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Early diagnosis, aggressive treatment may limit infectious keratitis effects
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An aggressive antimicrobial therapy coupled with early diagnosis can result in good outcomes in patients who develop infectious keratitis after undergoing PRK, a study of U.S. Army and Navy personnel found.
Keith J. Wroblewski, MD, and colleagues retrospectively studied 12,668 members of the Army or Navy who had undergone PRK at one of six military refractive surgery centers. A total of 24,337 PRK procedures were performed between Jan. 1995 and May 2004.
Definite or suspected infectious keratitis developed in five eyes of five patients. All cases presented 2 to 7 days postoperatively. All the patients had received topical antibiotics perioperatively.
Cultures from four of the cases grew Staphylococcus and included two methiciliin-resistant S. aureus. One case of presumed infectious keratitis was culture negative. There were no reported cases of either fungal keratitis or mycobacterial keratitis. An additional 26 eyes had corneal infiltrates in the first postoperative week. The researchers felt the infiltrates were sterile, however, and they resolved after contact lens bandage removal and increasing antibiotic coverage.
“In our experience, the presentation of corneal infiltrates in the first postoperative week after PRK necessitates aggressive treatment,” the researchers said.
The study is published in the April issue of Ophthalmology.