PMID- 33229656
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1998-3689 (Electronic)
IS  - 0301-4738 (Print)
IS  - 0301-4738 (Linking)
VI  - 68
IP  - 12
DP  - 2020 Dec
TI  - Keratitis following laser refractive surgery: Clinical spectrum, prevention and 
      management.
PG  - 2813-2818
LID - 10.4103/ijo.IJO_2479_20 [doi]
AB  - Laser refractive surgery (LRS) is one of the most demanding areas of ophthalmic 
      surgery and high level of precision is required to meet outcome expectations of 
      patients. Post-operative recovery is of vital importance. Keratitis occurring 
      after LRS can delay visual recovery. Both surface ablations [Photorefractive 
      keratectomy (PRK)] as well as flap procedures [Laser in-situ keratomileusis 
      (LASIK)/Small incision lenticule extraction] are prone to this complication. 
      Reported incidence of post-LRS infectious keratitis is between 0% and 1.5%. The 
      rate of infections after PRK seems to be higher than that after LASIK. 
      Staphylococci, streptococci, and mycobacteria are the common etiological 
      organisms. About 50-60% of patients present within the first week of surgery. Of 
      the non-infectious keratitis, diffuse lamellar keratitis (DLK) is the most common 
      with reported rates between 0.4% and 4.38%. The incidence of DLK seems to be 
      higher with femtosecond LASIK than with microkeratome LASIK. A lot of stress is 
      laid on prevention of this complication through proper case selection, asepsis, 
      and use of improved protocols. Once keratitis develops, the right approach can 
      help resolve this condition quickly. In cases of suspected microbial keratitis, 
      laboratory identification of the organism is important. Most lesions resolve with 
      medical management alone. Interface irrigation, flap amputation, collagen 
      cross-linking and therapeutic penetrating keratoplasty (TPK) are reserved for 
      severe/non-resolving cases. About 50-75% of all infectious keratitis cases post 
      LRS resolve with a final vision of 20/40 or greater. Improved awareness, early 
      diagnosis, and appropriate intervention can help limit the damage to cornea and 
      preserve vision.
FAU - Das, Shilpa
AU  - Das S
AD  - Cornea and Refractive Services, Narayana Nethralaya Eye Hospital, Bengaluru, 
      Karnataka, India.
FAU - Garg, Prashant
AU  - Garg P
AD  - Paul Dubord Chair of Cornea, L.V Prasad Eye Institute, Hyderabad, Telangana, 
      India.
FAU - Mullick, Ritika
AU  - Mullick R
AD  - Cornea and Refractive Services, Narayana Nethralaya Eye Hospital, Bengaluru, 
      Karnataka, India.
FAU - Annavajjhala, Sriram
AU  - Annavajjhala S
AD  - Cornea and Refractive Services, Narayana Nethralaya Eye Hospital, Bengaluru, 
      Karnataka, India.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - India
TA  - Indian J Ophthalmol
JT  - Indian journal of ophthalmology
JID - 0405376
SB  - IM
MH  - Cornea/surgery
MH  - Humans
MH  - *Keratitis/diagnosis/epidemiology/etiology
MH  - *Keratomileusis, Laser In Situ/adverse effects
MH  - Lasers, Excimer/therapeutic use
MH  - *Photorefractive Keratectomy
PMC - PMC7856934
OTO - NOTNLM
OT  - Infections
OT  - keratitis
OT  - refractive surgery
COIS- None
EDAT- 2020/11/25 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/12/01
CRDT- 2020/11/24 05:57
PHST- 2020/11/24 05:57 [entrez]
PHST- 2020/11/25 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/12/01 00:00 [pmc-release]
AID - IndianJOphthalmol_2020_68_12_2813_301253 [pii]
AID - IJO-68-2813 [pii]
AID - 10.4103/ijo.IJO_2479_20 [doi]
PST - ppublish
SO  - Indian J Ophthalmol. 2020 Dec;68(12):2813-2818. doi: 10.4103/ijo.IJO_2479_20.