Suspected Fungal Keratitis After LASIK: Treated with Flap Removal and Medical Therapy.

Kim, Yun Jeong; Choi, Sang Il; Kim, Woo Jung

Original Article

Journal of the Korean Ophthalmological Society 2001;42(11):1626-1631.
Published online November 1, 2001.

Suspected Fungal Keratitis After LASIK: Treated with Flap Removal and Medical Therapy.

Yun Jeong Kim, Sang Il Choi, Woo Jung Kim

Department of Ophthalmology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.

LASIK 수술후 각막편의 제거 치료가 필요했던 의증 진균 각막염 1 례

김우중(Woo Jung Kim),최상일(Sang Il Choi),김윤정(Yun Jeong Kim)

Abstract

PURPOSE
Infectious keratitis is a rare but serious vision- threatening potential complication which occurs after corneal refractive surgery. After LASIK, the risk of corneal infection is lower than that of after PRK which induces the presence of a large epithelial defect. But once the infectious keratitis after LASIK develops, treatment may be very difficult. METHODS: We experienced a case of suspected fungal keratitis which developed 6 weeks after LASIK in a 29- year old woman, who had central corneal opacity. There was no clinical improvement after antifungal therapy. The corneal flap was removed to improve antibiotic penetration and the stromal bed was irrigated. And antifungal medication continued . RESULTS: After 2 months of treatment, we could find progressive improvement of infection, but the central corneal scar and neovascularization remained. CONCLUSION: The treatment of fungal keratitis under the corneal flap which occurs after LASIK is difficult because the irreversibly damaged corneal flap forms a barrier against antibiotic penetration. So treatment after flap removal may be necessary for an effective medical therapy.

Key Words: Flap removal;Fungal keratitis;LASIK