Mycobacterium chelonae Keratitis Following Laser in situ Keratomileusis (LASIK) Specifically Identified by INNO-LIPA Method

keratomileusis (LASIK) is appoximately 1 in 5.000 . In recent years, several unusual corneal infections have been diagnosed with increasing frequency. The keratitis caused by the non-tuberculous Mycobacterium (i.e, atypical Mycobacterium) is chacterized by two species: Mycobacterium chelonae and Mycobacterium fortuitum . These two species are a facultative pathogen saprophytic in the environment and may cause severe opportunistic infection in humans, including lung diseases, cutaneous abscesses, cellulitis, soft tissue infectious, as well as postoperative wound infections, and prosthetic valve endocarditis (1). Ocular infections caused by atypical mycobacteriae include keratitis, endophthalmitis, orbital granuloma, lacrimal drainage system infection and scleral abscesses (1,2). The keratitis caused by this organism occurs in association with foreign body injury , contact lens wear, or after corneal surgical procedures, including penetrating keratoplasty, radial keratotomy, suture removal, extracapsular cataract with intraocular lens implantation and posterior capsulotomy (1,3).The exact mechanism of pathogenesis of mycobacterial infections is not well understood (1). Initial inoculation of the organisms appears to result from contaminated foreign bodies or surgical instruments (1). Nontuberculous mycobacterial keratitis may be difficult to differentiate at diagnosis (4). We report a case of keratitis after LASIK, caused by Mycobacterium chelonae identified by conventional methods and INNO-LIPA and discuss the difficulty and delay in identifying the organism, erroneously identified as Nocardia species on morphological grounds.