Infectious keratitis in pediatric population aged less than two years: a tertiary eye institute experience.

BACKGROUND: Infectious keratitis is a serious ocular condition, which can lead to corneal scarring, vision loss, and even blindness. Pediatric infectious keratitis accounts for about 13% of all cases, although there is a lack of comprehensive data regarding keratitis in less than two years of age population group. This study was aimed to determine predisposing factors, clinical characteristics, microbial profile, and management of infectious keratitis in a population of children aged less than two years. MATERIALS AND METHODS: A retrospective study was carried out in a tertiary eye institute over a period of 18 years from July 2005 to December 2022. Collected data was analyzed for demographics, predisposing factors, clinical features, and treatment methods. RESULTS: Fifty-seven cases of keratitis were identified. Age of the patients ranged from 1 to 24 months (Median: 6, interquartile range: 2-10). Thirty cases were male (52.6%). Predisposing factors were identified in 39 cases (68.4%): consisting of prior ocular trauma (n = 15), previous intraocular surgery (n = 11), ocular surface disease (n = 10), nasolacrimal duct obstruction (n = 4), prematurity (n = 3), developmental delay (n = 2), TORCH infection (n = 1), and contact lens (n = 1). Corneal thinning was observed in 29 eyes (50.9%), which progressed to perforation in 13 eyes (22.8%). Three patients developed endophthalmitis (95% CI, 1.5-13.4%). Most eyes had negative smear (60.4%) and culture (59.6%) results. Pseudomonas aeruginosa was the most common microorganism (11 of 21). Candida albicans was isolated in one case. In vitro susceptibility results showed good coverage of the combined ceftazidime and vancomycin regimen (100%). Surgical procedures were carried out in 35 eyes (61.4%) and 15 eyes required tectonic procedures (26.3%). CONCLUSION: Despite good coverage of medical treatment over cultured isolates, surgical tectonic intervention was required in nearly a quarter of cases to resolve the corneal infection. This finding indicates the necessity of prompt patient referring, corneal sampling and initiation of the treatment.

Unveiling the landscape of post-keratoplasty keratitis: a comprehensive epidemiological analysis in a tertiary center.

PURPOSE: The present study aimed to epidemiologically evaluate patients with infectious keratitis following corneal transplantation. METHODS: This retrospective study analyzed medical records of patients who underwent keratoplasty from March 2014 to March 2022 at a tertiary center. A total of seventy-five patients were evaluated. The data were classified based on culture results, the type of microorganisms involved, treatment requirements, and the type of primary keratoplasty performed. RESULTS: Seventy-five patients were evaluated in this study, with a mean age of 45.9 years (22-95 years). The mean duration between the first surgery and the incidence of infectious keratitis was 1.43 years, and most cases occurred in the first year (56.2%). Bacterial and fungal keratitis in 2.17%, 1.39%, and 1.26% of cases undergoing penetrating keratoplasty (PK), endothelial keratoplasty (EK), and anterior lamellar keratoplasty (ALK) occurred, respectively. Streptococcus viridans (9.3%) and Staphylococcus aureus (6.6%) had the highest prevalence. Across various smear and culture results (gram-positive, gram-negative, fungal, and negative culture), no significant differences were found in endophthalmitis rates (P = 0.797) and the necessity for tectonic grafts (P = 0.790). Similarly, the choice of surgical method (PK, ALK, EK) showed no significant impact on the need for tectonic grafts (P = 0.45) or the rate of endophthalmitis (P = 0.55). CONCLUSIONS: The incidence of keratitis after a corneal graft was 1.7%, with Streptococcus viridans and Staphylococcus aureus the most common microorganisms. The rate of endophthalmitis associated with post-keratoplasty keratitis was 0.053%. There was no correlation between the necessity for a tectonic graft or the incidence of endophthalmitis and the type of microorganisms involved.

All about traumatic cataracts: narrative review.

Ocular trauma is an important cause of monocular blindness worldwide. Injury to the lens after blunt or penetrating trauma is common and can result in vision impairment. Selecting the most appropriate therapeutic approaches depends on factors such as patients' age, mechanism of trauma, and underlying clinical conditions. Early management, especially within childhood, is essential because of the difficulties involved in examination; anatomical variations; as well as accompanying intraocular inflammation, amblyopia, or vitreoretinal adhesions. The objective of this study was to provide a comprehensive review of the epidemiology and clinical management of traumatic cataract, highlighting the significance of accurate diagnosis and selection of the optimal therapeutic approach.

