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Therapeutic contact lens-related bilateral fungal keratitis
Ana Luisa Höflin-Lima1, Roberto Roizenblatt
1Ophthalmology Department, Federal University of São Paulo, Brasil.
Purpose:
To describe a rare case of bilateral Candida keratitis after contact lens use following bilateral penetrating keratoplasty (PK).
Methods:
A 40-year-old female with a clinical diagnosis of Sjögren's syndrome was being followed for corneal thinning in both eyes. She suffered a spontaneous bilateral perforation and underwent penetrating keratoplasty. Therapeutic contact lenses were prescribed for both eyes owing to persistent epithelial defects. Two months later, a biomicroscopic examination revealed corneal infiltrates.
Results:
A corneal tissue sample, saline, and contact lens cultures were all positive for Candida albicans. Topical and systemic antifungal therapy successfully cleared the infection in the right eye; however, the left eye underwent another corneal graft surgery.
Conclusions:
Infectious fungal keratitis may be a complication of wearing therapeutic contact lenses after PK, in a patient with Sjögren's syndrome. The pre-existing eye disease is an important associated factor in cases of yeast infection; therefore, adequate care of these patients and careful follow-up after PK are indicated as measures to prevent early infections.