Combined treatment with flap amputation, phototherapeutic keratectomy, and collagen crosslinking in severe intractable post-LASIK atypical mycobacterial infection with corneal melt.

Details

Serval ID
serval:BIB_377FE2FCCEDA
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Combined treatment with flap amputation, phototherapeutic keratectomy, and collagen crosslinking in severe intractable post-LASIK atypical mycobacterial infection with corneal melt.
Journal
Journal of cataract and refractive surgery
Author(s)
Kymionis G.D., Kankariya V.P., Kontadakis G.A.
ISSN
1873-4502 (Electronic)
ISSN-L
0886-3350
Publication state
Published
Issued date
04/2012
Peer-reviewed
Oui
Volume
38
Number
4
Pages
713-715
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
A 23-year-old woman was referred for management of intractable post-laser in situ keratomileusis (LASIK) keratitis due to atypical mycobacteria in the left eye. Corrected distance visual acuity was 20/20 in the right eye and counting fingers at 3 meters in the left eye. Slitlamp examination revealed multiple infiltrates in the flap interface and severe corneal stromal melting with thinning. Despite maximum antibiotic therapy for 7 days, the keratitis continued to worsen. A penetrating keratoplasty (PKP) was scheduled. While waiting for a corneal graft, corneal collagen crosslinking (CXL) with riboflavin and ultraviolet-A was proposed as an alternative treatment. Flap amputation and limited phototherapeutic keratotomy (PTK) (10 μm) were also performed. One week postoperatively, all infiltrates and stromal edema had resolved. At 3 months, the uncorrected distance visual acuity improved to 20/35. Corneal crosslinking after flap amputation and limited PTK was an effective treatment for severe intractable post-LASIK keratitis with corneal melting and obviated PKP.
Keywords
Amputation, Collagen/metabolism, Combined Modality Therapy, Corneal Stroma/metabolism, Corneal Stroma/surgery, Corneal Ulcer/microbiology, Corneal Ulcer/therapy, Cross-Linking Reagents/metabolism, Eye Infections, Bacterial/drug therapy, Eye Infections, Bacterial/microbiology, Eye Infections, Bacterial/surgery, Eye Infections, Bacterial/therapy, Female, Humans, Keratomileusis, Laser In Situ, Mycobacterium Infections, Nontuberculous/drug therapy, Mycobacterium Infections, Nontuberculous/microbiology, Mycobacterium Infections, Nontuberculous/surgery, Mycobacterium Infections, Nontuberculous/therapy, Photorefractive Keratectomy, Photosensitizing Agents/therapeutic use, Postoperative Complications, Riboflavin/therapeutic use, Surgical Flaps/pathology, Ultraviolet Rays, Visual Acuity/physiology, Young Adult
Pubmed
Web of science
Create date
01/10/2019 13:42
Last modification date
06/10/2019 5:26
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