Original ArticleInfectious Keratitis after Photorefractive Keratectomy in the United States Army and Navy
Section snippets
Materials and Methods
We searched the Army and Navy data banks containing preoperative and postoperative patient information for cases of infectious keratitis, corneal ulcer, or corneal infiltrate. We conducted a retrospective chart review and queried all the surgeons involved in the care of those patients identified. Where possible, we obtained culture results and clinical photographs. We obtained the following information for review and analysis: preoperative preparation (povidone–iodine preparation, lid drapes),
Results
From January 1995 until May 2004, the United States Army and Navy completed 25337 PRK procedures at the 6 different institutions. All patients had a preoperative best-corrected visual acuity (BCVA) of 20/20 bilaterally. All patients were given a therapeutic bandage contact lens (BCL) and prophylactic antibiotics during surgery. All patients were discharged on topical antibiotics 4 times daily. Infectious keratitis developed in 5 eyes of 5 patients. These patients’ cases are summarized in Table 1
Discussion
Our review of 25337 PRK procedures at 6 institutions is the largest retrospective review of infectious keratitis after PRK. All of our patients except one received topical fluoroquinolones until the corneal epithelium healed. The other patient received trimethoprim–polymyxin B. Our cases presented within the first week after surgery, and despite the use of prophylactic fluoroquinolones and trimethoprim–polymyxin B in 1 patient, we had 4 culture-proven cases of gram-positive infectious
Acknowledgments
The authors acknowledge the assistance of COL (retired) Thomas Mader, MD, for review of the manuscript.
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Manuscript no. 2004-448
There was no financial support, public or private, used to fund the study. The authors have no financial interest in any product, drug, instrument, or equipment discussed in the article
The opinions expressed in the article are those solely of the authors and do not represent the views or official policies of the United States Army or Department of Defense