netilmicin and Hyperopia

The aim of this study was to evaluate the results of myopic excimer laser photorefractive keratectomy (PRK) performed using three different ablation approaches.. Using the Apex excimer laser (Summit Technology, Inc., Waltham MA), we have treated 75 eyes. Twenty-five of them were treated by a single ablation zone (SA, 6.5 mm diameter) to correct myopia of -4.50 +/- 2.10 D (mean +/- SD); 25 eyes underwent PRK for the correction of myopia of -4.98 +/- 2.17 D using a multipass multizone technique (MP, 3 zones); and 25 eyes were corrected for myopia of -5.03 +/- 1.98 D using new software which enables the creation of three ablation zones in a single-pass fashion (MZ).. Mean refractive error (+/-SD) at the first post-operative month was +1.34 +/- 1.00 D for SA, +1.78 +/- 1.49 D for MP, and +0.90 +/- 0.75 D for MZ. Eyes treated by MZ had significantly better uncorrected visual acuity than those treated by SA (P=0.04). Corneal topography revealed a central island in 14 eyes (56%) of those treated by SA and 2 eyes (8%) of those treated by MZ, but in no eyes treated by MP. Six months after treatment, mean refractive error was +0.28 +/- 0.75 D for SA, +0.36 +/- 0.92 D for MP, and - 0.07 +/- 0.77 D for MZ.. MZ ablation induced less hyperopic shift at 1 month, thus leading to a faster visual recovery and better uncorrected visual acuity. MP and MZ ablations proved effective in preventing central island formation, thus inducing less visual disturbances than SA ablations. These results suggest that MZ ablation may be preferable to the other techniques in performing myopic PRK.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Cornea; Corneal Opacity; Cyclopentolate; Diclofenac; Double-Blind Method; Evaluation Studies as Topic; Female; Gentamicins; Humans; Hyperopia; Lasers, Excimer; Male; Middle Aged; Mydriatics; Myopia; Netilmicin; Photorefractive Keratectomy; Refraction, Ocular; Software; Treatment Outcome; Visual Acuity

To report clinical manifestations of a female patient with bilateral bacterial keratitis following photorefractive keratectomy (PRK). Bilateral PRK was performed for moderate hyperopia. Bandage contact lenses were fitted at the conclusion of the surgery. Bilateral infectious keratitis with hypopion was diagnosed within 4 days after surgery. Smear and culture were obtained and showed the presence of methicillin-resistant Staphylococcus aureus (MRSA). The patient was treated with systemic prednisone and topical antibiotics (vancomycin, tobramycin and netylmicin) and betamethasone. After 1 month corneal leukoma was still present and remained unchanged during the following 7 months. Infectious keratitis is a rare complication of PRK that appears early in the postoperative period. MRSA keratitis may determine long-term visual impairment despite prompt therapeutic intervention.

Topics: Anti-Infective Agents; Antitubercular Agents; Aza Compounds; Diagnosis, Differential; Dose-Response Relationship, Drug; Female; Fluoroquinolones; Follow-Up Studies; Humans; Hyperopia; Keratitis; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Moxifloxacin; Netilmicin; Ophthalmic Solutions; Photorefractive Keratectomy; Quinolines; Staphylococcal Infections; Visual Acuity