Frequency-doubled YAG Laser as an Adjuvant Treatment for Treatment-Resistant Keratitis

Abstract

Infectious keratitis is a serious ocular condition and a leading cause of monocular blindness worldwide. Available medication have limited efficacy due to poor corneal penetration and resistance of some species to these agents. There is a need for treatment that achieves healing of corneal ulcers and improves visual quality in patients with treatment-resistant infectious keratitis. The use of frequency doubled YAG laser with photoactivated fluorescein allows corneal crosslinking and thus stops the progression of corneal degradation, favoring resolution with healing. The objective was to report the use of frequency-doubled YAG laser with photoactivated fluorescein for the treatment of refractory infectious keratitis. An 81-year-old female patient presented with pain, photophobia, tearing and foreign body sensation in the right eye. Biomicroscopic examination showed cornea with corneal infiltrate of medium density of 8 mm in diameter, whitish color and defined edges, which respected the upper sector. The patient was admitted to the cornea service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer with a diagnosis of infectious keratitis in the right eye. Complementary tests were indicated and medical treatment was started according to the established protocols. After seven days of treatment, as there was no improvement of the clinical picture, adjuvant treatment with YAG laser was decided. Stability and improvement of the clinical picture was observed, so surgical treatment was not required.