KERATITIS AS A COMPLICATION OF BILATERAL, SIMULTANEOUS RADIAL KERATOTOMY

During a one-month period, we examined four patients referred for eval uation of probable microbial keratitis after bilateral, simultaneous r adial keratotomy. Each patient had midstromal infiltrates compatible w ith microbial keratitis that involved one or more of the radial incisi ons. In two patients the keratitis was bilateral. All patients had bee n treated empirically with antibiotic agents; superficial cultures wit h cotton-tipped applicators and corneal scraping by inserting a platin um spatula into the radial incisions were negative. Corneal biopsy of one patient disclosed grampositive rods and culture of the biopsy spec imen grew diphtheroids. The infiltrates gradually resolved over a peri od of several months with intensive antibiotic therapy. Sight-threaten ing infectious keratitis can occur after radial keratotomy, and we bel ieve that simultaneous bilateral ocular surgery of any kind should be discouraged.