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Kunjal K Modi, David S Chu, Rudolph Wagner, Suquin Guo, Marco Zarbin, Neelakshi Bhagat; Infectious Ulcerative Keratitis Following Retinopathy of Prematurity (ROP) Treatment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4586.
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To report the complication of infectious ulcerative keratitis after laser photocoagulation and pars plana vitrectomy (PPV) for ROP.
Retrospective chart review of infants treated for ROP with plus disease, between 2004 and May 2013 at the University Hospital in Newark, NJ.
Of the 110 eyes of 55 patients that had undergone treatment for ROP, 8 eyes (7.27%) were noted to develop infectious ulcerative keratitis; 4 eyes after laser photocoagulation, and 4 eyes after PPV. These were bilateral eyes in 4 patients. All 8 eyes that developed ulcerative keratitis were noted to have preceding epithelial defect (ED) followed by corneal stromal haze. Seven of the 8 eyes that developed keratitis developed ED within 8 days of procedure, and all EDs progressed to ulcerative keratitis within 7 days. A total of 10 of 110 (9.1%) eyes developed post-procedure epithelial defects, 8 (80%) of which progressed to infectious ulcerative keratitis. Upon keratitis healing, corneal opacification was noted in all 8 eyes ranging from 10%-90% of the corneal surface area. Five of the 8 eyes had positive culture of corneal scrapings; 2 eyes grew coagulase-negative Staphylococcus as well as Stenotrophamonas, 1 coagulase-negative Staphylococcus, 1 S. viridans, and 1 S. hominis, S. mitis, and S. viridans. All 8 eyes were managed with fortified antibiotic eye drops.
Infectious ulcerative keratitis develops in a small, but not insignificant percentage of patients undergoing treatment for ROP. Post-operative corneal epithelial defect with subsequent corneal haze appears to be involved in the pathogenesis or disease progression to infectious ulcerative keratitis.
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