Fungal Keratitis Following Application Of Sutureless Dehydrated Amniotic Membrane (Omnigen) Using A Specialised Bandage Contact Lens (Omnilenz)

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR015 | Type: Case Report | DOI: 10.82333/7nky-9e66

Authors: Dr Albaraa T Alfaraidi* ¹ , Dr Rawan Alshabeeb ¹ , Dr Bayan Alsaif ¹

¹Anterior Segment,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia

Purpose

Amniotic membrane is a common treatment option for several corneal and conjunctival conditions. There are several methods for preserving amniotic membrane, and each involves some compromise of the tissue integrity. Dehydrated amniotic membrane has been used for several indications, including microbial infections, aniridia, chemical burns, and limbal stem cell deficiency, as in Steven-Johnson syndrome. We report a case of fungal keratitis following application of sutureless dehydrated amniotic membrane using specialized bandage contact lens OmnioLenz (NuVision Biotherapies Ltd., UK).

Setting

A 34 years old male with keratoconus who had undergone deep anterior lamellar keratoplasty presented with recurrent epithelial defect at the graft-host junction that was not responding to conservative management. A sutureless dehydrated amniotic membrane was applied but the patient developed fungal keratitis in the central cornea. The infiltrate culture revealed Candida parapsilosis. The patient responded to antifungal and antibacterial topical eyedrops on follow up.

Report of case

One month later, the patient presented with mild eye redness and decreased vision. On examination, there was a severe conjunctival injection, small central corneal infiltrates and a mild anterior chamber reaction. Corneal scraping was obtained for stains, cultures (blood, chocolate, sabouraud dextrose, and non-nutrient agars), and polymerase chain reaction for herpes simplex virus DNA. The impression was microbial keratitis confirmed with cultures and stains that were positive for Candida parapsilosis and Staphylococcus epidermidis. The patient was treated with topical antifungal eyedrops consisting of amphotericin B 0.15 % and voriconazole 1% along with fortified antibiotics eyedrops ceftazidime 50 mg/ml and vancomycin 25 mg/ml. The patient responded to treatment but developed corneal scarring with neovascularization and was maintained on a long-term regimen of amphotericin B 0.15 % and voriconazole 1% twice daily. The patient was started on topical steroid eyedrops two months after the diagnosis of fungal keratitis. On follow up, the patient had a (UCDVA) with pinhole of 20/60 and showed remarkable improvement of symptoms along with resolution of the corneal infiltrate. The low virulence of C. parapsilosis and the use of topical corticosteroids may have predisposed the patient to fungal proliferation without significant inflammation which can be overlooked especially when it occurs distant from the suspected infection site.

Conclusion/Take home message

High suspicion and close observation are recommended for patients who underwent keratoplasty especially in the presence of multiple risk factors such as dehydrated amniotic membrane transplant to detect any signs of infection in a timely manner and thereby preventing vision threatening complications.