This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (4)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Infectious Diseases  • Infectious Diseases, Other  • Corneal Disorders  • Endophthalmitis  • Alert me on articles by topic

Enrique Garcia-Valenzuela, MD, PhD; C. Diane Song, MD

Arch Ophthalmol. 2005;123:1721-1723.

Penetrating keratoplasty carries an infectious risk. Its requirement for topical corticosteroid therapy facilitates fungal growth with resulting keratitis. Although progression of fungal keratitis to intraocular infection is uncommon, endophthalmitis resulting from keratitis usually has a poor visual prognosis. Fungal infection under these circumstances remains a diagnostic and therapeutic challenge. We report a complicated case of recurrent fungal keratitis with endophthalmitis following a contaminated penetrating keratoplasty that ultimately was controlled with a new treatment modality. Intrastromal corneal injections combined with intravitreal injection of amphotericin B led to the eradication of the corneal fungal plaques and the intraocular infection. Intrastromal corneal injections of amphotericin B may offer a less invasive, in-office alternative to repeat penetrating keratoplasty.

Author Affiliations: Emory University Eye Center, Emory University School of Medicine, and Eye Clinic, Atlanta Veterans Affairs Medical Center, Atlanta, Ga. Dr Garcia-Valenzuela is now with the University of Illinois Eye Center, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, and Midwest Retina Consultants, SC, Park Ridge, Ill.