Infection after LASIK surgery, although rare, may cause significant visual loss. Infections presenting early after LASIK (with in 1 week) are commonly caused by gram-positive organisms, whereas delayed onset infections (presenting 2-3 weeks after LASIK) are commonly caused by atypical mycobacteria. Persistence of interface inflammation or appearance of corneal infiltrate after LASIK should be presumed infectious unless proven otherwise. Fungal infections should be considered in those cases lacking improvement after early broad-spectrum therapy, as they are associated with severe visual loss. A high index of suspicion and aggressive management, which includes early lifting of the flap, scrapings for microbiological investigation, and irrigation, and aggressive antibiotic therapy, may lead to better outcomes.
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