Post-laser Refractive Surgery Keratitis: A Concise Narrative Review

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2023 Oct 25

PMID 37879640

Authors

Sahel Soltani Shahgoli

Kasra Cheraqpour

Mohammad Soleimani

Mehrnaz Atighehchian

Seyed Ali Tabatabaei

Mohammad Sargolzaeimoghaddam

Maral Sargolzaeimoghaddam

Ali R Djalilian

Affiliations

Soon will be listed here.

Abstract

Laser refractive surgery (LRS) is a specialized surgical discipline within ophthalmology that focuses on vision correction via laser techniques. LRS requires a high rate of accuracy and exactitude to improve the visual outcome and minimize complications, which may lead to delayed visual recovery. Keratitis, either infectious or noninfectious, is a post-LRS complication that requires early diagnosis and proper interventional measures. In this narrative review, we summarize different aspects of keratitis following LRS. This literature review aims to provide a thorough understanding of the causes of post-LRS infectious keratitis and its appropriate management for successful outcomes.

Citing Articles

Infectious keratitis following photorefractive keratectomy: a 13-year study at a tertiary center.

Attar A, Jamali H, Ortega-Usobiaga J, Mahmoudinezhad G, Zhu D, Mohammadi M J Ophthalmic Inflamm Infect. 2025; 15(1):4.

PMID: 39792283 PMC: 11723873. DOI: 10.1186/s12348-025-00452-2.

References

Segev F, Mimouni M, Sela T, Munzer G, Kaiserman I . Risk Factors for Sporadic Diffuse Lamellar Keratitis After Microkeratome Laser-Assisted In Situ Keratomileusis: A Retrospective Large Database Analysis. Cornea. 2018; 37(9):1124-1129. DOI: 10.1097/ICO.0000000000001674. View

Soleimani M, Masoumi A, Khodavaisy S, Heidari M, Haydar A, Izadi A . Current diagnostic tools and management modalities of Nocardia keratitis. J Ophthalmic Inflamm Infect. 2020; 10(1):36. PMC: 7710777. DOI: 10.1186/s12348-020-00228-w. View

Moshirfar M, Milner D, Baker P, McCabe S, Ronquillo Y, Hoopes P . Corneal Refractive Surgery in Patients with a History of Herpes Simplex Keratitis: A Narrative Review. Clin Ophthalmol. 2020; 14:3891-3901. PMC: 7678688. DOI: 10.2147/OPTH.S282070. View

Ma J, Zhang L, Li M, Wang Y . Hypersensitivity reactions after femtosecond laser small incision lenticule extraction: a case report of corneal infiltrates. Allergy Asthma Clin Immunol. 2020; 16(1):101. PMC: 7661148. DOI: 10.1186/s13223-020-00498-y. View

Thomas P, Geraldine P . Infectious keratitis. Curr Opin Infect Dis. 2007; 20(2):129-41. DOI: 10.1097/QCO.0b013e328017f878. View

Daines B, Vroman D, Sandoval H, Steed L, Solomon K . Rapid diagnosis and treatment of mycobacterial keratitis after laser in situ keratomileusis. J Cataract Refract Surg. 2003; 29(5):1014-8. DOI: 10.1016/s0886-3350(02)01613-9. View

Mimouni M, Vainer I, Shapira Y, Levartovsky S, Sela T, Munzer G . Factors Predicting the Need for Retreatment After Laser Refractive Surgery. Cornea. 2016; 35(5):607-12. DOI: 10.1097/ICO.0000000000000795. View

Johnson J, Harissi-Dagher M, Pineda R, Yoo S, Azar D . Diffuse lamellar keratitis: incidence, associations, outcomes, and a new classification system. J Cataract Refract Surg. 2001; 27(10):1560-6. DOI: 10.1016/s0886-3350(01)00958-0. View

Leccisotti A, Fields S . Diffuse lamellar keratitis after LASIK with low-energy femtosecond laser. J Cataract Refract Surg. 2020; 47(2):233-237. DOI: 10.1097/j.jcrs.0000000000000413. View

10.

Salah T, Waring 3rd G, El-Maghraby A, Moadel K, Grimm S . Excimer laser in-situ keratomileusis (LASIK) under a corneal flap for myopia of 2 to 20 D. Trans Am Ophthalmol Soc. 1995; 93:163-83; discussion 184-90. PMC: 1312056. View

11.

de Oliveira G, Solari H, Ciola F, Lima A, Campos M . Corneal infiltrates after excimer laser photorefractive keratectomy and LASIK. J Refract Surg. 2006; 22(2):159-65. DOI: 10.3928/1081-597X-20060201-14. View

12.

Moorthy R, Valluri S, Rao N . Nontuberculous mycobacterial ocular and adnexal infections. Surv Ophthalmol. 2012; 57(3):202-35. DOI: 10.1016/j.survophthal.2011.10.006. View

13.

Moshirfar M, Durnford K, Lewis A, Miller C, West D, Sperry R . Five-Year Incidence, Management, and Visual Outcomes of Diffuse Lamellar Keratitis after Femtosecond-Assisted LASIK. J Clin Med. 2021; 10(14). PMC: 8304683. DOI: 10.3390/jcm10143067. View

14.

Liu J, Guo X, Wei Z, Zhang Y, Zhang Z, Xu X . Infectious Keratitis After Keratorefractive Surgery: Update and Review of the Literature. Eye Contact Lens. 2023; 49(7):275-282. PMC: 10281179. DOI: 10.1097/ICL.0000000000000996. View

15.

Alqahtani S . A Case Report of Diffuse Lamellar Keratitis after FemtoSMILE Refractive Surgery. Case Rep Ophthalmol. 2021; 11(3):582-587. PMC: 7747090. DOI: 10.1159/000509851. View

16.

Chang M, Jain S, Azar D . Infections following laser in situ keratomileusis: an integration of the published literature. Surv Ophthalmol. 2004; 49(3):269-80. DOI: 10.1016/j.survophthal.2004.02.007. View

17.

Lin R, Maloney R . Flap complications associated with lamellar refractive surgery. Am J Ophthalmol. 1999; 127(2):129-36. DOI: 10.1016/s0002-9394(98)00320-1. View

18.

Tomita M, Sotoyama Y, Yukawa S, Nakamura T . Comparison of DLK incidence after laser in situ keratomileusis associated with two femtosecond lasers: Femto LDV and IntraLase FS60. Clin Ophthalmol. 2013; 7:1365-71. PMC: 3711877. DOI: 10.2147/OPTH.S47341. View

19.

Spadea L, Giovannetti F . Main Complications of Photorefractive Keratectomy and their Management. Clin Ophthalmol. 2019; 13:2305-2315. PMC: 6885542. DOI: 10.2147/OPTH.S233125. View

20.

Soleimani M, Haydar A . Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature. J Ophthalmic Inflamm Infect. 2021; 11(1):25. PMC: 8413420. DOI: 10.1186/s12348-021-00256-0. View