Posters

Fungal keratitis after PRK

Poster Details

First Author: M.Jankov SERBIA

Co Author(s):    V. Jovanovic   T. Mrakovic   L. Nikolic              

Abstract Details

Purpose:

To report a case of fungal keratitis after PRK and its treatment steps

Setting:

LaserFocus Centre for Eye Microsurgery, Belgrade, Serbia

Methods:

A 27-year-old patient underwent uneventful PRK in both eyes for moderate myopic astigmatism. After the removal of the CL a small epithelial defect was present in his right eye that evolved in ulcer because of which fortifies antibiotics have been initiated. Culture at day 14 was positive to Aspergillus sp. treated with amphotericin B 0.15%, natamycine 5%, fluconazol 0.2% and itroconazol 100 mg orally. Eye developed intense iridocyclitis, anterior chamber fibrinous reaction and vitreous infiltration that calmed down over the following months. At 6 months a vasularized leucoma and prepupillary membrane decreased his VA to L+P+.

Results:

At 1 year (9 months ago) penetrating keratoplasty with prepupillary membrane ressection took place. The refraction was Sph + 9.5 D due to the lental fibrosis and 6 months later RGP CL was fitted yielding BCDVA 0.7. Lensectomy with secondary monofocal IOL implantation is planned after the suture removal at 1 year after PK.

Conclusions:

Fungal keratitis spreads quicker after PRK withoud Bowman membrane. Prompt culture resulted in adquate treatment plan and avoided fatal eye loss. Penetrating keratoplasty and RGP contact lens was needed for satisfactory visual recovery.

Financial Disclosure:

None