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Aspergillus keratitis after photorefractive keratectomy: a case report
Alireza Peyman1, Nahid Mirzaei1, Elaheh Foroughi1,2
1Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
Journal of Medical Case Reports
|June 19, 2026
Summary
Early fungal keratitis after photorefractive keratectomy (PRK) can occur in immunocompetent patients. Prompt diagnosis via corneal smear and PCR testing is crucial for effective antifungal treatment and favorable outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Fungal keratitis is a rare complication following refractive surgery.
- This case details early postoperative Aspergillus keratitis in an immunocompetent individual after photorefractive keratectomy (PRK).
Purpose of the Study:
- To report a case of early Aspergillus keratitis post-PRK.
- To emphasize the importance of considering fungal infections in post-PRK keratitis differential diagnosis.
Main Methods:
- A case of a 21-year-old male undergoing bilateral PRK for myopia is presented.
- Diagnosis involved corneal scrapings for direct microscopy and Polymerase Chain Reaction (PCR) testing.
- Empirical antibiotic therapy was followed by targeted antifungal treatment.
Main Results:
- The patient presented with eye redness and blurred vision 7 days post-PRK.
- PCR confirmed an Aspergillus corneal infection.
- Antifungal treatment led to significant clinical improvement within 7 days.
Conclusions:
- Early post-PRK keratitis necessitates consideration of atypical pathogens like fungi.
- Direct smear and PCR are vital diagnostic tools for timely identification of fungal keratitis.
- Early diagnosis and treatment are associated with favorable clinical outcomes.
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