Infectious keratitis: an update on the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis.

Abstract

This study aimed to assess the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis after surface ablation (PRK). This single-center prospective case-series review comprised 6500 eyes of 3400 patients undergoing PRK operation successively at the Ardabil Noor Surgical Center between January 1, 2003, and February 1, 2020. The incidence, risk factors, and clinical course were recorded for these samples. Three clinical and culture-proven cases of infectious keratitis in three eyes of three patients were diagnosed during the study period. Post-operative keratitis was observed in cases 1 and 2 after 3 days and in case 3 after 112 days. The results of cultures were positive in all three cases. The isolated microorganisms were Staphylococcus species in cases 1 and 2 and Candida Albicans in case 3. The final corrected distance visual acuity was 20/25 and 20/20 in cases 1 and 2, respectively, and hand motion in case 3. All three patients had some risk factors such as well-controlled familial Mediterranean fever, mild Meibomian gland dysfunction, and the healthcare environment of the patient's wife in case 1, contact lens manipulation in case 2, and dry eye in case 3. The prevalence of infectious keratitis after PRK was 0.046%. Infectious keratitis is one of the complications of PRK that can threaten patients' vision. Accordingly, proper preoperative clinical history taking, adequate eye exam and aggressive management can help maintain good eyesight in patients who undergo PRK surgery.