From the diagnosis of infectious keratitis to discriminating fungal subtypes; a deep learning-based study.

Infectious keratitis (IK) is a major cause of corneal opacity. IK can be caused by a variety of microorganisms. Typically, fungal ulcers carry the worst prognosis. Fungal cases can be subdivided into filamentous and yeasts, which shows fundamental differences. Delays in diagnosis or initiation of treatment increase the risk of ocular complications. Currently, the diagnosis of IK is mainly based on slit-lamp examination and corneal scrapings. Notably, these diagnostic methods have their drawbacks, including experience-dependency, tissue damage, and time consumption. Artificial intelligence (AI) is designed to mimic and enhance human decision-making. An increasing number of studies have utilized AI in the diagnosis of IK. In this paper, we propose to use AI to diagnose IK (model 1), differentiate between bacterial keratitis and fungal keratitis (model 2), and discriminate the filamentous type from the yeast type of fungal cases (model 3). Overall, 9329 slit-lamp photographs gathered from 977 patients were enrolled in the study. The models exhibited remarkable accuracy, with model 1 achieving 99.3%, model 2 at 84%, and model 3 reaching 77.5%. In conclusion, our study offers valuable support in the early identification of potential fungal and bacterial keratitis cases and helps enable timely management.

Numerical analysis of pressure drop reduction of bubbly flows through hydrophobic microgrooved channels.

Due to the high performance of hydrophobic surfaces in pressure drop reduction, they have been proposed for various applications. However, despite the extensive uses of two-phase flows in many industries, the effect of hydrophobic surfaces on the pressure drop reduction of two-phase flows has not been well understood yet. Thus, in the present study, by implementing the phase-field and finite element methods, the bubbly flows as an example of two-phase flows are considered for examining the effect of hydrophobic microgrooved microchannels on the pressure drop reduction of these regimes in the laminar state. We found out that hydrophobic microgrooved surfaces not only can be efficient in the bubbly flow but also can even cause a maximum pressure drop reduction of up to 70%, which is almost 3.5 times higher than in single-phase flow. We also studied the influence of each parameter, such as bubbles volume or length, Reynolds number, capillary number, and their combination on this phenomenon. The pressure drop reduction grows by increasing the volume of the bubbles but decreases by increasing the flow velocity or the surface tension coefficient. The combination of these parameters demonstrated different results in some circumstances.

Post-laser refractive surgery keratitis: A concise narrative review.

Laser refractive surgery (LRS) is a specialized surgical discipline within ophthalmology that focuses on vision correction via laser techniques. LRS requires a high rate of accuracy and exactitude to improve the visual outcome and minimize complications, which may lead to delayed visual recovery. Keratitis, either infectious or noninfectious, is a post-LRS complication that requires early diagnosis and proper interventional measures. In this narrative review, we summarize different aspects of keratitis following LRS. This literature review aims to provide a thorough understanding of the causes of post-LRS infectious keratitis and its appropriate management for successful outcomes.

A Case Series of Infectious Keratitis After Corneal Cross-linking.

PURPOSE: To present the 7-year experience of a tertiary eye hospital while exploring possible risk factors and incidence of infectious keratitis in patients undergoing standard corneal cross-linking (CXL). METHODS: This retrospective cohort study included patients with progressive keratoconus undergoing standard CXL in the Farabi Eye Hospital and all other patients who had undergone CXL in other facilities and were diagnosed as having infectious keratitis in the 7-year period of the study. RESULTS: Among the total of 4,863 eyes that underwent CXL, 6 eyes developed infectious keratitis, yielding an incidence rate of 0.12%. Additionally, 13 eyes from 10 patients with a CXL history in other facilities who developed infectious keratitis were included. The mean age was 23.75 years, and 75% of patients were men and 25% were women. Gram-positive bacteria and Staphylococcus aureus were the most prevalent pathogens. Meibomian gland dysfunction, dry eye disease, or blepharitis were present in 12 patients. Medical treatment did not arrest the disease progress in 5 patients, which eventually required cases to undergo keratoplasty. CONCLUSIONS: This study supports the need for proper patient selection by using a comprehensive medical history. It also highlights the imperative role of rigorous patient education and follow-up, particularly in the first postoperative week. Finally, the study emphasizes aggressive early therapy for patients with suspicious findings. [J Refract Surg. 2023;39(8):564-572.].

