Diagnosis and Treatment of Mycobacterial Keratitis Following LASIK

¹Holzer M. P., ²Sandoval H. P., ²Daines B. S., ²Vroman D. T., ²Solomon K. D.,
¹ (Charleston)
²Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina (Charleston)

Objective: Mycobacterial keratitis following LASIK is a rare complication. The diagnosis and treatment is often delayed due to confusion with other entities including diffuse lamellar keratitis and poor clinical outcomes with flap amputation and/or keratoplasty are often the case.
Methods: We report the results of LASIK in a 51-year-old woman with subsequent early-diagnosed mycobacterial keratitis and compared this case to treatments and outcomes reported in the literature.
Results: The patient presented 10 days following LASIK with a white focal infiltrate in the stromal interface. The flap was lifted and cultures from the stromal bed and the backside of the flap were obtained and the interface irrigated. The patient was treated with topical antibiotics for 8 weeks and at the most recent follow-up she had a visual acuity of 1,3. In the majority of published cases in the literature however, the flap had to be amputated and corneal transplants were necessary.
Conclusions: Mycobacterial keratitis following LASIK often results in flap amputation or keratoplasty. With the increasing number of LASIK surgeries early diagnosis is very important for a successful treatment.

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