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Optical coherence tomography (OCT) in a patient with fungal keratitis and LASIK history

Poster Details

First Author: E.Millan Valbuena SPAIN

Co Author(s):    N. Barnils Garcia   T. MartĂ­ Huguet   C. Comas Bedmar        

Abstract Details



Purpose:

To report a case of fungal keratitis in a patient with LASIK history using OCT. OCT shows a perfect visualization of corneal structures and corneal surgical interfaces, in corneal transplantation (DSAEK, DMEK) and in LASIK techniques.

Setting:

Hospital Universitari de Bellvitge is a tertiary adults hospital located in Barcelona (Spain) which aims to provide integral care for adults It services patients of adult age from the surrounding Barcelona area and complex cases referred from the rest of Cataluña and Spain. The ophthalmology service is divided into subspecialties to better fit the needs of the patient.

Methods:

A 42-years-old woman presented at the emergency with pain and loss of visual acuity. She had a LASIK refractive surgery 5 years ago for correction of her myopia. At the physical examination she had a corneal ulcer and a best corrected visual acuity (BCVA) of hands movement in her right eye (RE).

Results:

We decided to start treatment with topical reinforced antibiotics (vancomicin and ceftazidime every hour), without any improvement at 48 hours. The results of the corneal smear and corneal scraping where both negative. Then, we suspected a fungal infection so we started treatment with 0.5% natamicin® eye drops every 2 hours, with a very good response in a few days and a final BCVA of 8/20 in her RE at 2 months. We followed the patient with the slip lamp examination and the OCT images. OCT showed that the depth of the infection was through the LASIK scar, reaching the interface and developing an abscess in the corneal stroma.

Conclusions:

OCT demonstrate the resolution of fungal keratitis showing a good correlation between visual anatomy and function. Anterior segment OCT has become an increasingly valuable tool for the anterior segment surgeon. With increasing availability, this technology is now commonly used in the diagnosis and management of corneal diseases and refractive surgery. FINANCIAL INTEREST: NONE

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