Mark Speaker, M.D., Ph.D. Coauthors Infectious Keratitis &
Photorefractive Keratectomy (PRK) Article

Mark Speaker, M.D., Ph.D. is a Refractive Surgeon and Corneal Specialist in New York at Laser and Corneal Surgery Associates in Manhattan. He is widely recognized for his contributions to the fields of corneal and refractive surgery including LASIK and Corneal Transplantation through his efforts in patient care, research and ongoing physician education. Dr. Speaker, along with coauthors Drs. Donnenfeld, O’Brien. Solomon and Wittpen published the results of their study ”Infectious Keratitis After Photorefractive Keratectomy” in the April 2003 journal, Ophthalmology.

Abstract of Study and Publication

PURPOSE: To elucidate risk factors, microbial culture results, and visual outcomes for infectious keratitis after photorefractive keratectomy (PRK).

DESIGN: Multicenter, retrospective chart review, case report, and literature review. METHODS: The records of 12 patients with infectious keratitis after PRK were reviewed.

MAIN OUTCOME MEASURES: Causative organism, response to medical treatment, and visual outcome.

RESULTS: Infectious keratitis developed in 13 eyes of 12 patients after PRK. Organisms cultured were Staphylococcus aureus (n = 5), including a bilateral case of methicillin-resistant Staphylococcus aureus; Staphylococcus epidermidis (n = 4); Streptococcus pneumoniae (n = 3); and Streptococcus viridans (n = 1). Four patients manipulated their contact lenses, and 2 patients were exposed to nosocomial organisms while working in a hospital environment. Prophylactic antibiotics used were tobramycin (nine cases), polymyxin B-trimethoprim (three cases), and ciprofloxacin (one case). Final best spectacle-corrected visual acuity ranged from 20/20 to 20/100.

CONCLUSIONS: Infectious corneal ulceration is a serious potential complication of PRK. Gram-positive organisms are the most common pathogens. Antibiotic prophylaxis should be broad spectrum and should include gram-positive coverage.

About Mark Speaker, M.D., Ph.D.

Mark Speaker, M.D. received his Doctor of Medicine (M.D.) and Doctor of Philosophy (Ph.D.) degrees from the Albert Einstein College of Medicine and completed his residency in Ophthalmology at The New York Eye and Ear Infirmary in Manhattan where he served as the Chief Resident. In addition he completed a Fellowship in Corneal and Refractive Surgery at Wills Eye Hospital in Philadelphia. He has served as the Director of the Cornea Service and Director of the Ophthalmology Residency Program at The New York Eye and Ear Infirmary. He has served on the Board of Directors of the Cornea Society, the Program Committee of the American Academy of Ophthalmology, and has received the Honor Award from the American Academy of Ophthalmology. He is currently Medical Director of TLC Laser Eye Centers Manhattan. In addition, he is the author of numerous articles and publications in the areas of Corneal Disease, Cornea Transplants, LASIK and Ocular Surface Disease including Dry Eyes and Dry Eye Syndrome.