First Author: E.Pozharitskaya RUSSIA
Co Author(s): M. Pozharitskiy M. Nerpina
Purpose:
Report a case of deep stromal postfemtolasik keratitis of unknown etiology.
Setting:
Federal Medical Biological Agency of Russia, Moscow.
Methods:
Patient with diagnosis OU - myopia, myopic astigmatism. From the anamnesis - usage of contact lenses for more than 10 years. Femto-LASIK was performed in both eyes. The day after surgery VIS OU = 1,0. Standard protocol is followed after surgery: 3 weeks of instillation of tobradex and artificial tears. Regular examination did not arise concerns, visual function remained consistently high. Three weeks after surgery - decreased visual acuity of the left eye, objectively VIS OS = 0,4, mixed conjunctival injection, in the central zone of the corneal stroma irregular infiltrate about 2 mm. It is recommended to renew the antibacterial and anti-inflammatory therapy. Marked temporary improvement of visual functions and the objective status, but after 2 weeks the infiltration increases, in anterior chamber Tyndall effect +2 was observed. The results of microbiological studies did not identify the agent. Acanthamoeba mixed mycotic etiology was ipothized, treatment initiated, the question of corneal transplantation was considered. Lifting the flap with a revision was performed and interface was irrigate with solutions of moxifloxacin and diflucan. During the surgery material was taken directly from the infiltrate for further microbiological studies.
Results:
The operation and postoperative period was uneventful, but laboratory data did not reveal any pathogen in the operative biopsy. VIS OS =0,1 with diaphragm VIS OS=0,7. A month after surgery, VIS OS= 0.9-1.0, in the central zone of the cornea semitransparent scar, diameters about 1 mm.
Conclusions:
Even a quite safe operation can lead to serious complications, post operative early and late infectious complications, so caution must be observed. In our example, we were able to preserve not only the cornea, but also a high visual function with chosen tactic of management. FINANCIAL DISCLOSURE?: No
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