Journal of Clinical Case Reports

Late-Onset Gemella morbillorum Flap-Margin-Related Keratitis After Laser In Situ Keratomileusis

Abstract

Lucia Rial, Konrad Schargel, Albino Rial, Lidia Ortega and Jose I Belda

Purpose: Communicate a case of late onset Gemella morbillorum keratitis after laser in situ keratomileusis. Infectious keratitis after laser in situ keratomileusis (LASIK) is a rare complication. The most common microorganisms in this infection are atypical Mycobacterium and gram-positive cocci. We treated a healthy 45-year-old man, who developed a spontaneous flap interface keratitis in the right eye 6 years after laser in situ keratomileusis (LASIK). Visual acuity represented in decimal fraction was 0.96 (19/20 feet) in the right eye and 1.0 (20/20) in the left eye. Cultures were positive for Gemella morbillorum. Topical treatment with fortified vancomycin and dexamethasone elicited a response. One month following initial treatment, the bacterial infiltrate had resolved. To our knowledge, this is the first reported case of post-LASIK infectious keratitis caused by Gemella morbillorum that occurred several years after the procedure. Conclusions: This case emphasizes the importance of lifelong follow-up care after LASIK. When one of these patients exhibits symptoms of an infectious keratitis, it’s important to suspect an atypical microorganism, and a culture should be taken to determine the best manner of treatment for each microorganism.