Karp K O, Hersh P S, Epstein R J
Rush-Presbyterian-St. Luke's Medical Center, (Karp, Epstein), Chicago, Illinois 60612, USA.
J Cataract Refract Surg. 2000 Jun;26(6):925-8. doi: 10.1016/s0886-3350(99)00413-7.
We report 2 cases of delayed keratitis that occurred after uneventful laser in situ keratomileusis (LASIK). The first patient presented with a peripheral corneal infiltrate 3 months after a LASIK enhancement procedure. The infiltrate progressed despite treatment with topical combination tobramycin-dexamethasone. The flap was then lifted and the interface was irrigated with fortified antibiotics. The keratitis promptly resolved, and the patient recovered a best corrected visual acuity (BCVA) of 20/20. The second patient presented with decreased vision, inflammation, and a sublamellar infiltrate 1 month after primary LASIK. The flap was promptly lifted and irrigated with antibiotics. Cultures were positive for Staphylococcus epidermidis. One week later, the infiltrate had resolved and BCVA had returned to 20/20. Delayed bacterial keratitis has been described as a rare occurrence after incisional refractive surgery. To the best of our knowledge, it has not yet been reported after LASIK. It is important to consider infectious keratitis in the differential diagnosis of a patient who presents with corneal inflammation, even months after having LASIK.
我们报告2例在准分子原位角膜磨镶术（LASIK）术后发生的迟发性角膜炎病例。首例患者在LASIK增效手术后3个月出现周边角膜浸润。尽管使用局部妥布霉素 - 地塞米松联合治疗，浸润仍进展。随后掀起角膜瓣，用强化抗生素冲洗界面。角膜炎迅速消退，患者恢复了20/20的最佳矫正视力（BCVA）。第二例患者在初次LASIK术后1个月出现视力下降、炎症和板层下浸润。角膜瓣迅速掀起并用抗生素冲洗。培养结果显示表皮葡萄球菌阳性。1周后，浸润消退，BCVA恢复至20/20。迟发性细菌性角膜炎被描述为切开性屈光手术后的罕见情况。据我们所知，LASIK术后尚未见报道。对于即使在LASIK术后数月出现角膜炎症的患者，在鉴别诊断中考虑感染性角膜炎很重要。
