Post photorefractive keratectomy (PRK) infectious keratitis; six-year experience of a tertiary eye hospital

Abstract

BACKGROUND/OBJECTIVES: As an essential development in the new century, surface ablation procedures have attracted increasing attention. There exists a concern regarding the risk of infectious keratitis. Hence, we aimed to investigate the rate and predisposing factors of infectious keratitis after photorefractive keratectomy (PRK). SUBJECTS/METHODS: This retrospective study was designed in two phases. First, the rate of post-PRK keratitis of Farabi Eye Hospital was investigated. In other words, the targeted population was the patients who developed keratitis after performing procedure at Farabi Eye Hospital. In the second phase, all the patients with the diagnosis of post-PRK keratitis were studied regardless of the centre where surgery was performed. Patients with the diagnosis of infectious keratitis between 2014 and 2020 were enrolled and following information was analyzed: demographics, presentation time after surgery, perioperative medications, culture results, risk factors, medical treatment, complications, and final visual acuity. RESULTS: The total number of PRK procedures in our centre was 24,986 (13,253 patients), in which 6 eyes of 5 patients developed keratitis. Beside these 5 patients, 24 referred patients (24 eyes) from the other centres were enrolled. Finally, a total number of 29 patients (30 eyes) were included. Our analysis revealed that manipulation of contact lens, dry eye, and blepharitis were the essential predisposing factors for keratitis development. CONCLUSION: The overall post-PRK keratitis occurrence rate of our study was 0.02%. Our observation highlighted the importance of preoperative examination and treatment of the lids and dry eye disease.

Comparison of the efficacy and safety of removing bandage contact lenses on the fourth and seventh postoperative day after transepithelial photorefractive keratectomy

“…However, this study found that prolonged use of BCLs did not increase the risk of infectious keratitis, as the corneal epithelium healed in most patients within 4 days after surgery, and patients were administered antibiotic eye drops before removing the BCLs. Additionally, infectious keratitis following TransPRK is usually associated with a favorable prognosis [ 33 ], and both cases of infectious keratitis in this study were successfully treated, and resulting in a final UDVA of at least 0.0 LogMAR.…”

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

“…Thirteen of these patients had a history of blepharitis, meibomitis, and dry eyes. 14 – 16 Diabetes mellitus was discovered in four cases (Table 1 ). 55 , 56 …”

“…Finally, 84 studies meeting the inclusion criteria were included in this review, and 306 infectious eyes (involving 279 patients) after refractive surgery were analyzed. The mean age of patients was 36.9611.0 years (ranging from 16…”

“…Thirteen of these patients had a history of blepharitis, meibomitis, and dry eyes. [14][15][16] Diabetes mellitus was discovered in four cases (Table 1). 55,56 There were 33 cases (23.7%) in total associated with contamination during refractive surgery.…”

Research progress on animal models of corneal epithelial-stromal injury

“…Schallhorn et al [37] have conducted a review of suspected microbial keratitis cases after laser refractive surgery from 2008 to 2015, reporting an incidence of 0.013% for post-PRK and 0.0046% for post-LASIK microbial keratitis. Soleimani et al [38] have found an overall incidence of 0.02% for keratitis post-PRK. Liu et al [39] have retrospectively summarized the clinical treatments of patients who undergo SMILE in local hospital from 2019 to 2021, only 5 patients develops infectious corneal infiltration.…”