Outbreak of methanol-induced optic neuropathy in early COVID-19 era; effectiveness of erythropoietin and methylprednisolone therapy.

BACKGROUND: Methanol is a highly toxic, non-potable alcohol. Outbreaks of methanol toxicity occur due to its fraudulent addition to alcoholic beverages as a cheaper substitute for ethanol. Recently, alongside the coronavirus disease 2019 (COVID-19) pandemic, rumors circulated on social media that consuming alcohol can prevent or cure the virus, leading to a COVID-19 and methanol-induced optic neuropathy (MON) syndemic. AIM: To investigate the impact of erythropoietin (EPO) on the outcomes of patients diagnosed with MON. METHODS: In this prospective study, 105 patients presenting with acute bilateral visual loss secondary to methanol intoxication were enrolled from March to May 2020 at Farabi Eye Hospital. A comprehensive ocular examination was conducted for all participants. Recombinant human EPO and methylprednisolone were administered intravenously to all patients for three consecutive days. RESULTS: The mean age of the participants was 39.9 years (± 12.6). Ninety-four patients were male and eleven were female. The mean pre-treatment best corrected visual acuity (BCVA) improved from 2.0 ± 0.86 to 1.39 ± 0.69 logarithm of the minimum angle of resolution post-treatment (P < 0.001), with significant improvement observed in all age categories and genders (P < 0.001). Visual acuity improvement was also significant regardless of whether the patient presented before or after 72 h (P < 0.001), and the post-treatment BCVA remained significant at all monthly follow-up visits (P < 0.001). CONCLUSION: EPO and methylprednisolone therapy have been shown to be effective in improving visual outcomes in patients with MON when administrated within the first month of exposure. Public awareness efforts are necessary to prevent further outbreaks of methanol toxicity in the current COVID-19 era.

Clinical Features, Risk Factors, and Management of Candida Keratitis.

BACKGROUND/AIMS: To determine the clinical features, predisposing factors, and management of infectious keratitis caused by Candida spp. METHODS: Retrospective chart review. RESULTS: The medical records of 52 patients (54 eyes) with Candida keratitis were available for statistical analysis. Thinning of the corneal stroma was identified in 34 eyes (63.0%), and corneal perforation occurred in 16 eyes (29.6%). Corneal thinning and perforation were more common in Candida albicans compared with non-albicans (P-val < .001, P = .09, respectively). The most common predisposing factors for Candida keratitis were topical steroid use (21 patients, 40.4%), previous corneal transplantation (17 patients, 32.7%), and preexisting ocular surface disease (15 patients, 28.8%). Fourteen eyes (25.9%) required cyanoacrylate glue application and 10 eyes (18.5%) underwent therapeutic penetrating keratoplasty (TPK). CONCLUSION: Local immunosuppression and ocular surface disease play an important role in Candida keratitis. C. albicans appears to be more invasive compared with non-albicans spp.

The effect of povidone-iodine 2% eye drops in the treatment of adenoviral keratoconjunctivitis.

