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Candida parapsilosis Infection After Crescentic Lamellar Wedge Resection in Pellucid Marginal Degeneration
Selma Özbek-Uzman1, Ayşe Burcu1, Züleyha Yalnız-Akkaya1
1University of Health Sciences, Ankara Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey.
Abstract:
Infectious keratitis after corneal lamellar surgery is a rare complication. In this report, we present unexpected complications after crescentic lamellar wedge resection (CLWR) and their treatment in a patient with pellucid marginal degeneration. A 42-year-old male patient developed fungal keratitis due to Candida parapsilosis in the late postoperative period after CLWR. Infection was controlled with medical treatment. However, recurrent intraocular infections and cataract formation occurred, probably due to capsular damage and inoculation of microorganisms into the crystalline lens during antifungal drug injection. Lensectomy was performed due to cataract progression and recurrence of the infection when treatment was discontinued. Amphotericin B was administered to the anterior chamber at the end of the operation. Four months later, an intraocular lens was implanted and corneal cross-linking treatment was performed. At the last visit, visual acuity reached 9/10. This case shows that good visual acuity can be achieved with appropriate treatment of fungal keratitis and all associated complications after CLWR.
Insights
Fungal keratitis is a rare complication following crescentic lamellar wedge resection (CLWR). This case report details successful management of Candida parapsilosis infection and associated complications, restoring good visual acuity.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Infectious keratitis is a rare but serious complication after lamellar corneal surgery.
- Pellucid marginal degeneration (PMD) is a progressive corneal thinning disorder.
- Crescentic lamellar wedge resection (CLWR) is a surgical option for PMD.
Purpose of the Study:
- To report unexpected complications after CLWR in a patient with PMD.
- To describe the management of late-onset fungal keratitis post-CLWR.
- To highlight the treatment of associated intraocular infections and cataract formation.
Main Methods:
- A case report of a 42-year-old male patient with PMD undergoing CLWR.
- Diagnosis of late-onset fungal keratitis due to Candida parapsilosis.
- Medical management of keratitis, followed by lensectomy, intracameral amphotericin B, intraocular lens implantation, and corneal cross-linking.
Main Results:
- Successful control of fungal keratitis with medical treatment.
- Development of recurrent intraocular infections and cataract formation.
- Restoration of visual acuity to 9/10 after comprehensive surgical and medical interventions.
Conclusions:
- Fungal keratitis following CLWR can be successfully treated.
- Comprehensive management of associated complications, including intraocular infections and cataracts, is crucial.
- Good visual outcomes are achievable with appropriate and timely treatment.
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