Abstract
Abstract: :
Purpose:Mycobacterium terrae, the "raddish bacillus", at one time commonly considered nonpathogenic, is a very rare human pathogen that can present considerable diagnostic and therapeutic challenges. To our knowledge, there has never been a case of M. terrae endophthalmitis, or any other mycobacterial endophthalmitis after LASIK reported in the literature . Methods:Case Report. We present a patient who required a PK for a corneal ulcer following LASIK after RK. The graft also became infected the and the patient subsequently developed endophthalmitis requiring vitrectomy. Mycobacterium terrae was isolated from the vitreous biopsy. Results:After vitrectomy and intracameral injection of antibiotics and steroid, the patient's pain and clinical exam significantly improved. Her vision stabilized at 5/200. Unfortunately shortly after surgery the patient's pain increased and the corneal graft was lost. After a second corneal transplant, her pain again improved and the vision stablized at 5/125. Several weeks after the second PK the vision significantly decreased and the patient requred further intraocular injections of antibiotics and steriod. Conclusion:Mycobacterium interface keratitis after LASIK has been recently reported. This complication of refractive surgery is becoming more and more common. Mycobacterium terrae endophthalmitis is a very rare complication of refractive surgery, to our knowledge has never before been reported in the literature, and can present a significant therapeutic challenge.
Keywords: 398 endophthalmitis • 545 refractive surgery: complications