Endophthalmitis following photorefractive keratectomy with a history of radial keratotomy: a case report

BACKGROUND We report the case of an 81-year-old woman with a history of radial keratotomy 9 years prior who developed endophthalmitis without preceding keratitis 4 days after uneventful photorefractive keratectomy surgery. This case report utilized clinical examination and microbacterial laboratory findings. FINDINGS Diagnosis of bacterial endophthalmitis was made via clinical examination and cultured vitreous tap which grew methicillin-resistant Staphylococcus aureus. No preceding keratitis was seen on exam. The patient responded to intravitreal antibiotics. CONCLUSIONS We believe that the epithelium removed during the photorefractive keratectomy procedure may have uncovered areas of full-thickness radial keratotomy incisions allowing bacterial ingress, causing bacterial endophthalmitis without preceding keratitis.