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

TitleEarly-Onset Candida glabrata Interface Keratitis after Deep Anterior Lamellar Keratoplasty.
Publication TypeJournal Article
Year of Publication2015
AuthorsLe Q, Wu D, Li Y, Ji J, Cai R, Xu J
JournalOptometry and vision science : official publication of the American Academy of Optometry// Optom Vis Sci
Paginatione93 - 6
Date Published2015//
ISBN Number1538-9235
Other Numbersoiz, 8904931
Keywords*Candida glabrata/ip [Isolation & Purification], *Candidiasis/mi [Microbiology], *Corneal Transplantation/ae [Adverse Effects], *Corneal Ulcer/mi [Microbiology], *Eye Infections, Fungal/mi [Microbiology], *Keratoconus/su [Surgery], Adult, Candidiasis/di [Diagnosis], Candidiasis/su [Surgery], Corneal Stroma/mi [Microbiology], Corneal Stroma/pa [Pathology], Corneal Ulcer/di [Diagnosis], Corneal Ulcer/su [Surgery], Eye Infections, Fungal/di [Diagnosis], Eye Infections, Fungal/su [Surgery], Humans, Keratoplasty, Penetrating, Male, Microscopy, Confocal, Reoperation, Tomography, Optical Coherence

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 mum 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.

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