Late-Onset Laser In Situ Keratomileusis–Related Corneal

that developed 5 years after laser in situ keratomileusis (LASIK) procedures. Methods: We retrospectively documented the clinical and labora-tory characteristics of all patients between 2004 and 2008 who presented with LASIK-related corneal ulcer that appeared.5 years postoperatively. The 4 patients who had this condition were 25-, 33-, 61-, and 62-year-old males. Results: Two patients had cultures positive to Staphylococcus aureus and Streptococcus epidermidis. Two ulcers healed after stan-dard fortified topical antibiotic regimen, 1 ulcer healed after treatment with moxifloxacin, and the fourth healed after treatment with lomefloxacin. All cases presented 5 years after the LASIK procedure. Conclusions: LASIK procedures can be associated with the risk of corneal infection even years later. The mechanism may be flap margin instability causing epithelial defense barrier disturbance. Key Words: LASIK, corneal ulcer, late complications (Cornea 2009;28:586–588) Laser in situ keratomileusis (LASIK) is presently the mostcommon refractive procedure. The incidence of infectious keratitis after LASIK is estimated as being between 1/2919 and 1/5000.1,2 There are few reports of late-onset flap margin– related corneal ulcers in the literature: Most ulcers appeared between 3 and 15 months postoperatively.3,4 Recently, a case series reported 2 patients with keratitis occurring 2 and 6 years after the operation.5 We report 4 cases of flap margin–related corneal ulcers that did not develop until 5 years after the LASIK procedure