Interface fungal infection after laser in situ keratomileusis presenting as diffuse lamellar keratitis. A clinicopathological report.
OBJECTIVE
To report clinicopathological analyses of 3 cases of interface fungal infection following laser in situ keratomileusis (LASIK) and diffuse lamellar keratitis (DLK).


METHODS
Center for Research on Ocular Therapeutics and Biodevices and Arthur and Holly Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.


METHODS
Clinicopathological analysis of 5 eyes of 3 patients who developed culture-proven interface fungal infection after LASIK was performed. Detailed pathological analysis of the amputated flap from 1 case included light, scanning, and transmission electron microscopy.


RESULTS
Culture and pathological analysis revealed Candida albicans in all 3 cases. Common links among the cases were early onset of DLK following intensive corticosteroid and antibiotic treatment and later onset of interface fungal infection. All cases resolved, and good visual acuity was restored after medical treatment with antifungal agents.


CONCLUSIONS
Interface fungal infection after LASIK can be sight-threatening. Early lifting of the flap, fungal culture, and aggressive antifungal treatment are required to treat this complication and avoid deleterious sequelae.
Peng
Qun
Q
Center for Research on Ocular Therapeutics and Biodevices, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, 167 Ashley Avenue, Charleston, SC 19425-5536, USA.
Holzer
Mike P
MP
Kaufer
Peter H
PH
Apple
David J
DJ
Solomon
Kerry D
KD
D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D014792:Visual Acuity
D000935:Antifungal Agents