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

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

Optom Vis Sci. 2015 May;92(5):e93-6

Authors: Le Q, Wu D, Li Y, Ji J, Cai R, Xu J

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.

PMID: 25822017 [PubMed - indexed for MEDLINE]