Collagen Cross-linking With Photoactivated Riboflavin (PACK-CXL) for Bacterial Keratitis After Small Incision Lenticule Extraction (SMILE).

PURPOSE To report a case of infectious keratitis after small incision lenticule extraction (SMILE) treated with collagen cross-linking with photoactivated riboflavin (PACK-CXL). METHODS Case report and literature review. RESULTS A patient presented with culture-proven bacterial keratitis 5 days after SMILE was treated with fortified topical antibiotics and PACK-CXL. Irrigation of the corneal cap-stromal bed interface, which can be difficult and affect visual outcomes, was not performed. Clinical improvement was seen shortly after treatment and resolution of keratitis was achieved at 2 weeks. CONCLUSIONS This is the first reported use of PACK-CXL in the management of infectious keratitis after SMILE. PACK-CXL may help sterilize the infection and limit its spread within the interface. [J Refract Surg. 2017;33(4):278-280.].