Bilateral non-tuberculous mycobacterial keratitis after small incision lenticule extraction
Journal
Journal of Refractive Surgery
Journal Volume
34
Journal Issue
9
Pages
633-636
Date Issued
2018
Abstract
PURPOSE: To report a case of bilateral non-tuberculous mycobacterial keratitis after small incision lenticule extraction (SMILE) that was successfully treated with oral and topical fortified antibiotics. METHODS: Case report and literature review. RESULTS: An otherwise healthy 21-year-old woman presented with culture-proven bilateral Mycobacterium abscessus keratitis 8 days after undergoing SMILE, showing multiple white stromal infiltrates in the interface in both eyes. Progressive, diffuse flap edema followed by pocket abscess, exudation in the anterior chamber, granulation tissue formation in the pocket, intrastromal neovascularization, and eventually partial resolution of corneal opacity were noted after topical and oral antibiotic treatment for 6 months. Her corrected distance visual acuity was 20/32 and 20/50 in the right and left eyes, respectively, 12 months after initial presentation. CONCLUSIONS: This is the first report of successful medical management of bilateral non-tuberculous mycobacterial keratitis after SMILE. The manifestations are different from and even more difficult to treat than those of keratitis after LASIK. Copyright ? SLACK Incorporated.
SDGs
Other Subjects
amikacin; cefazolin; clarithromycin; gentamicin; imipenem; levofloxacin; moxifloxacin; prednisolone acetate; amikacin; antiinfective agent; clarithromycin; imipenem; moxifloxacin; quinolone derivative; abscess; acid fast bacterium; add on therapy; adult; amputation; anterior eye chamber; anterior eye segment; antibiotic therapy; Article; atypical mycobacteriosis; atypical Mycobacterium; bacterial keratitis; bacterium culture; bacterium identification; case report; clinical article; cornea edema; cornea neovascularization; cornea opacity; cornea stroma; corrected distance visual acuity; drug dose increase; drug dose reduction; drug substitution; drug withdrawal; female; granulation tissue; human; intraocular hemorrhage; Mycobacterium abscessus; optical coherence tomography; priority journal; skin defect; small incision lenticule extraction; systemic therapy; topical treatment; treatment refusal; young adult; atypical mycobacteriosis; bacterial eye infection; combination drug therapy; cornea ulcer; eye refraction; intraocular drug administration; isolation and purification; microbiology; microsurgery; myopia; oral drug administration; photorefractive keratectomy; physiology; surgical flaps; visual acuity; Administration, Ophthalmic; Administration, Oral; Amikacin; Anti-Bacterial Agents; Clarithromycin; Corneal Surgery, Laser; Corneal Ulcer; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Fluoroquinolones; Humans; Imipenem; Microsurgery; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous; Myopia; Refraction, Ocular; Surgical Flaps; Tomography, Optical Coherence; Visual Acuity; Young Adult
Type
journal article