December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Infections Following LASIK Surgery: an Integration of Published Literature
Author Affiliations & Notes
  • S Jain
    Ophthalmology Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute Boston MA
  • MA Chang
    Medicine Columbia University College of Physicians & Surgeons New York NY
  • DT Azar
    Ophthalmology Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute Boston MA
  • Footnotes
    Commercial Relationships   S. Jain, None; M.A. Chang, None; D.T. Azar, None. Grant Identification: NIH EY10101
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 2118. doi:
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      S Jain, MA Chang, DT Azar; Infections Following LASIK Surgery: an Integration of Published Literature . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2118.

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Abstract

Abstract: : Purpose: To perform a comprehensive analysis of the published literature and develop an integrative perspective on infections occurring after LASIK surgery. Methods: A systematic literature search using MEDLINE databases covering a period of 1991-2001 was performed to identify all published cases of infections occurring after LASIK. Authors were contacted to obtain additional missing information. Data were abstracted, and stratified by potential associations, microbiology, treatment, and the degree of visual loss. Fisher's exact tests and Student's t-tests were used for analysis. Results: Infections in 38 eyes (34 cases) appeared in 24 published reports from January 1997 to August 2001. Gram-positive infections were reported in 19 (50%) eyes, mycobacterium in 9 (23.7%) eyes, and fungus in 5 (13.2%) eyes. Gram-positive bacteria were more likely than other microorganisms to be associated with epithelial defects (p=0.02) and anterior chamber reactions (p=0.01) on presentation. Severe visual loss was significantly more associated with fungal and mycobacterial infections, as compared to gram-positive (p=0.001). In 63.2% eyes (24/38), simultaneous bilateral LASIK was performed. Early identification of the infectious agent and early flap lift for scraping and irrigation of the stromal bed were associated with better visual outcome (p<0.001, p=0.007 respectively). No significant association between type of post-operative antibiotic or steroid used and infecting organism or severity of visual loss was found. Conclusion: Infection after LASIK surgery may cause considerable visual loss. Early identification of the causative organism, and early flap lifts for scraping and irrigation may lead to a better visual outcome.

Keywords: 354 clinical (human) or epidemiologic studies: prevalence/incidence • 369 cornea: clinical science • 548 refractive surgery: LASIK 
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