BACKGROUND: Keratoconjunctivitis is one of the most common pathologies worldwide, caused by several infectious and noninfectious factors. This study aimed to determine the effect of povidone-iodine 2% eye drops in treating adenoviral keratoconjunctivitis. METHODS: This analytic cross-sectional study was conducted on patients referred to Farabi Eye Hospital Records of patients with adenoviral keratoconjunctivitis, more than 12 years of age, and no allergy to iodine who were treated by povidone-iodine 2% eye drops four times a day were assessed. Data included demographic characteristics, family history of adenoviral keratoconjunctivitis, follicular conjunctivitis, petechial conjunctival hemorrhages, periauricular lymphadenopathy, and the presence of conjunctival pseudomembrane were collected from the records. Discharge decrease, injection decrease, swelling decrease, pseudomembrane formation, periauricular lymphadenopathy, and subepithelial infiltration on the 7thday of assessment by physical examination were reported. RESULTS: Patients with a mean (±standard deviation) age of 33.77 (11.01) years were assessed. At the baseline, 95 (99.0%) follicular conjunctivitis, 94 (97.9%) petechial conjunctival hemorrhages, 29 (30.2%) periauricular lymphadenopathy, and 5 (5.2%) conjunctival pseudomembrane were recorded. On the 7thday of treatment, the discharge decreased in 92.7% of patients, and the injection decreased in 90.6%. The swelling decrease was also detected in 79.2% of patients. Subepithelial infiltration was only seen in 21.9% of the study population. Results showed that 2.1% of patients had periauricular lymphadenopathy, and only 13 out of 96 patients (13.5%) had pseudomembrane formation after 7 days. CONCLUSIONS: Based on the safety, availability, and tolerability of povidone-iodine and its promising effects on patients with adenoviral keratoconjunctivitis, further clinical trials assessing the impact of this drug in a longer duration of follow-up can be recommended.

Citrobacter keratitis: predisposing factors and clinical characteristics.

PURPOSE: To report predisposing factors, clinical presentation, antibiotic sensitivity, and management of Citrobacter-caused infectious keratitis. METHODS: We retrospectively reviewed the medical records of culture-proven cases of Citrobacter keratitis in a tertiary referral center for 8 years (from January 2012 to September 2020). Demographic data of the patients, predisposing factors, and presenting signs were extracted. RESULTS: Eighteen cases of microbial keratitis due to Citrobacter spp. were identified. The median age of the patients was 66 years (range: 10-89, interquartile range : 59-81). Thirteen patients were male and 5 were female. Multiple predisposing factors were identified in all eyes, including ocular surface disease (n = 8), previous corneal surgery (n = 6), and history of ocular trauma (n = 6). Five patients were diabetic. Corrected distance visual acuity (CDVA) of patients was light perception (LP) in 8 patients, hand motion (HM) in 7, counting fingers (CF) at 1 m in 1, and CF at 2 m in 2 patients. Thirteen eyes exhibited hypopyon. An area of corneal thinning was observed in 7 eyes (38.9%). Endophthalmitis due to infectious keratitis developed in one patient. In vitro susceptibility testing confirmed high sensitivity to ceftazidime and aminoglycosides. Medical management consisted primarily of topical amikacin (20 mg/ml) combined with topical cefazoline (50 mg/ml) (72.2%). Surgical tectonic procedures were carried out in 7 eyes (38.9%). CONCLUSION: Citrobacter spp. is a rare cause of bacterial keratitis.Previous keratoplasty and ocular surface problems are important risk factors. The prognosis is not good and surgical tectonic intervention is required in many cases to resolve the corneal infection.

Post photorefractive keratectomy (PRK) infectious keratitis; six-year experience of a tertiary eye hospital.

BACKGROUND/OBJECTIVES: As an essential development in the new century, surface ablation procedures have attracted increasing attention. There exists a concern regarding the risk of infectious keratitis. Hence, we aimed to investigate the rate and predisposing factors of infectious keratitis after photorefractive keratectomy (PRK). SUBJECTS/METHODS: This retrospective study was designed in two phases. First, the rate of post-PRK keratitis of Farabi Eye Hospital was investigated. In other words, the targeted population was the patients who developed keratitis after performing procedure at Farabi Eye Hospital. In the second phase, all the patients with the diagnosis of post-PRK keratitis were studied regardless of the centre where surgery was performed. Patients with the diagnosis of infectious keratitis between 2014 and 2020 were enrolled and following information was analyzed: demographics, presentation time after surgery, perioperative medications, culture results, risk factors, medical treatment, complications, and final visual acuity. RESULTS: The total number of PRK procedures in our centre was 24,986 (13,253 patients), in which 6 eyes of 5 patients developed keratitis. Beside these 5 patients, 24 referred patients (24 eyes) from the other centres were enrolled. Finally, a total number of 29 patients (30 eyes) were included. Our analysis revealed that manipulation of contact lens, dry eye, and blepharitis were the essential predisposing factors for keratitis development. CONCLUSION: The overall post-PRK keratitis occurrence rate of our study was 0.02%. Our observation highlighted the importance of preoperative examination and treatment of the lids and dry eye disease.

