1/6. Ulcerative keratitis caused by serratia marcescens after laser in situ keratomileusis.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.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/6. Adverse corneal events associated with corneal reshaping: a case series.PURPOSE: This case series presents the first documented cases of infectious ulcers associated with overnight orthokeratology in north america and other less serious complications associated with overnight corneal reshaping. case reports: Five cases of adverse corneal events associated with corneal refractive therapy are described: two cases of microbial keratitis, one case of infiltrates, one case of toxic keratitis, and one corneal abrasion. CONCLUSIONS: Corneal compromise and poor compliance can cause adverse events with corneal reshaping. The need for ongoing patient education is important not only for pediatric contact lens patients, but also for adults.- - - - - - - - - - ranking = 0.33333333333333keywords = keratitis (Clic here for more details about this article) |
3/6. Infectious keratitis after overnight orthokeratology in canada.PURPOSE: To report 3 cases of infectious keratitis related to overnight orthokeratology use. methods: Retrospective case observation. RESULTS: All 3 patients were using overnight orthokeratology lenses when they presented with unilateral corneal ulcers. The organisms isolated were acanthamoeba, pseudomonas aeruginosa, and serratia marcescens. The clinical presentation and treatment of each case is presented. CONCLUSIONS: Overnight orthokeratology use may be associated with infectious keratitis despite the use of more oxygen-permeable materials and improved lens design. Patient education with informed consent, appropriate lens care, and meticulous follow-up is important. Because this complication is potentially sight threatening, orthokeratology requires further analysis and evaluation to establish its safety. The cases here are the first few reported cases in north america.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
4/6. Bilateral serratia marcescens keratitis after simultaneous bilateral radial keratotomy.PURPOSE/methods: After bilateral simultaneous radial keratotomy, serratia marcescens keratitis, which involved multiple incisions of both eyes, developed in a 46-year-old physician. The keratitis was treated with repeated wound debridement, fortified topical antibiotics, and topical povidone-iodine. RESULTS/CONCLUSIONS: Six months after radial keratotomy, uncorrected visual acuity was R.E.: 20/25 and L.E.: 20/60, both eyes correctable to 20/20. health-care workers who undergo refractive surgery may be at increased risk of acquired postoperative infections because of their work environment. Although the occurrence of simultaneous bilateral ulcerative keratitis after simultaneous bilateral radial keratotomy is rare, it is nonetheless a real possibility, making it prudent to perform radial keratotomy on one eye at a time.- - - - - - - - - - ranking = 1.1666666666667keywords = keratitis (Clic here for more details about this article) |
5/6. Infectious keratitis with corneal perforation associated with corneal hydrops and contact lens wear in keratoconus.BACKGROUND: corneal perforation is an uncommon complication associated with keratoconus. The first cases of infectious keratitis and corneal perforation associated with corneal hydrops and contact lens wear are reported in two keratoconus patients. methods: A retrospective chart review and histopathological examination were carried out. RESULTS: Both patients progressed to corneal perforation and emergency penetrating keratoplasty. One patient cultured fusarium and the second patient Serratia marcesens. Both patients wore contact lenses against medical advice. CONCLUSIONS: The tear in Descement's membrane, stromal oedema, and epithelial bedewing associated with corneal hydrops results in loss of the epithelial-endothelial barrier of the cornea, creating a conduit for infectious organisms through the cornea. Acute hydrops associated with epithelial keratitis, stromal swelling, and a Descement's membrane tear may be a significant risk factor for infectious keratitis and corneal perforation. contact lenses should not be worn during an active corneal hydrops owing to the increased risk for severe infectious keratitis and corneal perforation.- - - - - - - - - - ranking = 1.3333333333333keywords = keratitis (Clic here for more details about this article) |
6/6. Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear.OBJECTIVE: An unusual presentation of contact lens-related bacterial keratitis is that of epithelial nodular infiltrates and stromal inflammation without epithelial ulceration. The authors study the initial diagnosis, clinical features, causative organisms, and outcomes of corneal infections presenting in this manner. DESIGN: The study design was a 20-month retrospective chart review. PARTICIPANTS: Five patients with culture-proven bacterial keratitis who had predominantly nodular epithelial lesions were studied. RESULTS: Four infections were associated with soft contact lens wear and one with rigid lens wear. All patients had largely intact epithelium; typical gray-colored epithelial nodules, some with underlying anterior stromal haze; and diffuse, fine, cellular stromal inflammation. Two patients were referred with the tentative diagnosis of acanthamoeba infection and two as contact lens-related sterile keratitis. Epithelial cultures from three cases yielded Serratia sp., one yielded corynebacterium, and one streptococcus pneumoniae. All responded to antibacterial medication; final corrected visual acuity in all cases was 20/30 or better. CONCLUSIONS: Bacterial infection associated with contact lens wear can be established within the corneal epithelium without initially producing an ulcer. A wide range of both gram-positive and gram-negative organisms can be involved. Early recognition and treatment appear to result in a favorable outcome.- - - - - - - - - - ranking = 1.1666666666667keywords = keratitis (Clic here for more details about this article) |