Infection and Drug Resistance (Aug 2022)
Bacterial Keratitis Following Small Incision Lenticule Extraction
Abstract
Jin Li,1 Sheng-Wei Ren,1 Li-Juan Dai,1 Bo Zhang,1 Yu-Wei Gu,1 Chen-Jiu Pang,1 Yan Wang2 1Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, People’s Republic of China; 2Clinical College of Ophthalmology Tianjin Medical University, and The Tianjin Eye Hospital Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, People’s Republic of ChinaCorrespondence: Chen-Jiu Pang, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, People’s Republic of China, Tel +8613939018599, Email [email protected]; [email protected] Yan Wang, Clinical College of Ophthalmology Tianjin Medical University, and The Tianjin Eye Hospital Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, People’s Republic of China, Tel +8613602089393, Email [email protected]: To describe the development of bacterial keratitis after small incision lenticule extraction in 5 patients and to explore its appropriate therapies.Methods: We retrospectively summarized the clinical treatments of five patients with postoperative bacterial infection after small incision lenticule extraction, who were referred to our hospital from 2019 to 2021.Results: Five male patients had undergone bilateral SMILE in the local hospital due to myopia aged from 18 to 26 years. The onset of keratitis during 1– 3 days postoperatively and four of them were severe infection (2 bilateral, 2 unilateral). In five cases, 1 patient (1 eye) who was infected mild keratitis after SMILE was treated with only topical antibiotics; the others who respond poorly to topical antibiotics require surgical treatment, which 1 patient (1 eye) infected necrotic mass of the corneal cap was scraped and irrigated with antibiotic, and 3 patients (5 eyes) were treated by converting the cap to flap, curetting the necrotic tissue and irrigating with the antibiotic solution. In all patients, the duration from onset to resolution was 1– 5 weeks. The final uncorrected visual acuity was above 20/32.Conclusion: Owing to the upward popularity of refractive surgery, the incidence of keratitis after SMILE should not be ignored. Early diagnosis and timely treatment of post-SMILE keratitis are essential. For severe keratitis that fails to respond to topical antibiotics, the corneal cap should be opened as a flap.Keywords: small incision lenticule extraction, bacterial keratitis, refractive surgery, postoperative infection, therapy
