Extensive lamellar keratectomy for treatment of nontuberculous mycobacterial keratitis.

Abstract

To determine the efficacy of using extensive lamellar keratectomy for treating patients who have nontuberculous mycobacterial keratitis that is unresponsive to medical treatment. Nine patients with bacteriologically proven nontuberculous keratitis, who had poor response to medical treatment and whose corneal infiltrate was not deeper than 80% of corneal thickness, were selected for extensive lamellar keratectomy. This procedure was performed freehand to remove all the corneal infiltration visible by operation-microscopic examination, to have a clean stromal bed. Corneal infection was eradicated in seven patients by a single procedure. In the other two patients, the condition was controlled by a second operation. Epithelialization was rapid and complete in all cases within ten days (mean, 4.8 days). Pain relief was dramatic after surgery. Visual acuity after surgery was improved in seven patients, but remained the same in two. There were no complications as a result of the lamellar keratectomy. Lamellar keratectomy should be considered as a treatment option for patients with nontuberculous mycobacterial keratitis who are unresponsive to medical therapy.