Taylan Sekeroglu H, Erdem E, Yar K, Yağmur M, Ersoz T R, Uguz A
Department of Ophthalmology, Cukurova University, Yuregir, 01330 Adana, Turkey.
J Ophthalmol. 2010;2010:450230. doi: 10.1155/2010/450230. Epub 2010 Nov 11.
Purpose. To report an unusual case of severe bilateral fungal keratitis following laser in situ keratomileusis (LASIK). Method. A 48-year-old man developed bilateral diffuse corneal infiltration two weeks after LASIK. The corneal scrapings revealed fungal filaments but cultures were negative. Results. The corneal ulceration was improved on the left eye whereas spontaneous perforation occurred and finally evisceration was needed on the right eye despite topical and systemic antifungal treatment. Conclusions. Fungal keratitis, especially with bilateral involvement, is a very rare and serious complication of LASIK surgery. Clinical suspicion is crucial because most of fungal keratitis are misdiagnosed as bacterial keratitis and can lead serious visual results, even eye loss.
目的。报告一例准分子原位角膜磨镶术(LASIK)后发生的罕见严重双侧真菌性角膜炎病例。方法。一名48岁男性在LASIK术后两周出现双侧弥漫性角膜浸润。角膜刮片显示有真菌丝,但培养结果为阴性。结果。左眼角膜溃疡有所改善,而右眼发生了自发性穿孔,尽管进行了局部和全身抗真菌治疗,最终仍需行眼球摘除术。结论。真菌性角膜炎,尤其是双侧受累,是LASIK手术非常罕见且严重的并发症。临床怀疑至关重要,因为大多数真菌性角膜炎被误诊为细菌性角膜炎,可导致严重的视力后果,甚至失明。