Infectious keratitis after photorefractive keratectomy

Eric D. Donnenfeld, Terrence P. O'Brien, Renée Solomon, Henry D. Perry, Mark G. Speaker, John Wittpenn

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

Purpose: To elucidate risk factors, microbial culture results, and visual outcomes for infectious keratitis after photorefractive keratectomy (PRK). Design: Multicenter, retrospective chart review, case report, and literature review. Methods: The records of 12 patients with infectious keratitis after PRK were reviewed. Main Outcome Measures: Causative organism, response to medical treatment, and visual outcome. Results: Infectious keratitis developed in 13 eyes of 12 patients after PRK. Organisms cultured were Staphylococcus aureus (n = 5), including a bilateral case of methicillin-resistant Staphylococcus aureus; Staphylococcus epidermidis (n = 4); Streptococcus pneumoniae (n = 3); and Streptococcus viridans (n = 1). Four patients manipulated their contact lenses, and 2 patients were exposed to nosocomial organisms while working in a hospital environment. Prophylactic antibiotics used were tobramycin (nine cases), polymyxin B-trimethoprim (three cases), and ciprofloxacin (one case). Final best spectacle-corrected visual acuity ranged from 20/20 to 20/100. Conclusions: Infectious corneal ulceration is a serious potential complication of PRK. Gram-positive organisms are the most common pathogens. Antibiotic prophylaxis should be broad spectrum and should include gram-positive coverage.

Original languageEnglish (US)
Pages (from-to)743-747
Number of pages5
JournalOphthalmology
Volume110
Issue number4
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Donnenfeld, E. D., O'Brien, T. P., Solomon, R., Perry, H. D., Speaker, M. G., & Wittpenn, J. (2003). Infectious keratitis after photorefractive keratectomy. Ophthalmology, 110(4), 743-747. https://doi.org/10.1016/S0161-6420(02)01936-X