Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis
Table 2
Clinical and microbiological features of patients.
Cases
Medical and surgical interventions
Indication for fresh multilayered AMT
Culture
Initial clinical signs
Presenting BCVA
Prior medical history and surgical interventions
Final BCVA
1
Flap amputation, amphotericin B 50 mcg/ml (interface wash, intrastromal injection), topical (amphotericin B 0.15%, natamycin 5%), oral (itraconazole, doxycycline, acetazolamide)
2.5 mm perforation
Aspergillus fumigatus
Lid edema, chemosis, ciliary injection, cornea (hypothesia, central interface infiltrates 3x3 mm, endothelial plaque, heaped up 3 mm hypopyon, dehiscent LASIK flap), T++
Flap amputation, amphotericin B 50 mcg/ml (interface wash, intrastromal and intracameral injection), topical (amphotericin B 0.15%, natamycin 5%), oral (itraconazole, doxycycline)
3.5 mm perforation
Aspergillus fumigatus
Lid edema, chemosis, ciliary injection, cornea (hypothesia, central interface infiltrates mm, endothelial plaque, heaped up hypopyon, macerated LASIK flap), Tn
Flap amputation, amphotericin B 50 mcg/ml (interface wash, intrastromal injection), topical (amphotericin B 0.15%, natamycin 5%), oral (itraconazole, doxycycline)
4 mm perforation
Aspergillus fumigatus
Lid edema, chemosis, ciliary injection, cornea (hypothesia, central interface infiltrates mm, endothelial plaque, heaped up 1.5 mm hypopyon, macerated LASIK flap), T+
Flap amputation, amphotericin B 50 mcg/ml (interface wash, intrastromal and intracameral injection twice), topical (amphotericin B 0.15%, natamycin 5%), oral (itraconazole, doxycycline)
4.5 mm perforation
Aspergillus fumigatus
Lid edema, ciliary injection, cornea (hypothesia, central interface infiltrates mm, endothelial plaque, peripheral satellites, heaped up 3 mm hypopyon, melted LASIK flap), Tn