Culture-negative ulcerative keratitis after laser in situ keratomileusis

A 40-year old man, highly myopic in both eyes, had laser in situ keratomile usis (LASIK) in the left eye in November 1996. Corneal melting and ulcerati on and fine striae-like interface infiltrates were noticed 1 day postoperat ively. There was no response to intensive topical antibiotics in the form o f hourly ofloxacin 3% (Tarivid(R)), and satellite lesions developed on day 4. Corneal scrapings for gram stain and culture were done twice. No bacteri al or fungal organisms were identified. Intensive topical fortified vancomy cin (50 mg/mL) was added, and the lesions resolved gradually over the ensui ng 2 weeks. Eighteen months after LASIK, I:refraction was -1.50 -0.75 x 105 in the left eye, and uncorrected visual acuity was 20/70, correctable to 2 0/25 with spectacles. J Cataract Refract Surg 1999; 25:1004-1008 (C) 1999 A SCRS and ESCRS.