Corneal Abscess On Intracorneal Ring: A Case Report
Published 2025 - 43rd Congress of the ESCRS
Reference: PO918 | Type: Poster | DOI: 10.82333/3re3-g261
Authors: Younes Akannour* 1 , khaoula bourdouane 2 , louai serghini 2 , Elhassan Abdallah 2
1ophthalmology B,hospital of specialities,rabat,Morocco, 2hospital of specialities,rabat,Morocco
Purpose
Intracorneal ring segment (ICRS) implantation is a well-established technique for managing keratoconus. Although generally safe, this procedure carries the risk of complications, including severe corneal infections. We report a rare case of fungal corneal abscess following ICRS implantation, emphasizing the need for early diagnosis and aggressive management.
Setting
This case was managed at the Hospital of Specialties, Department of Ophthalmology B, Rabat, Morocco, a tertiary ophthalmology center specializing in corneal diseases and refractive surgery complications.
Methods
A 32-year-old female patient with bilateral keratoconus underwent ICRS implantation for optical correction. A few weeks postoperatively, she developed progressive ocular pain, photophobia, and decreased visual acuity.
Slit-lamp examination revealed a corneal abscess localized around the ICRS, with significant corneal infiltration and stromal edema, but no anterior chamber involvement. Corneal scrapings were performed, and empirical fortified vancomycin (50 mg/mL) and ceftazidime (50 mg/mL) eye drops were initiated, along with topical amphotericin B 0.15% due to the suspicion of fungal involvement.
Results
Microbiological cultures identified Fusarium spp., a filamentous fungus frequently implicated in aggressive keratitis. Despite intensive medical therapy, the infection progressed to corneal melting, necessitating ICRS explantation. Due to progressive worsening, a therapeutic penetrating keratoplasty was required.
Histopathological analysis of the excised cornea confirmed septate fungal filaments, consistent with Fusarium keratitis. Postoperatively, the graft remained clear, and the patient achieved a final visual acuity of 4/10
Conclusions
Fungal keratitis following ICRS implantation is a rare but serious vision-threatening complication. Early diagnosis, aggressive antifungal therapy, and timely surgical intervention are crucial in preventing irreversible visual loss. This case underscores the need for strict postoperative surveillance, proper ocular hygiene, and patient education to minimize infection risks.