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Post-LASIK epithelial dendritic defect associated with Alternaria.

Tolga Kocatürk¹, Roberto Pineda, Laura K Green

¹Department of Ophthalmology, Adnan Menderes University Medical School, Aydin, Turkey.

|September 26, 2007

Summary

A rare fungal infection, Alternaria keratitis, can mimic herpes simplex virus after laser in situ keratomileusis (LASIK) surgery, presenting as a dendritic epithelial defect with inflammation. Prompt diagnosis and treatment are crucial for visual recovery.

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Area of Science:

Ophthalmology
Medical Mycology
Surgical Infections

Background:

Laser in situ keratomileusis (LASIK) is a common refractive surgery.
Postoperative infectious keratitis is a rare but serious complication.
Herpes simplex virus (HSV) keratitis is a frequent cause of infectious keratitis.

Observation:

A 46-year-old woman developed a dendritic epithelial defect and interface inflammation post-LASIK.
Initial presentation mimicked herpes simplex keratitis.
The condition did not respond to standard antiviral therapy.

Findings:

Cornea cultures revealed Alternaria fungal species.
Viral studies were negative for herpes simplex virus.
The patient underwent penetrating keratoplasty and later cataract extraction.

Implications:

Alternaria keratitis can present atypically, mimicking HSV keratitis.
Fungal keratitis should be considered in non-responsive post-LASIK epithelial defects.
Accurate microbiological diagnosis is essential for appropriate treatment and visual rehabilitation.