Infectious keratitis outbreak after laser in situ keratomileusis at a single laser center in Japan

Takefumi Yamaguchi, Hiroko Bissen-Miyajima, Yoshiko Hori-Komai, Yukihiro Matsumoto, Nobuyuki Ebihara, Hiroshi Takahashi, Kazuo Tsubota, Jun Shimazaki

研究成果: Article

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Purpose: To evaluate an outbreak of infectious keratitis after laser in situ keratomileusis (LASIK) at a single laser center in Japan. Setting: Tokyo Dental College, Chiba, Japan. Design: Case series. Methods: Relevant demographic and clinical data were obtained from case records using a standardized multicenter questionnaire at 12 major hospitals. The clinical manifestations, management, and outcomes were analyzed. Results: Thirty-nine eyes of 30 patients developed infectious keratitis after LASIK at the specified clinic. Cases of infection continued to appear over a 5-month period. The most common interval between LASIK and the onset of infection was within 2 weeks (36 eyes, 92.3%). Slitlamp manifestation included granular opacity beneath flap (71.8%), multiple infiltration (66.7%), and epithelial defect (30.8%). Mycobacterium was identified as the causative organism in 9 eyes (23.1%). In most cases, topical amikacin, arbekacin, and erythromycin in addition to fourth-generation fluoroquinolones were effective. Flap amputation was necessary in 10 eyes (25.6%) of 10 patients. Decimal visual acuity at initial presentation was worse than 0.10 in 14 eyes (35.9%), 0.15 to 0.50 in 8 eyes (20.5%), and 0.60 to 0.90 in 7 eyes (17.9%) and was better than 1.00 in 10 eyes (25.6%). Final decimal visual acuity was worse than 0.10 in 2 eyes (5.1%), 0.15 to 0.50 in 5 eyes (12.8%), and 0.60 to 0.90 in 11 eyes (28.2%) and was better than 1.00 in 21 eyes (53.8%). Conclusions: Mycobacterium was identified as the causative organism of this outbreak. This study shows the possibility of an epidemic of post-LASIK infectious keratitis. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

元の言語English
ページ(範囲)894-900
ページ数7
ジャーナルJournal of Cataract and Refractive Surgery
37
発行部数5
DOI
出版物ステータスPublished - 2011 5 1

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

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    Yamaguchi, T., Bissen-Miyajima, H., Hori-Komai, Y., Matsumoto, Y., Ebihara, N., Takahashi, H., Tsubota, K., & Shimazaki, J. (2011). Infectious keratitis outbreak after laser in situ keratomileusis at a single laser center in Japan. Journal of Cataract and Refractive Surgery, 37(5), 894-900. https://doi.org/10.1016/j.jcrs.2010.11.034