Ulcerative keratitis caused by Serratia marcescens after laser in situ keratomileusis

J Cataract Refract Surg. 2004 Feb;30(2):507-12. doi: 10.1016/S0886-3350(03)00651-5.

Abstract

We report 2 cases of severe corneal infections caused by Serratia marcescens after laser in situ keratomileusis (LASIK). Twenty-four hours after LASIK, 2 patients developed infectious keratitis, 1 bilaterally. In each eye, the corneal flap was edematous, ulcerated, and detached from the stromal bed. Treatment included removal of the necrotic flap and aggressive antibiotic therapy. Cultures from corneal exudates were positive for S marcescens. After 1 year, both patients had a loss of best corrected visual acuity (BCVA) ranging from 20/40 to 20/22 because of irregular astigmatism. Overrefraction with a hard contact lens resulted in a BCVA of 20/20 in the 3 affected eyes. Slitlamp examination showed trace subepithelial haze without severe corneal scarring. Videokeratography disclosed areas of paracentral inferior steepening resembling keratoconus. Refraction and videokeratography remained stable after 6 months of follow-up. Ulcerative keratitis caused by S marcescens is a potential complication of LASIK. Bilateral involvement may occur if bilateral simultaneous surgery is performed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents
  • Contact Lenses
  • Corneal Stroma / microbiology
  • Corneal Stroma / surgery
  • Corneal Topography
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / drug therapy
  • Corneal Ulcer / microbiology*
  • Drug Therapy, Combination / therapeutic use
  • Eye Infections, Bacterial* / diagnosis
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / etiology
  • Female
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Middle Aged
  • Refraction, Ocular
  • Serratia Infections* / diagnosis
  • Serratia Infections* / drug therapy
  • Serratia Infections* / etiology
  • Serratia marcescens / isolation & purification*
  • Surgical Flaps / microbiology
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / microbiology*
  • Visual Acuity

Substances

  • Anti-Bacterial Agents