[Keratomycosis and keratoplasty]

Three cases of corneal perforation in keratomycosis are reported. In the first two cases the etiological diagnosis had been made from the anatomo-pathological examination of the excised corneal buttons. The mycotic origin in the third case was known before perforation from corneal cultures. Although the prognosis of this condition is usually poor, the post-keratoplasty evolution in the three cases was uncomplicated. The authors analyse the peculiarities of corneal mycotic abscess and discuss the appropriate diagnostic approach and management. Treatment must be performed before intraocular mycotic invasion occurs, because of the poor intraocular diffusion of antifungal agents. In this case, penetrating keratoplasty is not as dangerous as previously reported; and moreover, allows simultaneous treatment of the mycosis and the anatomical and functional repair of the cornea.