Infectious Keratitis after Surgery

Abstract

Although infectious keratitis after refractive surgery is rare, it is of great importance due to its great devastating power. The most important etiology of infectious keratitis after refractive surgery is: Staphylococcus epidermidis. The risk factors associated with the development of infectious keratitis are divided into: pre-surgical, intra-surgical and post-surgical. The time of onset of symptoms after refractive surgery is one of the most important antecedents associated with the causative microorganism. Less than 7 days is considered “early onset”. After 7 days of “late onset.” The initiation of empirical treatment is recommended in the case of early onset of symptoms with 4th generation fluoroquinolone alternated with fortified cefazolin. In the case of late onset (more than 7 days after surgery), start with 4th generation fluoroquinolone alternating with Amikacin as well as oral doxycycline. At the end of the surgery, it is recommended to apply a drop of moxifloxacin. Regarding post-surgical measures, the time of contact lens use should be limited, avoid contaminated environments and administer antibiotics for a period of 7–10 days, or until the epithelial defect has been completely resolved.