bilateral bacterial keratitis following photorefractive keratectomy case reports with review of literature

purpose: to report two cases of bilateral bacterial keratitis as a sight-threatening complication following photorefractive keratectomy (prk) patients and findings: the first case was a 45-year-old man referred due to bilateral ocular pain and purulent discharge two days after bilateral prk. based on his clinical picture, smear and cultures from both corneal ulcers were taken with a diagnosis of bacterial keratitis. frequent topical fortified antibiotic treatment was started. smear showed many pmn cells but the culture was negative. corneal ulcers were controlled with medical treatment. the second case was a 24-year-old man who presented with bilateral severe pain and discharge. he was diagnosed as bilateral corneal ulcers 2 days after prk and topical antibiotics were started for him, but because of poor response he was referred to our center. culture result was positive for staphylococcus aureus. he had severe bilateral blepharitis. frequent fortified antibiotics were started which controlled his condition. conclusion: infectious keratitis after prk is a rare, but potentially devasting complication. the predisposing risk factors are breakdown of the barrier function of the corneal epithelium, active blepharitis, use of bandage contact lens on an extended wear basis and use of topical steroids to control wound healing. it is recommended not to operate bilateral eyes simultaneously in those at risk.