A Case of Mycobacterium Fortuitum Keratitis at the Interface of the Cornea after LASIK

ABSTRACT

PURPOSE: To report a case of Mycobacterium fortuitum keratitis which occurred in the interface between the corneal stromal bed and flap after laser in situ keratomileusis (LASIK). RESULTS: Forty five year old female patient presented with clinical picture of keratitis 20 days after LASIK. The keratitis started with one soft round colony in the interface between the corneal stromal bed and the flap and, then progressed slowly with crystal shaped colonies. The keratitis worsened after removal of colonies showing partially method flap. Inflammation was controlled only after removal of the partially melted flap and with intensive medical treatment. Mycobacterium fortuitum keratitis was confirmed 2 months later by culture of the excised flap tissue. The patient's corrected visual acuity improved to 20/400 at 6 months after treatment. CONCLUSIONS: Mycobacterium fortuitum should be considered as one of the causes of keratitis manifesting white colonies after LASIK. The characteristics of the colonies may change during the course of the disease. Vigorous work-up should be considered for early identification of the organism.