ABSTRACT
We present a case of a patient that experienced severe hemorrhagic occlusive retinal vasculitis secondary to injection of 1.0 mg/0.1 ml of intracameral vancomycin for endophthalmitis prophylaxis after an uneventful cataract surgery. The case is especially unique in that our patient ended up maintaining 20/25 vision with an ocular disease that is typically visually threatening. This may be due to the aggressive administration of periocular and oral steroids combined with scheduled anti-VEGF injections that were later transitioned into a treat and extend regimen.
Subject(s)
Anti-Bacterial Agents/adverse effects , Retinal Hemorrhage/drug therapy , Retinal Vasculitis/drug therapy , Vancomycin/adverse effects , Aged , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antiviral Agents/therapeutic use , Benzophenones/therapeutic use , Bromobenzenes/therapeutic use , Cataract Extraction , Drug Combinations , Endophthalmitis/microbiology , Endophthalmitis/prevention & control , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/prevention & control , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Prednisone/therapeutic use , Retinal Hemorrhage/chemically induced , Retinal Hemorrhage/diagnosis , Retinal Vasculitis/chemically induced , Retinal Vasculitis/diagnosis , Tomography, Optical Coherence , Valacyclovir/therapeutic useABSTRACT
Laser in situ keratomileusis (LASIK) has become the community standard in corneal refractive surgery and is being performed by surgeons in the Army, Navy, and Air Force. LASIK differs from photorefractive keratectomy (PRK) in that a partial-thickness corneal flap is created in the LASIK procedure before removing a microscopic amount of corneal tissue, whereas no flap creation is required in PRK. The benefits of LASIK include minimal discomfort after surgery, as well as a much faster return of visual function. PRK involves a surface ablation and therefore heals differently, involving more discomfort and a slower return of functional vision. LASIK flap integrity is a concern to anyone undergoing the procedure, as well as for those making recommendations on the best form of refractive surgery for military personnel. A case report and a review of the literature are presented on the identification and management of LASIK flap trauma.
