Posters

Intraoperative PACK-CXL during repeat penetrating keratoplasty for the management of multi-resistant fungal keratitis in an immunocompromised patient

Poster Details

First Author: E.Kaisari SWITZERLAND

Co Author(s): N. Voulgari   G. Kontadakis   E. Samutelela   G. Kymionis           

Abstract Details

Purpose:

To present a novel application of photoactivated chromophore for infectious keratitis - corneal cross-linking (PACK-CXL) in the management of post-penetrating keratoplasty (PKP) multi-resistant fungal keratitis in a patient with irradiation-related local immunosuppression.

Setting:

Jules Gonin Eye Hospital -Cornea Department

Methods:

A 62-year-old woman underwent uneventful PKP for the management of post-irradiation actinic keratopathy. Three months postoperatively she presented with a diffuse corneal melting abscess that was infiltrating the donor-recipient junction. Despite the intensive antibiotic and antifungal therapy, corneal melting progressed to graft perforation. A repeat PKP combined with intraoperative PACK-CXL was performed. PACK-CXL was applied initially on the infected graft, involving the corneoscleral rim and then following placement of the donor button.

Results:

No intraoperative or postoperative graft-related complications were encountered. No signs of infection were noted during the following nine months.

Conclusions:

Intraoperative PACK-CXL combined with repeat PKP seems to be a safe and effective technique for the management of post-PKP resistant fungal keratitis in a patient with irradiation-related local immunosuppression.

Financial Disclosure:

None