Abstract
Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about Mycobacterium abscess infection after laser in situ keratomileusis (LASIK). Participants: Both cases 1 and 2 were females who exhibited a corneal ulceration after LASIK in the same hospital. Methods: The first patient in the study was a 28-year-old woman who underwent Epi-LASIK surgery in both eyes. She developed an infectious corneal ulcer in one eye after 50 days post-surgery. She was referred to our out-patient clinic 3 months post-surgery with corneal perforation, and was treated with a therapeutic penetrating keratoplasty. The second patient was a 27-year-old woman who developed infectious keratitis in one eye after 2 months after bilateral LASIK and was referred to us 3 months later. Results: Cultures in both the cases were identified as a Mycobacterium abscess, and case 1 was treated with penetrating keratoplasty eventually, while case 2 recovered after sensitive treatment. Conclusions: Infectious keratitis after refractive surgery is uncommon, and Mycobacterium abscess has never been observed in corneal infections. An accurate diagnosis and identification of the causative agent is very important.
Highlights
Few reports were published relating to infectious keratitis after laser refractive surgery, and most of these cases were bacterial infection
We found that mycobacterium abscess was less common pathogen of infectious disease, especially in ocular surface
Both patients suffered from an extremely rare complication after laser in situ keratomileusis (LASIK), but both patients were young women with good immunity. It shows the potential infection risk of LASIK and the necessity of strict adherence to aseptic techniques. Both the cases presented in this study showed a delayed onset Mycobacterium abscess keratitis after LASIK; the source of the infection still remains a mystery as mycobacterial infection is commonly found at the skin, lung and large-area exposure wound, etc
Summary
With the extensive development of excimer laser in situ keratomileusis (LASIK), the incidence of postoperative complications of LASIK is in-. Non-tuberculous mycobacterium (NTM) is one of the main pathogenic microorganisms leading to postoperative infectious keratitis, among which Mycobacterium turtle (34.72% [2]) and Sporadic mycobacterium are the most common. The clinical case reports of Mycobacterium abscess keratitis (MAK) following LASIK (Mycobacterium abscessus keratitis,) are still very few, when related to etiology and pathology research [6]. Mycobacterium abscess (MA) is a type of the mycobacterium tuberculosis (non-tuberculous mycobacteria, NTM), widely distributed in the soil, water and animals. We received two cases of Mycobacterium abscess infection leading to keratitis after LASIK, and the reports are as follows
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