Fungal keratitis with intracameral extension following penetrating keratoplasty

PURPOSE: To report the clinical findings and management of a case of fungal keratitis with extension into the anterior chamber following penetrating keratoplasty. METHODS: Interventional case report. RESULTS: A 45-year-old man developed a white, cottonball-like mass in the anterior chamber 3 months after penetrating keraplasty for keratoconus. Cytology evaluation was performed following excisional biopsy of the intracameral portion of the lesion. The presence of filamentous fungus was confirmed. The patient was treated with oral, topical, and intracameral voriconazole with complete resolution of the infection 9 months after initial presentation. CONCLUSION: This case illustrates the unusual presentation of fungal keratitis with intracameral extension and demonstrates effective management with preservation of the corneal graft and restoration of visual function.