Aspergillus fumigatus keratitis following laser in situ keratomileusis.
A 31-year-old woman developed pain, decreased vision, and a corneal flap infiltrate 4 days following laser in situ keratomileusis (LASIK). Treatment with topical antibiotic agents did not improve the symptoms. Approximately 2 weeks after surgery, the patient was referred to Stanford University, with 20/400 visual acuity in the left eye and a stromal infiltrate posterior to the flap. Cultures demonstrated Aspergillus fumigatus sensitive to voriconazole. The corneal ulcer progressed despite aggressive antifungal treatment, requiring amputation of the corneal flap and daily debridement. The infiltrate resolved in response to topical voriconazole, natamycin, and oral voriconazole. Aspergillus fumigatus keratitis is a rare but serious complication of LASIK surgery. The infection was successfully treated with flap amputation and daily debridement in addition to antifungal therapy.
Sun
Young
Y
Department of Ophthalmology, Stanford University, Palo Alto, California, USA. yangxsun@yahoo.com
Jain
Atul
A
Ta
Christopher N
CN
D000328:Adult; D000671:Amputation, Surgical; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003646:Debridement; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008826:Microbial Sensitivity Tests; D011743:Pyrimidines / Q000627:therapeutic use; D013524:Surgical Flaps / Q000382:microbiology; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole