Delayed-onset Actinomyces keratitis after laser in situ keratomileusis.

PURPOSE: To present a case of delayed-onset unilateral keratitis caused by Actinomyces israelii after laser in situ keratomileusis (LASIK).

METHODS: A 28-year-old woman was referred to our clinic because of foreign-body sensation and mild blurred vision in her left eye. She had bilateral simultaneous LASIK approximately 5 months ago. On slit-lamp examination, there was an area of infiltration in the corneal interface. The LASIK flap was elevated, and the involved area was scraped and irrigated with antibiotic solutions.

RESULTS: Culture and smear showed A. israelii as a causative agent, and the keratitis was successfully treated by antibiotics chosen according to antibiotic sensitivity test.

CONCLUSIONS: Actinomyces israelii must be considered in differential diagnosis of delayed-onset microbial keratitis after LASIK. Flap elevation, scraping, and irrigating the involved area can be helpful to obtain specimens for culture and smear and to control infection.