Bilateral Fusarium oxysporum keratitis after laser in situ keratomileusis.
We report the successful management of a rare case of bilateral post-laser in situ keratomileusis (LASIK) Fusarium oxysporum keratitis and propose a therapeutic strategy. A 19-year-old white man with no systemic diseases was referred to our emergency service 3 days after microkeratome-assisted myopic bilateral LASIK correction. He complained of blurred-vision, photophobia, and ocular pain. Clinical findings (satellite lesions, hypopyon) suggested fungal keratitis. Flaps were immediately lifted and rinsed with povidone-iodine 10%, and intensive topical and systemic and combined antifungal and antibacterial treatment was introduced. Topical cortisone drops were administered after 3 days. Despite initial deterioration of the clinical picture, all symptoms resolved quickly. Polymerase chain reaction indicated F oxysporum. Relapse occurred in the left eye, which was successfully managed. The final uncorrected distance visual acuity was 20/20 in both eyes. Fusarium oxysporum post-LASIK keratitis may occur in the early phase. Prompt diagnosis, interface irrigation with povidone-iodine solution, and intensive long-term treatment contribute to a favorable outcome.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
Department of Ophthalmology, University of Saarland Medical Center UKS, Homburg/Saar, Germany.
Georgios
G
Labiris
Leonie
L
Troeber
Zisis
Z
Gatzioufas
Evangelos
E
Stavridis
Berthold
B
Seitz
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004271:DNA, Fungal / Q000032:analysis; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D060585:Fusariosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005670:Fusarium / Q000235:genetics / Q000302:isolation & purification*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use; D008297:Male; D009216:Myopia / Q000601:surgery; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D011206:Povidone-Iodine / Q000627:therapeutic use; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D004271:DNA, Fungal; D005938:Glucocorticoids; D011206:Povidone-Iodine; C009935:prednisolone acetate; D011239:Prednisolone