Interface infectious keratitis following deep anterior lamellar keratoplasty.
A 32-year-old female patient underwent deep anterior lamellar keratoplasty (DALK) in both eyes for advanced keratoconus. She developed an infiltrate in the nasal paracentral interface of the left eye. In view of the paracentral location, localized epithelial removal/stromal scraping was done and the infiltrate was removed using forceps and sent for microbiological assay, which revealed fungal filaments. The patient successfully responded to intensive topical antifungal therapy with the maintenance of visual acuity. Interface keratitis following DALK frequently needs graft lift/interface wash due to deep location, rapid spread and poor penetration and efficacy of topical medications. In view of a paracentral location, modified debulking with topical therapy resulted in a satisfactory outcome in our case thereby avoiding the need for more invasive treatments.
The Eye Foundation, Post Graduate Institute of Ophthalmology, Coimbatore, India.
Shreesha Kumar
SK
Kodavoor
The Eye Foundation, Post Graduate Institute of Ophthalmology, Coimbatore, India.
Ramamurthy
R
Dandapani
The Eye Foundation, Post Graduate Institute of Ophthalmology, Coimbatore, India.
Ajay Ramesh
AR
Kaushik
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016039:Corneal Transplantation / Q000009:adverse effects* / Q000379:methods; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures
D000935:Antifungal Agents
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