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Aspergillus keratitis after radial keratotomy
D G Heidemann1, S P Dunn, J C Watts
1Department of Ophthalmology, William Beaumont Hospital, USA.
Purpose/Methods:
A case of severe Aspergillus keratitis after radial keratotomy manifested as a discrete midstromal infiltrate along a radial incision. Despite aggressive treatment with topical amphotericin B and oral itraconazole, the patient required a therapeutic penetrating keratoplasty.
Results/Conclusions:
Histopathologic examination disclosed a corneal ulcer with numerous septate, branching hyphae throughout the stroma, and marked stromal necrosis. Aspergillus species should be included among the microbial pathogens responsible for infectious keratitis after radial keratotomy. If infectious keratitis is suspected, comprehensive cultures for bacteria and fungi should be obtained.
Insights
Severe Aspergillus keratitis, a fungal eye infection, can occur after radial keratotomy surgery. Prompt diagnosis and broad cultures for fungi and bacteria are crucial for effective treatment of this serious corneal condition.
Area of Science:
- Ophthalmology
- Mycology
Background:
- Radial keratotomy (RK) is a refractive surgical procedure.
- Infectious keratitis is a potential complication following ocular surgery.
Observation:
- A case of severe Aspergillus keratitis presented after RK.
- The infection manifested as a midstromal infiltrate along a radial incision.
Findings:
- Despite aggressive topical and oral antifungal treatment, penetrating keratoplasty was required.
- Histopathology confirmed Aspergillus species with stromal necrosis.
Implications:
- Aspergillus species are a cause of infectious keratitis post-RK.
- Comprehensive cultures for fungi and bacteria are essential for suspected cases.