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Infectious keratitis following LASIK potentially devastating
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WASHINGTON — Surgeons should have a high degree of suspicion of infection if they see flap elevation after LASIK, and cultures should be ordered for any patient who raises a suspicion of infectious keratitis following LASIK or surface ablation, said Eric D. Donnenfeld, MD.
“We are doing a better job of elevating and scraping the beds of infections following refractive surgery,” Dr. Donnenfeld said here during the World Cornea Congress.
“Treatment continues to be delayed by lack of suspicion of infectious keratitis. Increased incidence of infectious keratitis is likely due to an increase in Staphylococcus infections,” he said.
Dr. Donnenfeld said infectious keratitis is rare, but it can be a potentially devastating complication following refractive surgery.
Infectious keratitis may become evident only months after surgery, and its misdiagnosis at initial presentation can result in significant vision loss, he said.
One way of distinguishing diffuse lamellar keratitis from infection is to look at the flap, Dr. Donnenfeld said. In diffuse lamellar keratitis, there is a diffuse haze that is seen in the interface, and it is limited to within the flap.
The incidence of infectious keratitis has increased, Dr. Donnenfeld said, presumably due to an increase in the prevalence of resistant organisms.