Non-tuberculous mycobacterial keratitis at the interface after laser in situ keratomileusis

Kyoung Y. Seo, Jae B. Lee, Kyungwon Lee, Moon J. Kim, Kyu Ryong Choi, Eung K. Kim

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

PURPOSE: To describe two cases of bacterial keratitis with atypical mycobacteria after laser in situ keratomileusis (LASIK). METHODS: Two cases of non-tuberculous mycobacterial keratitis occurred in the interface between the stromal bed and flap, 20 days and 14 days after LASIK. The keratitis progressed slowly and worsened after attempts were made to remove the colonies. Mycobacterium fortuitum was confirmed 2 months after initial presentation following culture of the excised flap tissue in one case, and Mycobacterium chelonae was identified by culture of removed material and by RT-PCR with primers in the other case. The patients were treated medically and by surgical flap removal. RESULTS: In the first case, the keratitis was controlled only after removal of the partially melted flap and intensive medical treatment. In the second case, the lesion cleared after 2 months of antibiotics, but after tapering of antibiotics, the infiltrate progressed. Eventually, the keratitis was controlled after removal of the flap. CONCLUSIONS: Non-tuberculous Mycobacterium should be considered as one of the causes of keratitis when presenting as white colonies in the lamellar bed after LASIK. Treatment for 2 months may not be enough to eradicate the infection and excision of the flap may be necessary.

Original languageEnglish
Pages (from-to)81-85
Number of pages5
JournalJournal of Refractive Surgery
Volume18
Issue number1
Publication statusPublished - 2002 Feb 5

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Laser In Situ Keratomileusis
Keratitis
Mycobacterium chelonae
Mycobacterium fortuitum
Anti-Bacterial Agents
Nontuberculous Mycobacteria
Surgical Flaps
Mycobacterium
Polymerase Chain Reaction
Therapeutics
Infection

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

Cite this

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abstract = "PURPOSE: To describe two cases of bacterial keratitis with atypical mycobacteria after laser in situ keratomileusis (LASIK). METHODS: Two cases of non-tuberculous mycobacterial keratitis occurred in the interface between the stromal bed and flap, 20 days and 14 days after LASIK. The keratitis progressed slowly and worsened after attempts were made to remove the colonies. Mycobacterium fortuitum was confirmed 2 months after initial presentation following culture of the excised flap tissue in one case, and Mycobacterium chelonae was identified by culture of removed material and by RT-PCR with primers in the other case. The patients were treated medically and by surgical flap removal. RESULTS: In the first case, the keratitis was controlled only after removal of the partially melted flap and intensive medical treatment. In the second case, the lesion cleared after 2 months of antibiotics, but after tapering of antibiotics, the infiltrate progressed. Eventually, the keratitis was controlled after removal of the flap. CONCLUSIONS: Non-tuberculous Mycobacterium should be considered as one of the causes of keratitis when presenting as white colonies in the lamellar bed after LASIK. Treatment for 2 months may not be enough to eradicate the infection and excision of the flap may be necessary.",
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Non-tuberculous mycobacterial keratitis at the interface after laser in situ keratomileusis. / Seo, Kyoung Y.; Lee, Jae B.; Lee, Kyungwon; Kim, Moon J.; Ryong Choi, Kyu; Kim, Eung K.

In: Journal of Refractive Surgery, Vol. 18, No. 1, 05.02.2002, p. 81-85.

Research output: Contribution to journalArticle

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AB - PURPOSE: To describe two cases of bacterial keratitis with atypical mycobacteria after laser in situ keratomileusis (LASIK). METHODS: Two cases of non-tuberculous mycobacterial keratitis occurred in the interface between the stromal bed and flap, 20 days and 14 days after LASIK. The keratitis progressed slowly and worsened after attempts were made to remove the colonies. Mycobacterium fortuitum was confirmed 2 months after initial presentation following culture of the excised flap tissue in one case, and Mycobacterium chelonae was identified by culture of removed material and by RT-PCR with primers in the other case. The patients were treated medically and by surgical flap removal. RESULTS: In the first case, the keratitis was controlled only after removal of the partially melted flap and intensive medical treatment. In the second case, the lesion cleared after 2 months of antibiotics, but after tapering of antibiotics, the infiltrate progressed. Eventually, the keratitis was controlled after removal of the flap. CONCLUSIONS: Non-tuberculous Mycobacterium should be considered as one of the causes of keratitis when presenting as white colonies in the lamellar bed after LASIK. Treatment for 2 months may not be enough to eradicate the infection and excision of the flap may be necessary.

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