Introduction: The purpose of this study was to report the first case of acute bacterial keratitis produced by methicillin-resistant Staphylococcus aureus after the implantation of two intracorneal ring segments during an uneventful procedure for treating keratoconus in a 13-year-old child.
Case report: A patient with grade III keratoconus underwent an implantation of intracorneal ring segments with no complications during the procedure. Three days later, a whitish corneal infiltrate appeared in between the union of both corneal rings. Sample cultures were positive for methicillin-resistant S. aureus (MRSA). Corneal infiltrate did not improve despite intensive topical and systemic antibiotics. Melting appeared even after the explantation of both corneal rings. Keratoplasty à chaud had to be performed to preserve the eye integrity.
Conclusions: MRSA keratitis following intracorneal ring segment implantation is a rare but severe complication that can lead to a therapeutic penetrating keratoplasty to definitely cure the process.
Keywords: Acute keratitis; Complication; Intracorneal segment ring; Keratoconus; MRSA.