J Korean Ophthalmol Soc.  2008 Sep;49(9):1415-1424.

The Number of Cases, Cause and Treatment of Avellino Corneal Dystrophy Exacerbated After LASIK

• Yi JH
• Ha BJ
• Kim SW
• Kim TI
• Kim EK

Abstract

PURPOSE
To present a case report of fungal keratitis related to prolonged overnight use of orthokeratology contact lenses.
METHODS
A 13 year-old girl presented with a corneal ulcer in her left eye refractory to antibacterial medication. She had a history of wearing orthokeratology contact lenses overnight for seven months.
RESULTS
The organism Aspergillus was isolated by corneal scraping, the contact lens itself, and from the storage case. The patient was treated with topical fluconazole and Natamycin pimaricin in addition to oral itraconazole, resulting in a resolution of the ocular lesion.
CONCLUSIONS
The risk of fungal infection as a potential complication of the use of overnight orthkeratology contact lenses should be considered when using these lenses.

Keyword

Avellino corneal dystrophy; Deep lamellar keratoplasty; Laser in situ keratomileusis

MeSH Terms

Aspergillus
Contact Lenses
Corneal Dystrophies, Hereditary
Corneal Ulcer
Eye
Fluconazole
Humans
Itraconazole
Keratitis
Keratomileusis, Laser In Situ
Natamycin
Corneal Dystrophies, Hereditary
Fluconazole
Itraconazole
Natamycin

Figure

• 

  Figure 1. Slit-lamp photographs showing areas of corneal deposits after LASIK.

• 

  Figure 2. Slit-lamp photographs showing exacerbated Avellino corneal dystrophy after LASIK. Corneal images from case 1: (A) Right eye (B) Left eye

• 

  Figure 3. Contrast sensitivity test: (A) before mechanical removal of corneal deposits from LASIK interface, (B) at 2 weeks after surgery, (C) at three and a half years after surgery (R=right eye; L=left eye; solid line=right; dotted line=left).

• 

  Figure 4. (a) Corneal image from case 1: (A) before removal of LASIK flap (at three and a half years after mechanical removal of corneal deposits from LASIK interface). (B) 2 weeks and (C) 1 year and 1 month after LASIK flap removal (R=right eye; L=left eye).

• 

  Figure 5. Corneal images from case 2 (A) before deep lamellar keratoplasty (DLKP). (B) after 6 months of DLKP (R) and after 4 months of DLKP (L). (R=right eye; L=left eye)

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