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      • Record: found
      • Abstract: found
      • Article: found

      Mycobacterium abscessus Keratitis after LASIK with IntraLase ® Femtosecond Laser

      case-report

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          Abstract

          A healthy 38-year-old woman developed 2 white spots in her left eye 2 weeks after bilateral laser in situ keratomileusis (LASIK) using the IntraLase<sup>®</sup> femtosecond laser. Initial treatment included levofloxacin 0.5% but was unsuccessful. The surgeon irrigated the interface and repositioned the flap due to a worsened lesion. She was referred to us after the keratitis had not improved. The flap was lifted for collection of the specimen and irrigation of the interface. The keratitis was treated with intensive topical clarithromycin 1%, amikacin 1.25% and oral clarithromycin, which improved her clinical condition. She developed a toxic reaction to amikacin 1.25%, which was replaced by moxifloxacin 0.5%. Mycobacterium abscessus was identified. The keratitis resolved over 2 months. Five months after treatment, the patient had a visual acuity of 20/20 with correction. Nontuberculous mycobacteria should be considered as an etiologic agent, even in cases of infectious keratitis after LASIK using the femtosecond laser.

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          Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis.

          Karl G Stonecipher, Guy Kezirian (2004)
          To compare laser in situ keratomileusis (LASIK) results obtained with the femtosecond laser (IntraLase Corp.) to those obtained using 2 popular mechanical microkeratomes. Private practice, Greensboro, North Carolina, USA. This retrospective analysis compared LASIK outcomes with the femtosecond laser to those with the Carriazo-Barraquer (CB) microkeratome (Moria, Inc.) and the Hansatome microkeratome (Bausch & Lomb, Inc.). The 3 groups were matched for enrollment criteria and were operated on under similar conditions by the same surgeon. There were 106 eyes in the IntraLase group, 126 eyes in the CB group, and 143 eyes in the Hansatome group. One day postoperatively, the uncorrected visual acuity (UCVA) results in the 3 groups were similar; at 3 months, the UCVA and the best spectacle-corrected visual acuity results were not significantly different. A manifest spheroequivalent of +/-0.50 diopter (D) was achieved in 91% of eyes in the IntraLase group, 73% of eyes in the CB group, and 74% of eyes in the Hansatome group (P<.01). IntraLase flaps were significantly thinner (P<.01) and varied less in thickness (P<.01) than flaps created with the other devices. The mean flap thickness was 114 microm +/- 14 (SD) with the IntraLase programmed for a 130 microm depth, 153 +/- 26 microm with the CB using a 130 microm plate, and 156 +/- 29 microm with the Hansatome using a 180 microm plate. Loose epithelium was encountered in 9.6% of eyes in the CB group and 7.7% of eyes in the Hansatome group but in no eye in the IntraLase group (P =.001). Surgically induced astigmatism in sphere corrections was significantly less with the IntraLase than with the other devices (P<.01). The IntraLase demonstrated more predictable flap thickness, better astigmatic neutrality, and decreased epithelial injury than 2 popular mechanical microkeratomes.
          Article 0 comments Cited 58 times – based on 0 reviews     Review now
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            A large localized outbreak of Mycobacterium ulcerans infection on a temperate southern Australian island.

            D. Leslie, Michael J Hayman, Andrew Flood … (1997)
            Mycobacterium ulcerans, the organism which causes Buruli or Bairnsdale ulcer, has never been isolated in culture from an environmental sample. Most foci of infection are in tropical regions. The authors describe the first 29 cases of M. ulcerans infection from a new focus on an island in temperate southern Australia, 1992-5. Cases were mostly elderly, had predominantly distal limb lesions and were clustered in a small region in the eastern half of the main town on the island. The authors suspected that an irrigation system which lay in the midst of the cluster was a source of infection. Limitation of irrigation was associated with a dramatic reduction in the number of new cases. These findings support the hypothesis that M. ulcerans has an aquatic reservoir and that persons may be infected directly or indirectly by mycobacteria disseminated locally by spray irrigation.
            Article 0 comments Cited 34 times – based on 0 reviews     Review now
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              An outbreak of Mycobacterium chelonae infection after LASIK.

              E Sato, Lenio Alvarenga, Chao-Yu Shen … (2003)
              To describe an outbreak of mycobacterial keratitis after laser in situ keratomileusis (LASIK), including the microbiologic investigation, clinical findings, treatment response, and outcome. Retrospective, noncomparative, interventional case series. Patients (n = 10) who underwent LASIK surgery between August 22 and September 4, 2000, and developed mycobacterial infection. Patients were prospectively followed in relation to microbiologic investigation, clinical findings, treatment response, and outcome. Most patients underwent bilateral simultaneous LASIK. Postoperative infection was signaled by the appearance of corneal infiltrates in the third postoperative week. The microbiologic workup was performed on cultures obtained either by direct scraping of the cornea or by lifting the flap. Medical therapy was instituted based on drug susceptibility testing. Surgical interventions such as corneal debridement and flap removal were performed during recurrences or when there was no satisfactory clinical response. Cultures revealed Mycobacterium subspecies chelonae. Patients were treated with topical clarithromycin (1%), tobramycin (1.4%), and ofloxacin (0.3%). Oral clarithromycin (500 mg twice a day) was prescribed for those patients who did not respond clinically to topical treatment. Four eyes healed on this regimen. Flap removal was necessary in seven eyes. This report highlights mycobacteria as an etiologic infectious agent after LASIK. Diagnosis can be difficult and is often delayed. The treatment mainstay is prolonged antibiotic therapy. Surgical debridement and flap removal may shorten the disease course.
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): OPH
                Journal ID (nlm-ta): Ophthalmologica
                Journal ID (doi): 10.1159/issn.0030-3755
                Title: Ophthalmologica
                Publisher: S. Karger AG
                ISSN (Print): 0030-3755
                ISSN (Electronic): 1423-0267
                Publication date Subscription-year: 2006
                Publication date (Print): June 2006
                Publication date (Electronic): 21 June 2006
                Volume: 220
                Issue: 4
                Pages: 277-280
                Affiliations
                aDepartment of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, bKong Eye Center, cYong-Dong Severance Hospital, Department of Ophthalmology, Yonsei University College of Medicine, and dBrain Korea 21 Project for Medical Sciences, Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
                Article
                Publisher ID: 93084 Other ID: Ophthalmologica 2006;220:277–280
                DOI: 10.1159/000093084
                PubMed ID: 16785761
                SO-VID: aff10763-b128-4746-94b5-c889e867ae99
                Copyright © © 2006 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 09 December 2005
                Page count
                Figures: 3, References: 20, Pages: 4
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Laser in situ keratomileusis,Moxifloxacin,Clarithromycin,IntraLase® femtosecond laser,<italic>Mycobacterium abscessus</italic>
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Laser in situ keratomileusis, Moxifloxacin, Clarithromycin, IntraLase® femtosecond laser, <italic>Mycobacterium abscessus</italic>

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