Open AccessCombined Bacterial and Herpes Simplex Virus Keratitis following Small-Incision Lenticule Extraction for the Correction of Myopia
Author(s) -
Ramirez-Miranda Arturo,
Mangwani-Mordani Simran,
Quiroz-Casian Natalia,
Oliva-Bienzobas Valeria,
Cabral-Macias Jesus,
Navas Alejandro,
Graue-Hernandez Enrique O.
Publication year - 2021
Publication title -
case reports in ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 17
ISSN - 1663-2699
DOI - 10.1159/000511374
Subject(s) - case report
A 28-year-old male presented unilateral visual loss, intense ocular pain, redness and intraocular hypertension in his right eye 2 days after undergoing small-incision lenticule extraction (SMILE) in both eyes. Initial examination of the affected eye revealed the presence of white infiltrates within the corneal interface, as well as a central epithelial defect. The patient was diagnosed with infectious keratitis, posteriorly the eye was irrigated with balanced saline solution and treatment was initiated with hourly moxifloxacin 0.5%. Since this approach failed to resolve symptoms, a sample from the interface was obtained for PCR assay, which revealed the presence of herpes simplex virus DNA, confirming the cause of the infection. The patient was prescribed a regimen of oral acyclovir, topical ganciclovir and prednisolone. Clinical improvement following resolution of the epithelial defect was observed. Although rare, herpetic keratitis following SMILE is best managed via early diagnosis and initiation of appropriate anti-herpetic treatment.