Design and simulation of a novel integrated microfluidic chip for cell isolation and culture.

The lab on a chip is utilized as a background and a substrate for creating a proper flow for cellular processes in medicine. In this study, the concepts of cell isolation and cell transfer methods have been discussed. After that, the device of separation and transfer systems has been designed, simulated, and verified by placing the frequency of particle separation and droplet formation, which is tried to introduce a new device that can be used in cellular studies. The optimal operation conditions for the problem have also been investigated. High separation efficiency (99%) could be achieved when the velocity of the sample inlet in the microchannel separator is 180 µm/s. Also, a microfluidic device for droplet generation has been designed to transfer the isolated cells to the culture medium. For this purpose, the frequency of droplet production must be synchronized with particle ejection frequency and equals 9.09 Hz.

Microbiological study on foreign body and vitreous samples of patients with intraocular foreign body.

OBJECTIVE: To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body (IOFB). METHODS: Seventy-one patients with an IOFB were included in this descriptive prospective case series. All patients underwent immediate IOFB removal. Vitreous sampling was performed during vitrectomy. Foreign bodies were placed directly into culture media for microbiological study. RESULTS: Thirteen (18.3%) patients developed endophthalmitis. The results of microbiological analysis of IOFB and vitreous humor specimens were negative in nine patients and positive in four. Fifty-eight (81.6%) patients with an IOFB had no evidence of endophthalmitis. Among them, seven patients showed positive microbiological results of foreign bodies with no manifestations of endophthalmitis. In five patients, a Staphylococcus epidermidis strain was observed in the culture of the IOFB specimen. Two patients had only positive smear test results of their vitreous humor specimen. CONCLUSION: A correlation appears to be present between the microbiological results of the vitreous humor and IOFB specimens in patients with clinical findings of endophthalmitis but not in patients with a pure IOFB without clinical features of endophthalmitis. This may justify early use of intravitreal and intravenous antibiotics before the development of endophthalmitis.

Metallic intralenticular foreign body removal without crystalline lens extraction: a case report.

We describe a technique for metallic intralenticular foreign body (ILFB) removal in a patient in whom there was no or minimal cataract formation or other complications. This technique required creating two corneal small incisions around the ILFB for inserting iris retractors to expose the ILFB. At the foreign body position, a clear corneal incision was made, and then the ILFB was removed with minimal manipulation by an intraocular magnet without complications. Because most occupational traumas occur in young people, this technique avoids the adverse outcomes of lens extraction in this age group.

Etiology, pathogenesis, and management of acute intraocular lens opacification: a systematic review.

Millions of cataract surgeries with intraocular lens (IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients' visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification.

Accuracy of different lens power calculation formulas in patients with phacomorphic glaucoma.

PURPOSE: The purpose of the study was to determine the most accurate formula for intraocular lens (IOL) power calculation among five currently used formulas in eyes with phacomorphic glaucoma (PG) undergoing cataract extraction surgery. MATERIALS AND METHODS: In this prospective interventional case series Patients diagnosed with PG were undergone uneventful phacoemulsification and IOL implantation. After 3 months, the refractive outcome for each formula was evaluated with mean prediction error (PE), mean absolute error (MAE), and the percentages of eyes within 0.25 D and 0.5 D of predicted error. RESULTS: Twenty-three patients completed the study. PEs were significantly different among the 5 formulas (P = 0.019), and Holladay I had the least error (-0.02 ± 1.11). Haigis formula had the highest hyperopic shift (0.37 ± 1.22), highest MAE (0.99 ± 0.78) and the lowest percentages of desired PEs, while the SRK II produced the greatest percentages. The overall differences in MAE between the 5 formulas were statistically insignificant (P = 0.547). CONCLUSION: In some extreme situations like patients with PG, lower generation of IOL power calculation formulas may still produce more acceptable refractive outcomes.

Idiopathic combined retinal vessels occlusion in a pregnant woman: a case report.

