Optical coherence tomography (OCT) can help in the diagnosis and treatment of infectious keratitis, but it has not been studied in cases occurring after corneal refractive surgery procedures such as femtosecond laser in situ keratomileusis (FS-LASIK) and keratorefractive lenticule extraction (KLEx). In these procedures a surgical interface is created, where infections usually start, thus determining a different OCT pattern compared to non-surgical infections, which instead begin in the corneal surface. A total of 4 cases of post-refractive surgery infectious keratitis are reported (2 after FS-LASIK and 2 after KLEx), in which the OCT identified an initial infiltrate in the interface, followed by interface inflammation. In 1 case after FS-LASIK, interface fluid accumulation occurred. In 1 case after KLEx, diffuse interface inflammation led to stromal reabsorption, later compensated by stromal reformation and epithelial hyperplasia, well documented by OCT.