Laser in situ Keratomileusis Following Acanthamoeba Keratitis

Abstract

Although data regarding reactivation of microbial corneal infections following LASIK is scarce, the use of excimer laser is known to be an efficient trigger for the reactivation of herpes simplex keratitis. With this in mind, the use of excimer laser, including LASIK, theoretically places the cornea at potential risk for reactivation of other microbial infections. Acanthamoeba keratitis is a severe, painful, sight-threatening infection most often associated with soft contact lens use. Treatment of Acanthamoeba keratitis is notoriously difficult, and despite prolonged administration of anti-protozoal agents such as polyhexamethylene, propamidine isethionate (Brolene), and neomycin, recurrence of the keratitis can occur. Postoperative reactivation following penetrating keratoplasty performed for visual rehabilitation in patients with previous Acanthamoeba keratitis has been documented, and LASIK, when performed on these patients, may raise concerns about the potential risk of reactivation of the infection. We report the case of a myopic patient with previous Acanthamoeba keratitis and corneal scarring who underwent LASIK without preoperative anti-protozoal prophylaxis. During a 6-month follow-up period after LASIK, no recurrence of the infection was noted. In our patient who previously suffered from Acanthamoeba keratitis and underwent LASDX, no reactivation of the infection was seen. [J Refract Surg 2000;16(suppl):S251-S252].