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Post intrastromal corneal ring segments insertion complicated by Candida parapsilosis keratitis
Bradley M Mitchell1, A John Kanellopoulos, Ramon L Font
1Eclipse IS Consulting, Rosenberg, TX.
Clinical Ophthalmology (Auckland, N.Z.)
|March 8, 2013
Summary
This case report details a rare fungal keratitis infection caused by Candida parapsilosis following intrastromal corneal ring segment implantation for keratoconus. The infection was confirmed via molecular methods after other treatments failed.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Intrastromal corneal ring segments (ICRS) are used to correct myopia and irregular astigmatism in conditions like keratoconus.
- Fungal keratitis is a serious ocular infection that can lead to vision loss.
Observation:
- A 52-year-old woman developed fungal keratitis after ICRS implantation and subsequent extrusion/replacement.
- Initial treatment with antibiotics and steroids was ineffective, and cultures were negative.
- Symptoms included infiltrates and an epithelial defect, leading to suspicion of fungal or Mycoplasma infection.
Findings:
- Histopathology and panfungal polymerase chain reaction (PCR) confirmed Candida parapsilosis keratitis.
- This is the first reported case of C. parapsilosis infection complicating ICRS implantation.
- Therapeutic keratoplasty was required for treatment.
Implications:
- Highlights a rare but serious complication of ICRS implantation.
- Emphasizes the importance of considering fungal infections in refractory keratitis post-ICRS.
- Suggests the need for advanced diagnostic methods like PCR in suspected cases.
