Antonio Leccisotti, Stefania V. Fields, G. De Bartolo, Christian Crudale
{"title":"10 万眼病例系列中的光屈光性角膜切除术、飞秒激光角膜磨镶术和皮瓣摘除术后感染性角膜炎","authors":"Antonio Leccisotti, Stefania V. Fields, G. De Bartolo, Christian Crudale","doi":"10.4081/ltj.2024.389","DOIUrl":null,"url":null,"abstract":"This study evaluates the incidence and outcome of infectious keratitis after laser vision correction by photorefractive keratectomy (PRK), femtosecond LASIK, and keratorefractive lenticule extraction (KLEx) in a retrospective, consecutive, single-institute series. Patients with presumed infectious keratitis between 2011 and 2023 were analyzed. In PRK, manual deepithelialization was done, and mitomycin C was used with spherical equivalents greater than 3 diopters. Femtosecond LASIK and KLEx were performed with an LDV Ziemer laser; the interface was rinsed in both techniques. All treatments received post-operative netilmicin eyedrops. Finally, 106269 eyes of 54278 patients were included; 6 eyes of 6 patients were identified as having infectious keratitis (3 by staphylococci, 3 culture-negative). The overall incidence of infectious keratitis was 0.0056% (0.0164% after PRK, 0.0023% after femtosecond LASIK, 0.1366% after KLEx; Chi2 p<0.00001). The odds ratio for PRK compared to LASIK was 7.2 (p=0.0307); for KLEx compared to LASIK 59.7 (p=0.0008). Presentation after KLEx (2 days) was earlier than after PRK (5, 4, and 5 days) and LASIK (6 and 4 days). In all cases, hourly fortified cefazolin and tobramycin eyedrops were used, with a good response: 3 eyes maintained a 20/20 uncorrected visual acuity; 2 eyes 20/20 with myopic astigmatism; 1 eye ended 20/25 with correction because of irregular astigmatism. In conclusion, infectious keratitis was a rare complication, more common after KLEx and less common after femtosecond-LASIK. Only 3/6 cases had a positive culture. All the cases in our series had a favorable outcome.","PeriodicalId":17981,"journal":{"name":"Laser therapy","volume":"39 18","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Infectious keratitis after photorefractive keratectomy, femtosecond-LASIK and lenticule extraction in a 100,000-eye case series\",\"authors\":\"Antonio Leccisotti, Stefania V. Fields, G. De Bartolo, Christian Crudale\",\"doi\":\"10.4081/ltj.2024.389\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"This study evaluates the incidence and outcome of infectious keratitis after laser vision correction by photorefractive keratectomy (PRK), femtosecond LASIK, and keratorefractive lenticule extraction (KLEx) in a retrospective, consecutive, single-institute series. Patients with presumed infectious keratitis between 2011 and 2023 were analyzed. In PRK, manual deepithelialization was done, and mitomycin C was used with spherical equivalents greater than 3 diopters. Femtosecond LASIK and KLEx were performed with an LDV Ziemer laser; the interface was rinsed in both techniques. All treatments received post-operative netilmicin eyedrops. Finally, 106269 eyes of 54278 patients were included; 6 eyes of 6 patients were identified as having infectious keratitis (3 by staphylococci, 3 culture-negative). The overall incidence of infectious keratitis was 0.0056% (0.0164% after PRK, 0.0023% after femtosecond LASIK, 0.1366% after KLEx; Chi2 p<0.00001). The odds ratio for PRK compared to LASIK was 7.2 (p=0.0307); for KLEx compared to LASIK 59.7 (p=0.0008). Presentation after KLEx (2 days) was earlier than after PRK (5, 4, and 5 days) and LASIK (6 and 4 days). In all cases, hourly fortified cefazolin and tobramycin eyedrops were used, with a good response: 3 eyes maintained a 20/20 uncorrected visual acuity; 2 eyes 20/20 with myopic astigmatism; 1 eye ended 20/25 with correction because of irregular astigmatism. In conclusion, infectious keratitis was a rare complication, more common after KLEx and less common after femtosecond-LASIK. Only 3/6 cases had a positive culture. All the cases in our series had a favorable outcome.\",\"PeriodicalId\":17981,\"journal\":{\"name\":\"Laser therapy\",\"volume\":\"39 18\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laser therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4081/ltj.2024.389\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laser therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/ltj.2024.389","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Infectious keratitis after photorefractive keratectomy, femtosecond-LASIK and lenticule extraction in a 100,000-eye case series
This study evaluates the incidence and outcome of infectious keratitis after laser vision correction by photorefractive keratectomy (PRK), femtosecond LASIK, and keratorefractive lenticule extraction (KLEx) in a retrospective, consecutive, single-institute series. Patients with presumed infectious keratitis between 2011 and 2023 were analyzed. In PRK, manual deepithelialization was done, and mitomycin C was used with spherical equivalents greater than 3 diopters. Femtosecond LASIK and KLEx were performed with an LDV Ziemer laser; the interface was rinsed in both techniques. All treatments received post-operative netilmicin eyedrops. Finally, 106269 eyes of 54278 patients were included; 6 eyes of 6 patients were identified as having infectious keratitis (3 by staphylococci, 3 culture-negative). The overall incidence of infectious keratitis was 0.0056% (0.0164% after PRK, 0.0023% after femtosecond LASIK, 0.1366% after KLEx; Chi2 p<0.00001). The odds ratio for PRK compared to LASIK was 7.2 (p=0.0307); for KLEx compared to LASIK 59.7 (p=0.0008). Presentation after KLEx (2 days) was earlier than after PRK (5, 4, and 5 days) and LASIK (6 and 4 days). In all cases, hourly fortified cefazolin and tobramycin eyedrops were used, with a good response: 3 eyes maintained a 20/20 uncorrected visual acuity; 2 eyes 20/20 with myopic astigmatism; 1 eye ended 20/25 with correction because of irregular astigmatism. In conclusion, infectious keratitis was a rare complication, more common after KLEx and less common after femtosecond-LASIK. Only 3/6 cases had a positive culture. All the cases in our series had a favorable outcome.