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The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty

The purpose of this study was to describe the clinical characteristics of fungal keratitis caused by Candida albicans in an eye after Descemet stripping automated endothelial keratoplasty (DSAEK). A 72-year-old male with a history of three trabeculectomies, cataract surgery, and two DSAEK procedures...

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Autores principales: Araki-Sasaki, Kaoru, Fukumoto, Atsuko, Osakabe, Yasuhiro, Kimura, Hideya, Kuroda, Shinichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164285/
https://www.ncbi.nlm.nih.gov/pubmed/25228792
http://dx.doi.org/10.2147/OPTH.S67326
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author Araki-Sasaki, Kaoru
Fukumoto, Atsuko
Osakabe, Yasuhiro
Kimura, Hideya
Kuroda, Shinichiro
author_facet Araki-Sasaki, Kaoru
Fukumoto, Atsuko
Osakabe, Yasuhiro
Kimura, Hideya
Kuroda, Shinichiro
author_sort Araki-Sasaki, Kaoru
collection PubMed
description The purpose of this study was to describe the clinical characteristics of fungal keratitis caused by Candida albicans in an eye after Descemet stripping automated endothelial keratoplasty (DSAEK). A 72-year-old male with a history of three trabeculectomies, cataract surgery, and two DSAEK procedures developed a corneal ulcer in his right eye two years after his last DSAEK. Fungal keratitis was most likely related to the immunosuppressive conditions that occurred due to the previous operations, the continuous use of steroid eye drops, and the use of disposable soft contact lenses. A smear and culture from the ulcer detected Candida albicans. Slit-lamp examination showed the characteristic feature was the presence of interface infiltrates located between the host and the graft cornea and in the enlarged area around the ulcer. Two weeks after intense antimycotic treatments with voriconazole, miconazole, and natamycin, perforation of the cornea occurred and further therapeutic penetrating keratoplasty was required. Histological analysis revealed an accumulation of infiltrated cells and fibrotic tissue. The poor prognosis for fungal keratitis that occurs in eyes after undergoing DSAEK may be related to the rapid expansion of inflammatory cells through the interface between the host and the graft. In eyes that develop fungal keratitis after DSAEK, special attention should be paid to the possibility that perforation could occur in these patients.
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spelling pubmed-41642852014-09-16 The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty Araki-Sasaki, Kaoru Fukumoto, Atsuko Osakabe, Yasuhiro Kimura, Hideya Kuroda, Shinichiro Clin Ophthalmol Case Report The purpose of this study was to describe the clinical characteristics of fungal keratitis caused by Candida albicans in an eye after Descemet stripping automated endothelial keratoplasty (DSAEK). A 72-year-old male with a history of three trabeculectomies, cataract surgery, and two DSAEK procedures developed a corneal ulcer in his right eye two years after his last DSAEK. Fungal keratitis was most likely related to the immunosuppressive conditions that occurred due to the previous operations, the continuous use of steroid eye drops, and the use of disposable soft contact lenses. A smear and culture from the ulcer detected Candida albicans. Slit-lamp examination showed the characteristic feature was the presence of interface infiltrates located between the host and the graft cornea and in the enlarged area around the ulcer. Two weeks after intense antimycotic treatments with voriconazole, miconazole, and natamycin, perforation of the cornea occurred and further therapeutic penetrating keratoplasty was required. Histological analysis revealed an accumulation of infiltrated cells and fibrotic tissue. The poor prognosis for fungal keratitis that occurs in eyes after undergoing DSAEK may be related to the rapid expansion of inflammatory cells through the interface between the host and the graft. In eyes that develop fungal keratitis after DSAEK, special attention should be paid to the possibility that perforation could occur in these patients. Dove Medical Press 2014-09-09 /pmc/articles/PMC4164285/ /pubmed/25228792 http://dx.doi.org/10.2147/OPTH.S67326 Text en © 2014 Araki-Sasaki et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Araki-Sasaki, Kaoru
Fukumoto, Atsuko
Osakabe, Yasuhiro
Kimura, Hideya
Kuroda, Shinichiro
The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title_full The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title_fullStr The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title_full_unstemmed The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title_short The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty
title_sort clinical characteristics of fungal keratitis in eyes after descemet’s stripping and automated endothelial keratoplasty
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164285/
https://www.ncbi.nlm.nih.gov/pubmed/25228792
http://dx.doi.org/10.2147/OPTH.S67326
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