Late-onset infections after LASIK.

PURPOSE: To report two cases of infectious keratitis that developed 2 and 6 years after LASIK.

METHODS

Case 1 was a 56-year-old woman who presented with redness and decreased vision in the right eye 6 years after LASIK. Slit-lamp examination revealed inflammation of the flap interface, a partially detached flap, anterior chamber reaction, and hypopyon. Corneal scrapings were taken. Case 2 was a 23-year-old woman who presented with pain and a corneal infiltrate in the left eye 36 hours after eye trauma. She had undergone bilateral LASIK 2 years prior. The condition worsened despite treatment, and a flap amputation was performed.

RESULTS

Cultures revealed Pseudomonas mesophilic and Fusarium solani, respectively. Keratitis in case 1 resolved after 21 days of fortified antibiotic therapy. Visual acuity of 20/40 was achieved after antibiotic treatment in case 2.

CONCLUSIONS

These case reports demonstrate the risk of microbial keratitis occurring years after LASIK and emphasize the need for lifelong postoperative vigilance by patient and physician.