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Speaker gives pearls for preventing infectious keratitis after laser vision correction
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CHICAGO — Preventing infectious keratitis after primary laser vision correction is preferred over treating a post laser vision correction infection, a speaker here said.
“Infectious keratitis may not be so common; however, it is devastating when it does happen. Half of patients have moderate to severe reduction of visual acuity. We know it is better to prevent it than treat it. If you have prompt recognition and aggressive treatment, you can end up with a very nice, reasonable result,” Deepinder K. Dhaliwal, MD, said at Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting.
One patient in every 2,800 patients undergoing laser vision correction will develop infectious keratitis, she said, with infections tending to occur both early and late, such as after primary surgery, enhancement, flap lift or later trauma.
Deepinder K. Dhaliwal
Optimizing the ocular surface is key to preventing infectious keratitis, Dhaliwal said.
“It is very important. I have been using hypochlorous acid preoperative ly , oral nutraceuticals, lifitegrast and cyclosporine. After the inflammation is controlled, I put some punctal plugs in there. For Demodex we’ll do some tea tree oil as well,” she said.
Intraoperatively, Dhaliwal stressed careful draping, using an antiseptic for the lids and a sterile technique to reduce the chance of infections. Additionally, using a separate set of instruments for each eye and being careful to avoid contaminated water exposure can reduce infection rates, she said . – by Robert Linnehan
Reference:
Dhaliwal DK. Infectious keratitis after laser vision correction: How to prevent and treat. Presented at: American Academy of Ophthalmology annual meeting; Oct. 14-18, 2016; Chicago.
Disclosure: Dhaliwal reports she is a consultant for NovaBay and Bausch + Lomb. She is a researcher/speaker for Abbott, Avedro, Imprimis, Oasis, Ocular Systems, Ocular Therapeutix and STAAR. She is a trainer for AMO VISX and Intralase Lasers.