RESUMEN
OBJECTIVE: To study the incidence of infectious keratitis (IK) after laser-assisted in situ keratomileusis (LASIK), along with its diagnosis, therapeutic action taken, its management and the results. MATERIAL AND METHOD: We carried out a retrospective study of 262,191 eyes intervened consecutively with LASIK, in our 20 centres, during the period from September 2002 and December 2009. All the cases susceptible to being diagnosed with IK, either clinically or due to the biological findings were analysed. RESULTS: A total of 82 cases were found with infectious keratitis, which assumed an incidence of 0.031%. Distributions are presented by gender, mean age of the patients, mean days since the surgery, the clinical signs and symptoms, predisposing factors, therapeutic action, complications, details of the causal germ, and the loss of lines of vision. CONCLUSIONS: Infectious keratitis after LASIK is a rare complication. The early diagnosis and management of the process are determining factors when establishing the prognosis. In our series all the cases were resolved without causing any other serious complications.
Asunto(s)
Queratitis/etiología , Queratomileusis por Láser In Situ/efectos adversos , Infecciones Estafilocócicas/etiología , Infecciones Estreptocócicas/etiología , Infección de la Herida Quirúrgica/etiología , Adolescente , Adulto , Antibacterianos/uso terapéutico , Terapia Combinada , Dolor Ocular/etiología , Femenino , Humanos , Incidencia , Queratitis/diagnóstico , Queratitis/tratamiento farmacológico , Queratitis/epidemiología , Masculino , Persona de Mediana Edad , Soluciones Oftálmicas , Estudios Retrospectivos , España/epidemiología , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/epidemiología , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/epidemiología , Irrigación Terapéutica , Trastornos de la Visión/etiología , Adulto JovenRESUMEN
Fungi belonging to the genus Acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin B was unsuccessful and the infection eventually resolved with penetrating keratoplasty.