BACKGROUND: Ocular vascular occlusion is an extremely rare event, especially in the young population. This diagnosis is always associated with active systemic diseases in young adults and needs thrombophilia workup. Nevertheless, we present the case of a pregnant woman suffering from idiopathic combined central retinal vein and cilioretinal artery occlusion. CASE PRESENTATION: A 36-year-old pregnant Iranian woman at the 36th week of her second pregnancy complained of subacute unilateral painless decreased vision of her left eye. She had experienced a transient vision loss that lasted several minutes, but attacks gradually became more frequent and finally persistent over a several-day period. Finally combined central retinal vein and cilioretinal artery occlusion was established. Her visual acuity improved to 4/10 in a month without any ocular intervention except for a short duration of prophylactic dose enoxaparin, and the acuity reached 8/10 without any complications in the third month follow-up visit. At 1 year follow-up, the visual acuity had not changed and no macular edema was seen. CONCLUSIONS: Ocular vascular occlusion is extremely rare among young adults, and even rarer among pregnant women. According to this, any suspected retinal vascular event in this population should raise suspicion for underlying diseases such as hypertension, diabetes, autoimmune diseases, migraine, preeclampsia syndrome, and thrombophilia. However, as seen in this presented case, idiopathic ocular vascular occlusion events can occur also.

Ionic current magnetic fields in 3D finite-length nanopores and nanoslits.

Deoxyribonucleic acid (DNA) encodes all genetic information, and in genetic disorders, DNA sequencing is used as an effective diagnosis. Nanopore/slit is one of the recent and successful tools for DNA sequencing. Passage of DNA along the pores creates non-uniform ionic currents which creates non-uniform electric and magnetic fields, accordingly. Sensing the electric field is usually used for sequencing application. We suggest to use the magnetic field induced by pressure-driven ionic currents as a secondary signal. We systematically compared the induced magnetic field of nanopores and nanoslits with equal cross-sectional area. The 3D magnetic field is numerically obtained by solving the Poisson-Nernst-Planck, Ampere, and Navier-Stokes equations. As expected, the maximum value of the maximum magnetic flux occurs near the wall and inside the channel, and increasing the pressure gradient along the pore/slit increases the flowrate and magnetic field, consequently. At a given pressure difference across the pore/slit, nanopores are better than nanoslits in sensing the magnetic flux. For example, by applying 2 MPa across the pore/slit, the maximum magnetic flux density for nanopore, nanoslit A R = 1 and nanoslit A R = 5 are 1.10 pT, 1.08 pT and 0.45 pT, accordingly. Also, at a given flowrate across the pore/slit, nanoslits are the better choice. It should be noted the external magnetic fields as small as pico-Tesla are detectable and measurable in voltage/pressure driven electrokinetic flow slits.

Increased Rate of Infectious Keratitis After PRK in the COVID-19 Era: The Possible Role of Face Masks.

PURPOSE: To evaluate the rate of infectious keratitis after photorefractive keratectomy (PRK) before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A retrospective chart review was performed on patients who were diagnosed as having infectious keratitis after PRK between January 2015 and January 2021. RESULTS: The study period was divided into the pre-COVID-19 era (between January 2015 and February 2020) and the COVID-19 era (between February 2020 and January 2021). A total of 47 patients were diagnosed as having infectious keratitis after PRK: 22 were diagnosed in the pre-COVID-19 era and 25 were diagnosed in the COVID-19 era. The rate ratio for infectious keratitis after PRK was 5.68 during the COVID-19 pandemic (CI: 3.20 to 10.07, P < .001). The odds ratio for the ratio of cases of infectious keratitis after PRK to all cases of infectious keratitis was 9.00 during the COVID-19 pandemic (CI: 5.05 to 16.05, P < .001). To better understand the change in the rate of infectious keratitis after PRK during the COVID-19 pandemic, the analysis was narrowed to the patients with infectious keratitis who had their procedure in Farabi Eye Hospital. Of the 8 patients who were diagnosed as having infectious keratitis after PRK, 4 were diagnosed in the pre-COVID-19 era and 4 were diagnosed in the COVID-19 era. The risk ratio of infectious keratitis after PRK was 9.11 in our department in the COVID-19 era (95% CI limit: 2.28 to 36.46, P = .005). CONCLUSIONS: The rate of infectious keratitis after PRK increased during the COVID-19 pandemic. This may be due to the increased use of face masks in this era. [J Refract Surg. 2022;38(2):78-81.].