MYCOBACTERIUM-CHELONAE KERATITIS AFTER EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY

This is the first report of a severe case of Mycobacterium chelonae ke ratitis; ii occurred in a 26-year-old man after he had undergone excim er laser photorefractive keratectomy for the correction of severe myop ia, once the epithelium was already healed. The diagnosis was made by culture results and acid-fast staining of corneal scrapings. Topical c iprofloxacin sodium, 0.3 mg/mL, plus amikacin sodium, 10 mg/mL, and or al clarithromycin sodium led to, remission of the ulceration after 3 m onths of therapy. Subsequent topical corticosteroid therapy led to com plete visual recovery during 1 year of follow-up. There may be an incr eased risk of severe keratitis during the first postoperative months i n eyes that have already undergone photorefractive keratectomy, due to the presence of some microepithelial defects symptomatically negative and not easily detectable by slit-lamp examination.