August 1986

Late Development of Ulcerative Keratitis in Radial Keratotomy Scars

Author Affiliations

From the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine (Drs Mandelbaum, Forster, and Culbertson and Ms Espinal); the Department of Ophthalmology, Emory University School of Medicine, Atlanta (Dr Waring); and the Dean A. McGee Eye Institute, University of Oklahoma, Oklahoma City (Dr Rowsey).

Arch Ophthalmol. 1986;104(8):1156-1160. doi:10.1001/archopht.1986.01050200062050

• We describe three patients in whom ulcerative keratitis developed seven months to 2½ years after uncomplicated radial keratotomy. All ulcers occurred along keratotomy scars within the interpalpebral fissure or inferiorly. At least one case developed spontaneously; another patient may have sustained an unrecognized corneal injury. The third patient was using an extended-wear soft contact lens for correction of residual myopia. Bacteria were isolated from two of the ulcers. With therapy, all ulcers healed without reducing visual acuity. We hypothesize that the altered structure of the slowly healing keratotomy incisions coupled with redistribution of the tear film due to changes in corneal topography may result in intermittent epithelial irregularities. Alone or in conjunction with any form of mechanical or hypoxic corneal injury, these changes along keratotomy incisions may predispose to corneal infection.