ENDOPHTHALMITIS AND ORBITAL CELLULITIS AFTER RADIAL KERATOTOMY

Purpose: To report the findings concerning three patients with endopht halmitis and one with panophthalmitis and orbital cellulitis radial ke ratotomy surgery. Methods: One man referred with panophthalmitis and o rbital cellulitis and three women referred with endophthalmitis were t reated. Results: After radial keratotomy surgery, during which no micr operforation or macroperforation had been reported, a severe Pseudomon as panophthalmitis and orbital cellulitis developed in the man. All vi sion was lost in that eye. Staphylococcus epidermidis endophthalmitis developed in one woman, Streptococcus pneumoniae endophthalmitis in th e second woman and Pseudomonas endophthalmitis in the third woman, aft er undergoing radial keratotomy procedures during which microperforati ons occurred. In the latter patient, bilateral simultaneous surgery wa s performed, but only one eye became infected. The latter two infectio ns resulted in light perception and hand motion vision respectively, I n three cases, an initial keratitis was located in the inferior cornea . Conclusions: Severe bacterial endophthalmitis can occur after radial keratotomy surgery, even in the absence of microperforation during th e procedure. Any evidence of postoperative keratitis must be regarded seriously and treated aggressively. Despite use of this approach, the effect on final visual acuity can be devastating.