Intrastromal antifungal injection with secondary lamellar interface infusion for late-onset infectious keratitis after DSAEK

Elmer Y. Tu, Joshua Hou

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Purpose: The aim of this study was to report the successful medical management of 2 cases of late-onset endothelial keratoplasty-related stromal interface infections. Methods: All cases of endothelial keratoplasty-related infections treated with intrastromal antifungal injections were compiled. The following information was collected: demographic data, surgical indications, donor rim cultures, donor mate outcomes, clinical course, diagnostic tests, and clinical outcome. Results: Two cases of interface fungal keratitis diagnosed on clinical appearance and confocal microscopy were identified. Both patients refused to undergo further surgery and failed systemic and/or topical therapy. Each received 3 to 4 intrastromal injections, with secondary infusion into the graft-host interface, which resulted in the complete involution of their interface opacities. Conclusions: Intrastromal antifungal injection may be an effective alternative to surgical intervention in late-onset fungal Descemet stripping endothelial keratoplasty interface keratitis. Early treatment may preserve graft viability and result in a good visual outcome without the need for either penetrating keratoplasty or potential pathogen exposure to the anterior chamber.

Original languageEnglish (US)
Pages (from-to)990-993
Number of pages4
JournalCornea
Volume33
Issue number9
DOIs
StatePublished - Sep 2014

Keywords

  • amphotericin B
  • candida
  • cornea
  • endothelial keratoplasty
  • fungal
  • infection
  • lamellar interface
  • lamellar keratoplasty
  • voriconazole
  • yeast

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