Bacterial keratitis after laser subepithelial keratectomy.
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Biomedical subjects
Publications and source records attributed to Tova Lifshitz.
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PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) for correction of myopia in eyes with previous retinal detachment surgery. METHODS: A retrospective review was conducted of all consecutive eyes that underwent LASIK after retinal detachment surgery. Data was collected regarding previous ocular surgery and its time prior to LASIK, intra- and postoperative complications, and visual outcome measures pre- and postoperatively. RESULTS: Ten eyes with previous retinal detachment surgery were scheduled for LASIK. One eye was excluded from data analysis as LASIK was aborted due to inadequate microkeratome suction because of conjunctival scarring. Nine eyes underwent an uneventful LASIK procedure. On average, LASIK was performed 130+/-123 months following retinal detachment surgery. Postoperative LASIK follow-up was 14.8+/-12.5 months. No significant intraoperative, postoperative, or retinal complications were observed. The mean preoperative spherical equivalent refraction was -9.00+/-3.00 diopters (D), uncorrected visual acuity (UCVA) was 0.06+/-0.02, and best spectacle-corrected visual acuity (BSCVA) was 0.64+/-0.16. At the end of follow-up, the mean spherical equivalent refraction was 0.65+/-0.88 D, mean UCVA was 0.57+/-0.14, and mean BSCVA was 0.72+/-0.19. Differences between BSCVA before and after LASIK were statistically significant (P=.038). At final follow-up, the safety index was 1.22 and efficacy index was 1.01. CONCLUSIONS: Laser in situ keratomileusis was found to be a safe and efficient option for treating refractive errors in eyes with previous retinal detachment surgery.
PURPOSE: To report two cases of herpes simplex virus (HSV) keratitis after laser in situ keratomileusis (LASIK). METHODS: Interventional small case series. Two patients underwent uneventful LASIK. History of herpes labialis in one patient and herpetic eye disease > 10 years prior to intervention in the other patient was reported. Both patients developed stromal herpetic keratitis 6 weeks and 2 years after the procedure, respectively. RESULTS: Treatment consisting of topical steroid drops and topical and systemic antiviral therapy was administered. Recurrences of the herpetic keratitis were seen after tapering of the topical steroids; four and three recurrences were observed, respectively. Final visual acuity was > 6/9 in both cases. CONCLUSIONS: Herpetic keratitis after LASIK is an uncommon, possibly under-reported, entity. Even patients without history of herpetic eye disease can present with this complication. Oral antiviral prophylaxis may be appropriate when performing LASIK on patients with a history of ocular or systemic HSV infection.
PURPOSE: To report a rare case of late bilateral ectasia developing after LASIK for low myopia without preoperative risk factors. METHODS: A 21-year-old man underwent bilateral uneventful LASIK for low myopia of -2.75 diopters in both eyes. Preoperative corneal pachymetry was 531 microm in the right eye and 526 microm in the left eye. The total ablation depth was 46.8 microm in the right eye and 42.2 microm in the left eye. Preoperative corneal topography was normal and did not reveal forme fruste keratoconus. RESULTS: Twenty-four months postoperatively, the patient developed bilateral inferior keratectasia of +0.50 -3.00 x 72 degrees in the right eye and +1.00 -2.75 x 99 degrees in the left eye. CONCLUSIONS: Late keratectasia may follow LASIK for low myopia despite a thorough preoperative work-up.
PURPOSE: To report two cases of pneumococcal keratitis after LASIK. METHODS: Retrospective interventional small case series of two patients who underwent bilateral LASIK for myopia and developed pneumococcal keratitis after surgery. This complication was encountered 2 days after surgery in one eye in both cases. The corneal flap was lifted, and irrigation and cultures from the stromal bed performed. Topical and subconjunctival antibiotics were started. RESULTS: Culture revealed Streptococcus pneumoniae in both cases. The infiltrates responded well to treatment. One year after the procedure, uncorrected visual acuity is > 20/40 in both cases. CONCLUSIONS: Pneumococcal keratitis can complicate LASIK. Patients should be informed of this potential complication, as prompt treatment is crucial.
A 52-year-old man sought treatment for decreased vision in his right eye for 3 weeks. Visual acuity was 20/120. Examination revealed an elevated choroidal nevus at the posterior pole. Fluorescein and indocyanine green angiographies disclosed fibrovascular pigment epithelial detachment extending under the fovea. The patient was treated by two sessions of photodynamic therapy with verteporfin. Visual acuity improved to 20/40. The fibrovascular pigment epithelial detachment area diminished and the fovea is clear of lesion. Seven months after the last treatment, visual acuity remains stable. Photodynamic therapy with verteporfin could be an effective option for treating subfoveal choroidal neovascularization secondary to choroidal nevus.
A 69-year-old man who had pseudoexfoliation and significant nuclear cataract underwent cataract surgery in his right eye. At the beginning of the phacoemulsification, inferior zonulolysis was observed and a capsular tension ring was implanted. Anterior vitrectomy was also performed because of vitreous in the anterior chamber at the end of surgery. A tear in the posterior capsule could not be identified. Three days after surgery, the capsular tension ring was observed partially in the anterior vitreous. A 3-port pars plana vitrectomy was performed and the ring was removed. Three weeks later, the eye developed retinal detachment and was successfully repaired. Retinal complications can develop if the capsular tension ring moves into the vitreous.