Repeat Lamellar Keratoplasty Treatment for Positive Rim Lamellar Keratoplasty

Yazeed A Alferyan1, Mohammed A Almutlak1, Abdullah S Alobaidan2

  • 1Department of Anterior Segment, King Khalid Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

Insights

Repeat lamellar keratoplasty (LKP) successfully treated a positive rim fungal keratitis caused by Candida glabrata. This approach addresses a significant risk factor for graft infection, offering a potential solution for managing fungal keratitis in corneal grafts.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Surgical Techniques

Background:

  • Positive rim cultures after corneal transplantation are a significant risk factor for developing fungal keratitis.
  • Fungal keratitis in corneal grafts presents a management challenge with various treatment modalities explored.
  • Candida glabrata is a potential causative agent of fungal keratitis in post-keratoplasty cases.

Approach:

  • This case report details the clinical presentation and management of fungal keratitis with a positive rim culture post-lamellar keratoplasty (LKP).
  • The study focuses on repeat LKP as a therapeutic strategy for this specific complication.
  • A comprehensive review of the literature on managing fungal keratitis in corneal grafts was conducted.

Key Points:

  • Repeat lamellar keratoplasty (LKP) was employed as a treatment for a positive rim culture of Candida glabrata following a previous corneal graft.
  • The positive rim finding is recognized as a substantial risk factor for fungal keratitis development.
  • The clinical findings, management strategy, and surgical technique are described.

Conclusions:

  • Repeat LKP can be an effective surgical option for managing fungal keratitis with positive rim cultures in corneal grafts.
  • This case highlights a successful intervention for a known risk factor of graft infection.
  • Further investigation into optimal management strategies for fungal keratitis post-keratoplasty is warranted.

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