Aspergillus fumigatus keratitis following intracorneal ring segment implantation

BACKGROUND: Fungal keratitis has been rarely reported following intracorneal ring segment (ICRS) inmplantation. This paper aims to report a case of fungal keratitis with aspergillus fumigatus following ICRS implantation for correction of keratoconus. METHODS: A retrospective chart review was done. Data including demographics, clinical history and presentation, microbiological analysis as well as clinical management were recorded. RESULTS: A 34 year old male presented with pain, photophobia, redness and decreased vision in his right eye ten days after ICRS implantation for correction of keratoconus. Slit-lamp examination showed chemosis, ciliary injection, corneal abcess with ill defined edges and hypopyon. Microbiological analysis and culture of the corneal scrapes were positive for aspergillus fumigatus. The patient did not respond to medical treatment and ended up with corneal transplantation. CONCLUSION: Although rare, fungal keratitis is a serious vision threatening complication that can complicate intrastromal ring implantation. Prompt and aggressive treatment is essential to prevent irreversible reduction of vision.