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Bilateral bacterial keratitis in three patients following photorefractive keratectomy.
J Refract Surg. 2007 Mar; 23(3):312-5.JR

Abstract

PURPOSE

To report clinical manifestations and the bacteriologic profiles of three patients with bilateral bacterial keratitis following photorefractive keratectomy (PRK).

METHODS

Photorefractive keratectomy was performed for mild to moderate myopia or compound myopic astigmatism. Bandage contact lenses were fitted at the conclusion of each surgery. Bilateral infectious keratitis was diagnosed within 3 days after surgery. Smear and culture were obtained in all three cases. Patients were treated with topical fortified antibiotics (cefazolin and gentamicin).

RESULTS

All patients presented with severe bilateral ocular pain, photophobia, purulent discharge, and dense corneal infiltration. Causative organisms were Staphylococcus aureus (n = 2) and Streptococcus pneumoniae (n = 1). Ulcers were controlled with aggressive medical therapy in five eyes; however, tectonic penetrating keratoplasty was required in one eye.

CONCLUSIONS

Uncontrolled blepharitis and bandage contact lens use appears to play a role in the development of bacterial keratitis after PRK. Avoidance of simultaneous bilateral surgery in patients with risk factors for bacterial keratitis, preoperative control of blepharitis, and good contact lens hygiene is suggested.

Authors+Show Affiliations

Cornea and Anterior Segment Service, Department of Ophthalmology, Labbafinejad Medical Center, Shaheed Beheshti Medical University, Tehran, Iran. karimianf@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17385301

Citation

Karimian, Farid, et al. "Bilateral Bacterial Keratitis in Three Patients Following Photorefractive Keratectomy." Journal of Refractive Surgery (Thorofare, N.J. : 1995), vol. 23, no. 3, 2007, pp. 312-5.
Karimian F, Baradaran-Rafii A, Javadi MA, et al. Bilateral bacterial keratitis in three patients following photorefractive keratectomy. J Refract Surg. 2007;23(3):312-5.
Karimian, F., Baradaran-Rafii, A., Javadi, M. A., Nazari, R., Rabei, H. M., & Jafarinasab, M. R. (2007). Bilateral bacterial keratitis in three patients following photorefractive keratectomy. Journal of Refractive Surgery (Thorofare, N.J. : 1995), 23(3), 312-5.
Karimian F, et al. Bilateral Bacterial Keratitis in Three Patients Following Photorefractive Keratectomy. J Refract Surg. 2007;23(3):312-5. PubMed PMID: 17385301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral bacterial keratitis in three patients following photorefractive keratectomy. AU - Karimian,Farid, AU - Baradaran-Rafii,Alireza, AU - Javadi,Mohammad-Ali, AU - Nazari,Roshanak, AU - Rabei,Hossein Mohammad, AU - Jafarinasab,Mohammad-Reza, PY - 2007/3/28/pubmed PY - 2007/4/20/medline PY - 2007/3/28/entrez SP - 312 EP - 5 JF - Journal of refractive surgery (Thorofare, N.J. : 1995) JO - J Refract Surg VL - 23 IS - 3 N2 - PURPOSE: To report clinical manifestations and the bacteriologic profiles of three patients with bilateral bacterial keratitis following photorefractive keratectomy (PRK). METHODS: Photorefractive keratectomy was performed for mild to moderate myopia or compound myopic astigmatism. Bandage contact lenses were fitted at the conclusion of each surgery. Bilateral infectious keratitis was diagnosed within 3 days after surgery. Smear and culture were obtained in all three cases. Patients were treated with topical fortified antibiotics (cefazolin and gentamicin). RESULTS: All patients presented with severe bilateral ocular pain, photophobia, purulent discharge, and dense corneal infiltration. Causative organisms were Staphylococcus aureus (n = 2) and Streptococcus pneumoniae (n = 1). Ulcers were controlled with aggressive medical therapy in five eyes; however, tectonic penetrating keratoplasty was required in one eye. CONCLUSIONS: Uncontrolled blepharitis and bandage contact lens use appears to play a role in the development of bacterial keratitis after PRK. Avoidance of simultaneous bilateral surgery in patients with risk factors for bacterial keratitis, preoperative control of blepharitis, and good contact lens hygiene is suggested. SN - 1081-597X UR - https://www.unboundmedicine.com/medline/citation/17385301/Bilateral_bacterial_keratitis_in_three_patients_following_photorefractive_keratectomy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17385301.ui DB - PRIME DP - Unbound Medicine ER -