Delayed onset Mycobacterium intracellulare keratitis after laser in situ keratomileusis: A case report and literature review

Jae Sang Ko, Se Kyung Kim, Dong Eun Yong, Tae Im Kim, Eung Kweon Kim

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)

Abstract

Rationale: Infectious keratitis is a relatively uncommon but potentially sight-threatening complication of laser in situ keratomileusis (LASIK). Mycobacterial keratitis is usually regarded as late onset keratitis among post-LASIK keratitis. There has been no documented case of Mycobacterium intracellulare post-LASIK keratitis of a long-latent period. Patient concerns: A 36-year-old man was referred to our out-patient clinic, for persistent corneal epithelial defect with intrastromal infiltration. He had undergone uneventful bilateral LASIK procedure 4 years before. He complained decreased vision, accompanied by ocular pain, photophobia, and redness in his left eye for 7 months. Diagnosis: Lamellar keratectomy was taken using femtosecond laser. Bacterial culture with sequenced bacterial 16s ribosomal DNA confirmed the organism to be M intracellulare. Interventions: After 3 months of administration of topical clarithromycin, amikacin, and moxifloxacin, the corneal epithelial defect was resolved and the infiltration was much improved. However, newly developed diffuse haziness with surrounding granular infiltration in the central cornea was noted. Drug toxicity was suspected and topical moxifloxacin was discontinued, resulting in resolution of the diffuse haze with infiltration. Outcome: The patient was followed up regularly without medication thereafter and recurrence was not found for 7 years. Lessons: This case presents the first case of M intracellulare keratitis after LASIK. LASIK surgeons should aware that post-LASIK keratitis can develop long after the operation and careful suspicion of infectious disease with meticulous diagnostic test is needed.

Original languageEnglish
Article numbere9356
JournalMedicine (United States)
Volume96
Issue number51
DOIs
Publication statusPublished - 2017 Dec 1

Bibliographical note

Funding Information:
Editor: N/A. EKK is the medical advisory board member of the Avellino LAB USA. Other authors have no conflicts of interest to declare. This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (No. HI16C1009). The authors have no conflicts of interest to disclose.

Publisher Copyright:
© 2017 the Author(s).

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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