Early-Onset Candida glabrata Interface Keratitis after Deep Anterior Lamellar Keratoplasty.

Abstract

PURPOSE:

Fungal interface keratitis by Candida species can occur several weeks to several months after deep anterior lamellar keratoplasty (DALK). Here, we report a case of early-onset fungal interface keratitis by Candida glabrata after DALK.

CASE REPORT:

A 31-year-old Chinese man complained of decreased vision 4 days after an uneventful DALK for keratoconus. White to cream-colored interface deposits were identified under slit-lamp examination. The confocal scan disclosed clusters of hyperreflective granular deposits of 2 to 4 μm at the interface, without evidence of inflammation or hyphae-like structures. The graft was then removed, along with interface irrigation, and another graft was sutured. Finally, a penetrating keratoplasty was performed because the interface opacities recurred and deteriorated after graft replacement. Histopathological examination disclosed yeast-like structures at the retrocorneal side. The microbiologic results of both corneal scrapings taken from the recipient stromal bed and the removed half cornea button showed C. glabrata.

CONCLUSIONS:

Candida glabrata interface keratitis can occur early after DALK, which can only be effectively treated with penetrating keratoplasty. Confocal microscopy is a promising tool to diagnose this rare complication. The importance of donor corneoscleral rim cultures should be emphasized during DALK.

• Authors: Qihua Le, Dan Wu, Yimin Li, Jian Ji, Rongrong Cai, Jianjiang Xu
• Journal: Optometry and vision science : official publication of the American Academy of Optometry (Optom Vis Sci) Vol. 92 Issue 5 Pg. e93-6 (May 2015) ISSN: 1538-9235 [Electronic] United States
• PMID: 25822017 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Candida glabrata (isolation & purification)
• Candidiasis (diagnosis, microbiology, surgery)
• Corneal Stroma (microbiology, pathology)
• Corneal Transplantation (adverse effects)
• Corneal Ulcer (diagnosis, microbiology, surgery)
• Eye Infections, Fungal (diagnosis, microbiology, surgery)
• Humans
• Keratoconus (surgery)
• Keratoplasty, Penetrating
• Male
• Microscopy, Confocal
• Reoperation
• Tomography, Optical Coherence