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CASE REPORT
Activation of Cytomegalovirus corneal endotheliitis following laser in situ keratomileusis
  1. Tien-En Tan1,
  2. Chui Ming Gemmy Cheung1,2,
  3. Jodhbir S Mehta1,2
  1. 1Singapore National Eye Centre, Singapore, Singapore
  2. 2Singapore Eye Research Institute, Singapore, Singapore
  1. Correspondence to Dr Jodhbir S Mehta, jodmehta{at}gmail.com

Summary

A case of Cytomegalovirus (CMV) corneal endotheliitis following laser in-situ keratomileusis (LASIK) is presented. A 32-year-old man presented 3 weeks after uncomplicated myopic LASIK with unilateral LASIK flap oedema, interface fluid accumulation, keratic precipitates, anterior uveitis and raised intraocular pressure. Despite treatment with topical corticosteroids, he had 3 further recurrent episodes. Specular microscopy showed decreased endothelial cell density and aqueous humour. Polymerase chain reaction (PCR) testing was positive for CMV DNA. He was treated with topical ganciclovir and ketorolac, and the inflammation and oedema resolved. Repeat aqueous humour PCR testing was negative for CMV DNA, and he remained well at last follow-up (3 months after stopping all medications). CMV corneal endotheliitis can be reactivated after LASIK, and CMV DNA PCR of aqueous humour samples can help in definitive diagnosis. Early recognition and treatment of this condition is important to prevent permanent endothelial cell loss and corneal decompensation.

https://doi.org/10.1136/bcr-2016-216774

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    Footnotes

    • Contributors All three authors have made substantial contributions towards conception and design, acquisition of data, analysis and interpretation of data, as well as drafting of the article and revising it critically. JSM and CMGC made substantial contributions towards conception and design. TET, JSM and CMGC made substantial contributions towards acquisition of data, analysis and interpretation of data. TET, JSM and CMGC made substantial contributions towards drafting of the manuscript and critical revision. All three authors approve of the version submitted, and all are accountable for the article and will ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. JSM is responsible for the overall content as guarantor.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.