A case series of contact lens-associated Fusarium keratitis in Hong Kong.
OBJECTIVE
To report the clinical features and management outcomes of a cluster of Fusarium keratitis in patients that used the Bausch & Lomb ReNu MostureLoc contact lens solution.


METHODS
Retrospective case series.


RESULTS
In a 1-year period starting from June 2005, we treated 12 patients with unilateral Fusarium keratitis in our tertiary care center. All patients were contact lens users that used ReNu MostureLoc contact lens solution and had no other specific predisposing conditions. Microbiological examination yielded growth of Fusarium spp. in 7 patients from corneal scrapings at presentation and from 3 patients in subsequent corneal specimens. For 2 other patients, fungi were not detected from corneal scrapings, but Fusarium spp. were isolated from their contact lenses. The infections were treated with topical natamycin and amphotericin B eye drops and with systemic itraconazole in 8 patients. The infection resolved with medical treatment in 8 eyes, a conjunctival flap in 1 eye, and a therapeutic corneal graft in 1 eye. Two eyes required tectonic corneal grafts for perforation. Two of the 3 corneal grafts failed because of graft rejection. Final visual acuities ranged from count fingers to 1.0.


CONCLUSIONS
This cluster of Fusarium keratitis seems to be related to the use of the ReNu MoistureLoc contact lens solution. The cure rate with medical therapy was 66%. However, corneal scarring limited visual recovery. This episode highlights the need for clinical vigilance when dealing with corneal infiltrates in contact lens users.
Rao
Srinivas K
SK
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, Kowloon, Hong Kong Special Administrative Region, PR China.
Lam
Philip T H
PT
Li
Emmy Y M
EY
Yuen
Hunter K L
HK
Lam
Dennis S C
DS
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D018639:Contact Lens Solutions; D003261:Contact Lenses / Q000382:microbiology*; D003320:Corneal Ulcer / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005670:Fusarium / Q000302:isolation & purification*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D010866:Natamycin / Q000627:therapeutic use; D012189:Retrospective Studies
D000935:Antifungal Agents; D018639:Contact Lens Solutions; D017964:Itraconazole; D000666:Amphotericin B; D010866:Natamycin