”

Corneal complications of rheumatoid arthritis

“…It has been described 10 days after trabeculectomy in a 35-year-old patient with a past history of RA and sSS, well controlled under systemic treatment [70]. In addition, peripheral keratitis in a RA patient post-LASIK surgery was reported, with a good outcome after aggressive topical treatment [71]. In a large retrospective case series including 622 patients (1224 eyes) with collagen disease (50.6% with RA) who underwent excimer laser refractive surgery (LRS) between 2008 and 2015, refractive outcomes were satisfactory.…”