Late-onset laser in situ keratomileusis-related corneal ulcer-A case series

PURPOSE: To report 4 cases of flap margin-related corneal ulcer that developed 5 years after laser in situ keratomileusis (LASIK) procedures. METHODS: We retrospectively documented the clinical and laboratory characteristics of all patients between 2004 and 2008 who presented with LASIK-related corneal ulcer that appeared >5 years postoperatively. The 4 patients who had this condition were 25-, 33-, 61-, and 62-year-old males. RESULTS: Two patients had cultures positive to Staphylococcus aureus and Streptococcus epidermidis. Two ulcers healed after standard fortified topical antibiotic regimen, 1 ulcer healed after treatment with moxifloxacin, and the fourth healed after treatment with lomefloxacin. All cases presented 5 years after the LASIK procedure. CONCLUSIONS: LASIK procedures can be associated with the risk of corneal infection even years later. The mechanism may be flap margin instability causing epithelial defense barrier disturbance.