Mycobacterium chelonae keratitis after excimer laser photorefractive keratectomy
R. Brancato, F. Carones, E. Venturi, A. Cavallero and G. Gesu
Department of Ophthalmology and Visual Sciences, Scientific Institute San Raffaele Hospital, University of Milan, Italy. r.brancato@ophthalm.hsr.it
This is the first report of a severe case of Mycobacterium chelonae
keratitis; it occurred in a 26-year-old man after he had undergone excimer
laser photorefractive keratectomy for the correction of severe myopia, once
the epithelium was already healed. The diagnosis was made by culture
results and acid-fast staining of corneal scrapings. Topical ciprofloxacin
sodium, 0.3 mg/mL, plus amikacin sodium, 10 mg/mL, and oral clarithromycin
sodium led to remission of the ulceration after 3 months of therapy.
Subsequent topical corticosteroid therapy led to complete visual recovery
during 1 year of follow-up. There may be an increased risk of severe
keratitis during the first postoperative months in eyes that have already
undergone photorefractive keratectomy, due to the presence of some
microepithelial defects symptomatically negative and not easily detectable
by slit-lamp examination.
