Flap Amputation After Fungal Keratitis
Purpose
To report a fungal keratitis associated to minor ocular trauma treated with topical and systemic antifungals and flap amputation.
Methods
A 37-year-old woman was referred to our institution for evaluation and treatment of persistent keratitis in the left eye. The ocular history was remarkable for uneventful lasik surgery 8 years earlier. The patient reported two weeks of red eye, decreased vision and pain in the left eye after minor trauma. On examination, the corrected visual acuity was 20/20 for right eye and 20/20000 for left eye. Conjunctival injection, epithelial defect, flap infiltration, lysis and hypopyon were observed in the left eye. Amputation of flap was performed. Culture reported Fusarium. Systemic and topic antifungals were iniciated.
Results
Keratitis resolved leaving mild corneal opacity. One month later, the corrected visual acuity was 20/100 and central corneal paquimetry was 452 microns. Eight years later, best corrected visual acuity was 20/30.
Conclusion
Severe cases of post-LASIK infection may lead to endophthalmitis. This patient presented flap infiltration and melting that required immediate treatment. Flap amputation is an aggressive treatment that should be reserved for special cases.