Microbial keratitis after INTACS implantation with loose suture.

PURPOSE: To report a case of rapidly progressive infectious keratitis after INTACS implantation for keratoconus.

METHODS

A 32-year-old man presented with pain and decreased vision in the right eye of 2 days' duration. Right eye visual acuity was 20/800. He had undergone bilateral INTACS implantation 40 days prior for treatment of keratoconus.

RESULTS

Slit-lamp examination revealed corneal ulceration and loose suture. The corneal ulcer progressed despite aggressive therapy, and the patient underwent penetrating keratoplasty 48 hours after admission. The culture from corneal scraping and corneal button was positive for Staphylococcus aureus.

CONCLUSIONS

Infectious keratitis is a rare but devastating complication of INTACS implantation for treatment of keratoconus. Meticulous wound closure is necessary to reduce the risk of infection, especially in eyes with irregular corneal contour and variable corneal thickness.