Staphylococcus aureus keratitis following femtosecond laser
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A 38-year-old woman had simultaneous bilateral femtosecond laser in situ keratomileusis (LASIK) for compound hyperopic astigmatism. Three days postoperatively, she presented to the surgeon complaining of decreased vision, redness, pain, and photophobia in her right eye. Slitlamp examination revealed a corneal epithelial defect measuring 3.5 mm × 3.0 mm, flap folding and displacement, multiple white infiltrations in the corneal flap–stromal interface, and severe anterior chamber reaction and a 0.5 mm hypopyon. Gram staining disclosed gram-positive cocci and cultures grew Staphylococcus aureus. The infection was treated with frequent topical fortified cefazolin and gentamicin eye drops. Two months later, the corrected distance visual acuity was 20/50 and slitlamp examination showed corneal flap and interface scarring. This case demonstrates that S aureus keratitis can occur following uneventful femtosecond LASIK. The keratitis was successfully treated by antibiotics with no need for flap excision.

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