title: Therapeutic sectorial full-thickness sclero-keratoplasty for recurrent fungal keratitis.
abstract: OBJECTIVE
  To report the management of a severe and recurrent fungal keratitis that required repeated penetrating keratoplasties. Despite multiple topical, intraocular and systemic antifungal treatments, superotemporal hyphal infiltration repeatedly penetrated the corneal transplant causing continuous recurrences. Cultures collected before and during surgery isolated the same organism, Fusarium spp.
  
  
  CONCLUSIONS
  Corneal infection extending to the sclera and internal angle structures is the main cause of recurrence of fungal keratitis after corneal transplantation. Sectorial full-thickness sclero-keratoplasty combined with a central penetrating keratoplasty should be a surgical technique to be considered in cases where these locations are suspected to be the source of recurrence. It enables a definitive elimination of the infection, with excellent final visual acuities. No postoperative complications were reported in this case.
authors.affiliation: Instituto de Microcirugía Ocular (IMO), Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: miriambarbany@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Barbany
authors.affiliation: Instituto de Microcirugía Ocular (IMO), Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: O
authors.initials: O
authors.lastname: Gris
authors.affiliation: Instituto de Microcirugía Ocular (IMO), Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Güell
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D002387:Cataract Extraction; D003320:Corneal Ulcer / Q000382:microbiology / Q000601:surgery*; D025141:Drug Resistance, Fungal; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D005131:Eye Injuries / Q000150:complications; D060585:Fusariosis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012590:Sclera / Q000601:surgery*; D012987:Soil; D014946:Wound Infection / Q000382:microbiology / Q000601:surgery
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D012987:Soil
keywords: Corneal transplant; Escleroqueratoplastia sectorial; Fungal keratitis; Queratitis fúngica; Queratitis recurrente; Recurrent keratitis; Sectorial sclero-keratoplasty; Trasplante de córnea