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Bacillus megaterium delayed onset lamellar keratitis after LASIK.
J Refract Surg. 2006 Mar; 22(3):309-12.JR

Abstract

PURPOSE

To report the history and clinical presentation of a 23-year-old man who developed delayed onset lamellar keratitis in his right eye 2 weeks after uneventful LASIK for correction of myopia.

METHODS

Initial clinical presentation suggested an infectious etiology, which led to therapeutic elevation of the LASIK flap and further microbiologic investigation with bacterial cultures.

RESULTS

Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. Twenty-four hours after initiating aggressive topical and oral antibiotic therapy, symptomatic relief occurred in the affected eye. The patient's uncorrected final visual acuity at 1-year follow-up was 20/15 in the right eye, and the stromal bed developed a faint peripheral non-visually significant scar.

CONCLUSIONS

This case is an unusual presentation and course for microbial keratitis following LASIK, which occurred despite aseptic technique and fluoroquinolone antibiotic prophylaxis. Following refractive surgery one should be prepared to culture the lamellar interface in cases of suspected microbial keratitis and begin aggressive antibiotic therapy.

Authors+Show Affiliations

Department of Ophthalmology, Yale University School of Medicine, New Haven, Conn, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16602323

Citation

Ramos-Esteban, Jerome C., et al. "Bacillus Megaterium Delayed Onset Lamellar Keratitis After LASIK." Journal of Refractive Surgery (Thorofare, N.J. : 1995), vol. 22, no. 3, 2006, pp. 309-12.
Ramos-Esteban JC, Servat JJ, Tauber S, et al. Bacillus megaterium delayed onset lamellar keratitis after LASIK. J Refract Surg. 2006;22(3):309-12.
Ramos-Esteban, J. C., Servat, J. J., Tauber, S., & Bia, F. (2006). Bacillus megaterium delayed onset lamellar keratitis after LASIK. Journal of Refractive Surgery (Thorofare, N.J. : 1995), 22(3), 309-12.
Ramos-Esteban JC, et al. Bacillus Megaterium Delayed Onset Lamellar Keratitis After LASIK. J Refract Surg. 2006;22(3):309-12. PubMed PMID: 16602323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacillus megaterium delayed onset lamellar keratitis after LASIK. AU - Ramos-Esteban,Jerome C, AU - Servat,Juan Javier, AU - Tauber,Shachar, AU - Bia,Frank, PY - 2006/4/11/pubmed PY - 2006/5/5/medline PY - 2006/4/11/entrez SP - 309 EP - 12 JF - Journal of refractive surgery (Thorofare, N.J. : 1995) JO - J Refract Surg VL - 22 IS - 3 N2 - PURPOSE: To report the history and clinical presentation of a 23-year-old man who developed delayed onset lamellar keratitis in his right eye 2 weeks after uneventful LASIK for correction of myopia. METHODS: Initial clinical presentation suggested an infectious etiology, which led to therapeutic elevation of the LASIK flap and further microbiologic investigation with bacterial cultures. RESULTS: Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. Twenty-four hours after initiating aggressive topical and oral antibiotic therapy, symptomatic relief occurred in the affected eye. The patient's uncorrected final visual acuity at 1-year follow-up was 20/15 in the right eye, and the stromal bed developed a faint peripheral non-visually significant scar. CONCLUSIONS: This case is an unusual presentation and course for microbial keratitis following LASIK, which occurred despite aseptic technique and fluoroquinolone antibiotic prophylaxis. Following refractive surgery one should be prepared to culture the lamellar interface in cases of suspected microbial keratitis and begin aggressive antibiotic therapy. SN - 1081-597X UR - https://www.unboundmedicine.com/medline/citation/16602323/Bacillus_megaterium_delayed_onset_lamellar_keratitis_after_LASIK_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16602323.ui DB - PRIME DP - Unbound Medicine ER -