Chicago Cornea Consultants, Ltd, Chicago, IL; and.
Rush University Medical Center, Department of Ophthalmology, Chicago, IL.
Cornea. 2022 Jul 1;41(7):917-920. doi: 10.1097/ICO.0000000000002892. Epub 2021 Oct 22.
The purpose of this study was to describe infectious interface keratitis after Descemet membrane endothelial keratoplasty (DMEK) more than 2 years after surgery.
A case study.
In this study, we report a case of fungal infectious interface keratitis occurring 2 years after uncomplicated Descemet membrane endothelial keratoplasty. The donor corneal rim culture at the time of surgery grew a single colony of Candida albicans/dubliniensis , but the patient was not treated with antifungals at that time. At the onset of clinical infection, more than 2 years postoperatively, the patient was treated with systemic antifungals and adjuvant intrastromal amphotericin-B injection. The patient subsequently required penetrating keratoplasty with ultimately well-preserved visual acuity.
Fungal infectious interface keratitis (IIK) is a rare complication associated with lamellar keratoplasty. Although most common in the early postoperative period, this complication can occur several years after successful transplantation. Management may require a combination of systemic and stromal antifungal therapy. However, some patients may eventually require penetrating keratoplasty for definitive treatment.
本研究旨在描述术后 2 年以上行 Descemet 膜内皮角膜移植（DMEK）后发生的感染性界面性角膜炎。
病例研究。
本研究报告了 1 例无并发症的 Descemet 膜内皮角膜移植术后 2 年发生真菌性感染性界面性角膜炎的病例。手术时供体角膜边缘培养出白色念珠菌/都柏林念珠菌的单个菌落，但当时未给予抗真菌治疗。在临床感染发作时，即术后 2 年以上，患者接受了全身抗真菌药物和辅助的角膜内注射两性霉素 B 治疗。随后，患者需要穿透性角膜移植，最终视力保持良好。
真菌性感染性界面性角膜炎（IIK）是一种与板层角膜移植相关的罕见并发症。尽管最常见于术后早期，但该并发症也可在成功移植数年后发生。治疗可能需要全身和基质抗真菌治疗的联合应用。然而，一些患者最终可能需要穿透性角膜移植进行确定性治疗。
