Extensively Drug-Resistant Pseudomonas aeruginosa Keratitis After Photorefractive Keratectomy Because of Contaminated Eye Drops: Experience With Colistin-Based Therapy
Charuta Ravindra Shrotriya, Joveeta Joseph, Bhupesh BaggaPurpose:
This study aims to report the clinico-microbiological characteristics of cases of infectious keratitis caused by extensively drug-resistant
Methods:
Retrospective review of 7 eyes from 4 patients presenting with infectious keratitis after bilateral PRK performed at different centers and time points, evaluated at a tertiary eye care center in India between March 2024 and August 2025. We analyzed demographic, clinical, microbiological, treatment, and outcome data.
Results:
The study included 7 eyes from 4 patients. Patients presented, on average, after 2.5 days (range, 1–4 ), and visual acuity ranged from 20/50 to perception of light with inaccurate projection of rays. Corneal infiltrates were central and full-thickness, with severe stromal lysis in 5 of the 7 eyes; 1 eye had a midstromal infiltrate, and 1 eye had pinpoint anterior stromal infiltrates. Hypopyon was present in 6 eyes. In all cases, microbiological examination revealed Gram-negative bacilli, confirmed to be
Conclusions:
This series highlights early recognition of extensively drug-resistant infections after PRK surgery, source identification, and prompt, microbiology-guided therapy, resulting in favorable outcomes.