ABSTRACT
PURPOSE: Corneal infection with unfamiliar organisms such as nontuberculous (atypical) mycobacteria after laser in situ keratomileusis (LASIK) can be a significant clinical problem, and mismanagement of such corneal infection in an otherwise healthy, young individual can lead to significant medicolegal issues for the refractive surgeon. Because nontuberculous (atypical) mycobacterial keratitis is the most common infection after LASIK, the refractive surgeon should be aware of all aspects of this dreaded infection to be better prepared to manage such cases. METHODS: Literature search. RESULTS/CONCLUSIONS: This article provides a comprehensive compilation of all reported cases of nontuberculous (atypical) mycobacterial keratitis in the English literature and provides some useful recommendations for the clinical management of such corneal infection after LASIK.
Subject(s)
Eye Infections, Bacterial/microbiology , Keratitis/microbiology , Keratomileusis, Laser In Situ/adverse effects , Mycobacterium Infections, Nontuberculous/microbiology , Antibiotics, Antitubercular/therapeutic use , Cornea/microbiology , Eye Infections, Bacterial/epidemiology , Eye Infections, Bacterial/therapy , Humans , Keratitis/epidemiology , Keratitis/therapy , Keratoplasty, Penetrating , Mycobacterium Infections, Nontuberculous/epidemiology , Mycobacterium Infections, Nontuberculous/therapy , Nontuberculous Mycobacteria/isolation & purification , Prevalence , Refractive Surgical Procedures , ReoperationABSTRACT
Crouzon syndrome is an autosomal dominant disorder resulting in facial dysmorphism and craniosynostosis involving multiple cranial sutures. A common but often unrecognized early complication associated with craniosynostosis is a finding of increased intracranial pressure (ICP). This increase in ICP can lead to optic atrophy, neuronal damage, and mental deficits. The case of a 21-month-old girl with Crouzon syndrome is described. Although the child was clinically asymptomatic, a routine ophthalmic exam revealed papilledema and subsequently increased intracranial pressure and craniosynostosis were found. Cranial expansion and bicanthal advancement were performed to relieve the increased pressure. In cases such as these, long-term follow-up is essential because of the progressive nature of the disorder as well as the possibility of a recurrence of elevated intracranial pressure and a need for secondary decompressive surgery.
