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Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis
Joint Authors
Eleiwa, Taher
Ozcan, Eyup
Abdelrahman, Samar
Solyman, Omar
Elhusseiny, Abdelrahman M.
Youssef, Gehad
Bayoumy, Ahmed
Source
Case Reports in Ophthalmological Medicine
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-09-15
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
Fungal keratitis is an extremely rare complication of laser vision correction resulting in poor visual outcomes.
Amniotic membrane transplantation should be kept in mind in eyes with corneal perforation prior to penetrating keratoplasty.
Aim.
To assess the outcomes of multilayered fresh amniotic membrane transplantation (MLF-AMT) in patients with severe keratomycosis after laser-assisted in situ keratomileusis (LASIK).
Study design.
Hospital-based prospective interventional case series.
Methods.
Five eyes of 5 patients were included in the study.
All cases underwent microbiological scrapings from residual bed and intrastromal injections of amphotericin (50 mcg/mL), with flap amputation if needed, followed by topical 5% natamycin and 0.15% amphotericin.
MLF-AMT was performed after corneal perforation.
Later, penetrating keratoplasty (PK) was performed when corneal opacity compromised visual acuity.
The outcome measures were complete resolution of infection, corneal graft survival, and best-corrected visual acuity (BCVA).
Results.
The mean age of patients was 22±1.2 years with 4/5 (80%) were females.
The mean interval between LASIK and symptom onset was 8.8±1 day, and the mean interval between symptom onset and referral was 14±1.4 days.
Potassium hydroxide (KOH) smears showed filamentous fungi, and Sabouraud’s medium grew Aspergillus in all cases.
Melted flaps were amputated in 4 (80%) cases.
MLF-AMT was performed in all cases due to corneal perforation after a mean time of 12.4±1.2 days of antifungals.
In all cases, complete resolution of infection was seen 26±1.8 days after MLF-AMT, and optical PK was done at a mean of 2.4 months later.
No postoperative complications after MLF-AMT or PK were observed, with a 0% incidence of corneal graft rejection, and a final BCVA ranged from 20/20 to 20/80 after a mean follow-up of 14±1.1 months.
Conclusion.
MLF-AMT is a safe and valid option to manage corneal perforation during keratmycosis treatment to avoid emergency therapeutic keratoplasty.
American Psychological Association (APA)
Eleiwa, Taher& Ozcan, Eyup& Abdelrahman, Samar& Solyman, Omar& Elhusseiny, Abdelrahman M.& Youssef, Gehad…[et al.]. 2020. Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis. Case Reports in Ophthalmological Medicine،Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1149653
Modern Language Association (MLA)
Eleiwa, Taher…[et al.]. Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis. Case Reports in Ophthalmological Medicine No. 2020 (2020), pp.1-8.
https://search.emarefa.net/detail/BIM-1149653
American Medical Association (AMA)
Eleiwa, Taher& Ozcan, Eyup& Abdelrahman, Samar& Solyman, Omar& Elhusseiny, Abdelrahman M.& Youssef, Gehad…[et al.]. Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis. Case Reports in Ophthalmological Medicine. 2020. Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1149653
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1149653