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Interface fungal infection after laser in situ keratomileusis presenting as diffuse lamellar keratitis

2002; Lippincott Williams & Wilkins; Volume: 28; Issue: 8 Linguagem: Inglês

10.1016/s0886-3350(02)01241-5

1873-4502

Qun Peng, Mike P. Holzer, Peter H. Kaufer, David J. Apple, Kerry D. Solomon,

Corneal surgery and disorders

Purpose: To report clinicopathological analyses of 3 cases of interface fungal infection following laser in situ keratomileusis (LASIK) and diffuse lamellar keratitis (DLK). Setting: Center for Research on Ocular Therapeutics and Biodevices and Arthur and Holly Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Methods: Clinicopathological analysis of 5 eyes of 3 patients who developed culture-proven interface fungal infection after LASIK was performed. Detailed pathological analysis of the amputated flap from 1 case included light, scanning, and transmission electron microscopy. Results: Culture and pathological analysis revealed Candida albicans in all 3 cases. Common links among the cases were early onset of DLK following intensive corticosteroid and antibiotic treatment and later onset of interface fungal infection. All cases resolved, and good visual acuity was restored after medical treatment with antifungal agents. Conclusions: Interface fungal infection after LASIK can be sight-threatening. Early lifting of the flap, fungal culture, and aggressive antifungal treatment are required to treat this complication and avoid deleterious sequelae.