Evidence map›Paper›PMID 39792283›Full record

ArticleJournal of ophthalmic inflammation and infection2025

Infectious keratitis following photorefractive keratectomy: a 13-year study at a tertiary center.

Alireza Attar, Hossein Jamali, Julio Ortega-Usobiaga, Golnoush Mahmoudinezhad, Dagny Zhu, Mohammad Mohammadi

Abstract read
In one paragraph

Article in Journal of ophthalmic inflammation and infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alireza AttarPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Hossein JamaliPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Julio Ortega-UsobiagaDepartment of Cataract & Refractive Surgery, Clínica Baviera-AIER Eye Hospital Group, Bilbao, Spain.
Golnoush MahmoudinezhadHamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.
Dagny ZhuNVISION Eye Centers, Rowland Heights, CA, USA.
Mohammad MohammadiSchool of medicine, Shahid Sadoughi University of Medical sciences, Yazd, Iran. mohammadmohammadi16@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInfectious keratitis is a rare but devastating complication following photorefractive keratectomy (PRK) that may lead to visual impairment. This study assessed the clinical features, treatment strategies, and outcomes of post-PRK infectious keratitis.

methodsThis retrospective study was conducted on patients with post-PRK infectious keratitis presenting to Khalili Hospital, Shiraz, Iran, from June 2011 to March 2024. The study was conducted in two stages: the first stage assessed the incidence of post-PRK infectious keratitis among patients who underwent PRK at our center, while the second stage included all patients with post-PRK infectious keratitis, regardless of where their PRK was performed. The following data were collected: demographics, post-surgery presentation time, risk factors, culture results, treatments, follow-up duration, complications, and corrected distance visual acuity (CDVA) at admission and the last follow-up.

resultsForty-two patients (42 eyes) with a mean age of 28.74 years (male-to-female ratio of 1.2:1) were included. Among 38,938 PRK procedures performed at our center, the incidence of keratitis was estimated to be 0.018% (7/38,938). The odds of keratitis during the COVID-19 pandemic were 7.05 times higher (95% CI: 1.58 to 31.52, p-value = 0.015) than outside this timeframe (February 2020 to August 2023). Gram-positive bacteria were the most commonly isolated pathogens in microbiological studies, accounting for 45.2% (19/42) of cases. Early-onset infections were primarily caused by Staphylococcus aureus (9/26, 34.6%), Staphylococcus epidermidis (4/26, 15.4%), and Pseudomonas aeruginosa (4/26, 15.4%), whereas all of the cases with fungi (4/4, 100% (and Acanthamoeba (3/3, 100%) infections caused late-onset infections. All patients received broad-spectrum antibiotic therapy, followed by adjusted treatment based on microbial results. Cases developing endophthalmitis and those not responding to treatment or having non-resolving corneal scars required further interventions, such as penetrating keratoplasty and deep vitrectomy. The mean follow-up duration was 40.81 months, and 97.6% (41/42) of cases experienced CDVA improvement at follow-up.

conclusionThis long-term study found a post-PRK keratitis rate of 0.018%, with gram-positive bacteria as the most common pathogens. Prompt management and regular follow-up assessments are essential for achieving satisfactory outcomes.

Indexed as

COVID-19Infectious keratitisManagementPhotorefractive KeratectomyPRKRefractive surgeryRisk factorsVisual acuity

Identifiers

PMID39792283
PMCPMC11723873

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.