Corneal infection after radial keratotomy

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Abstract
Purpose: To evaluate nine eyes that developed corneal infection after radial keratotomy (RK) and their subsequent management. Setting: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India. Method: The parameters evaluated were interval between RK and development of the ulcer, number of keratotomy incisions, nature of surgery (primary or secondary), status at presentation, and best corrected visual acuity (BCVA). Corneal scrapings were taken from all eyes for microbiological evaluation. Initial therapy was based on clinical impression and subsequent therapy, on the microbiological report. Results: Staphylococcus species were the most frequently isolated bacteria followed by Pseudomonas aeruginosa. Two eyes had fungal growth, and no organisms were isolated from one. All but one eye responded to medical therapy; healing took 23 to 26 days: Therapeutic penetrating keratoplasty (PKP) was done in one eye. Presenting BCVA of hand movement to 6/36 improved to hand movement to 6/18 after the ulcer healed. Final BCVA was 6/36 to 6/9 after lamellar keratoplasty or PKP or with contact lens or spectacle correction. Conclusion: Our study shows that corneal infection is a potential complication of RK. Therefore, persistent postoperative irritation should be carefully observed to ensure early diagnosis and prompt therapy.

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