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Infectious keratitis after photorefractive keratectomy in the United States army and navy.
Ophthalmology. 2006 Apr; 113(4):520-5.O

Abstract

PURPOSE

To review the incidence, culture results, clinical course, management, and visual outcomes of infectious keratitis after photorefractive keratectomy (PRK) at 6 Army and Navy refractive surgery centers.

DESIGN

Retrospective study.

PARTICIPANTS

Twelve thousand six hundred sixty-eight Navy and Army sailors and service members.

METHODS

Army and Navy refractive surgery data banks were searched for cases of infectious keratitis. A retrospective chart review and query of the surgeons involved in the care of those patients thus identified provided data regarding preoperative preparation, perioperative medications, treatment, culture results, clinical course, and final visual acuity.

RESULTS

Between January 1995 and May 2004, we performed a total of 25337 PRK procedures at the 6 institutions. Culture proven or clinically suspected infectious keratitis developed in 5 eyes of 5 patients. All patients received topical antibiotics perioperatively. All cases presented 2 to 7 days postoperatively. Cultures from 4 cases grew Staphylococcus, including 2 methicillin-resistant S. aureus (MRSA). One case of presumed infectious keratitis was culture negative. There were no reported cases of mycobacterial or fungal keratitis. In addition, we identified 26 eyes with corneal infiltrates in the first postoperative week that were felt to be sterile, and which resolved upon removal of the bandage contact lens and increasing antibiotic coverage.

CONCLUSIONS

Infectious keratitis is a rare but potentially vision-threatening complication after PRK. It is often caused by gram-positive organisms, including MRSA. Early diagnosis, appropriate laboratory testing, and aggressive antimicrobial therapy can result in good outcomes.

Authors+Show Affiliations

Kimbrough Army Health Clinic, Fort Meade, Maryland, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Multicenter Study

Language

eng

PubMed ID

16488012

Citation

Wroblewski, Keith J., et al. "Infectious Keratitis After Photorefractive Keratectomy in the United States Army and Navy." Ophthalmology, vol. 113, no. 4, 2006, pp. 520-5.
Wroblewski KJ, Pasternak JF, Bower KS, et al. Infectious keratitis after photorefractive keratectomy in the United States army and navy. Ophthalmology. 2006;113(4):520-5.
Wroblewski, K. J., Pasternak, J. F., Bower, K. S., Schallhorn, S. C., Hubickey, W. J., Harrison, C. E., Torres, M. F., & Barnes, S. D. (2006). Infectious keratitis after photorefractive keratectomy in the United States army and navy. Ophthalmology, 113(4), 520-5.
Wroblewski KJ, et al. Infectious Keratitis After Photorefractive Keratectomy in the United States Army and Navy. Ophthalmology. 2006;113(4):520-5. PubMed PMID: 16488012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infectious keratitis after photorefractive keratectomy in the United States army and navy. AU - Wroblewski,Keith J, AU - Pasternak,Joseph F, AU - Bower,Kraig S, AU - Schallhorn,Steven C, AU - Hubickey,Walter J, AU - Harrison,Cary E, AU - Torres,Mark F, AU - Barnes,Scott D, Y1 - 2006/02/17/ PY - 2004/12/27/received PY - 2005/09/02/revised PY - 2005/09/06/accepted PY - 2006/2/21/pubmed PY - 2006/4/12/medline PY - 2006/2/21/entrez SP - 520 EP - 5 JF - Ophthalmology JO - Ophthalmology VL - 113 IS - 4 N2 - PURPOSE: To review the incidence, culture results, clinical course, management, and visual outcomes of infectious keratitis after photorefractive keratectomy (PRK) at 6 Army and Navy refractive surgery centers. DESIGN: Retrospective study. PARTICIPANTS: Twelve thousand six hundred sixty-eight Navy and Army sailors and service members. METHODS: Army and Navy refractive surgery data banks were searched for cases of infectious keratitis. A retrospective chart review and query of the surgeons involved in the care of those patients thus identified provided data regarding preoperative preparation, perioperative medications, treatment, culture results, clinical course, and final visual acuity. RESULTS: Between January 1995 and May 2004, we performed a total of 25337 PRK procedures at the 6 institutions. Culture proven or clinically suspected infectious keratitis developed in 5 eyes of 5 patients. All patients received topical antibiotics perioperatively. All cases presented 2 to 7 days postoperatively. Cultures from 4 cases grew Staphylococcus, including 2 methicillin-resistant S. aureus (MRSA). One case of presumed infectious keratitis was culture negative. There were no reported cases of mycobacterial or fungal keratitis. In addition, we identified 26 eyes with corneal infiltrates in the first postoperative week that were felt to be sterile, and which resolved upon removal of the bandage contact lens and increasing antibiotic coverage. CONCLUSIONS: Infectious keratitis is a rare but potentially vision-threatening complication after PRK. It is often caused by gram-positive organisms, including MRSA. Early diagnosis, appropriate laboratory testing, and aggressive antimicrobial therapy can result in good outcomes. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16488012/Infectious_keratitis_after_photorefractive_keratectomy_in_the_United_States_army_and_navy_ DB - PRIME DP - Unbound Medicine ER -