Infections after refractive surgery

Curr Opin Ophthalmol. 2016 Jul;27(4):367-72. doi: 10.1097/ICU.0000000000000275.

Abstract

Purpose of review: The purpose of the review is to provide a summary of the recent literature concerning infections after refractive surgery pertinent to each procedure category.

Recent findings: New data from a large retrospective study suggest that the incidence of post-laser assisted in-situ keratomileusis infectious keratitis is declining. Additionally, recent case studies have reported viral, fungal, and Acanthamoeba pathogens. Corneal collagen cross-linking is emerging as an alternative therapeutic option for early stage post-LASIK infectious keratitis. Postoperative bandage contact lens used in patients undergoing surface ablation procedures may confer a higher risk of infection because of greater colonization rates in those individuals, such as healthcare providers, with relatively high risk of exposure to potential pathogens. In the setting of post-penetrating keratoplasty astigmatism, femtosecond laser astigmatic keratotomy procedures pose a risk of infectious keratitis and even endophthalmitis. Lastly, recent case reports of endophthalmitis after refractive lens procedures highlight the importance of postoperative monitoring for this sight threatening, albeit rare, complication.

Summary: The risks and management of infections after surgical refractive procedures vary widely depending on the specific technique employed. As technology and treatment options continue to evolve with further research, we anticipate continued success in the management of postoperative infections after refractive surgery.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bandages
  • Cornea / surgery
  • Cross-Linking Reagents / therapeutic use
  • Eye Infections / epidemiology
  • Eye Infections / etiology*
  • Eye Infections / therapy
  • Humans
  • Incidence
  • Lens, Crystalline / surgery
  • Postoperative Complications / etiology
  • Refractive Surgical Procedures / adverse effects*
  • Refractive Surgical Procedures / methods
  • Retrospective Studies
  • Visual Acuity

Substances

  • Anti-Bacterial Agents
  • Cross-Linking Reagents