Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature

Mohammad Soleimani; Ali A Haydar

doi:10.1186/s12348-021-00256-0

Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature

J Ophthalmic Inflamm Infect. 2021 Sep 3;11(1):25. doi: 10.1186/s12348-021-00256-0.

Authors

Mohammad Soleimani¹, Ali A Haydar²

Affiliations

¹ Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran.
² Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, 1336616351, Iran. ali.haydar01@lau.edu.

Abstract

Purpose: To report a case of perforated fungal keratitis after small incision lenticule extraction (SMILE) treated with penetrating keratoplasty (PKP).

Methods: Case report and literature review.

Results: A 41-year-old woman presented with culture-proven unilateral fungal keratitis 4 days after uneventful SMILE. Her visual acuity was hand motion. The patient was treated with voriconazole irrigation (50 μm/0.1 ml) of the pocket and intrastromal voriconazole injection, in addition to systemic and topical antifungals. Despite aggressive management and decreased infiltration, the cornea was perforated and subsequently treated with PKP.

Conclusions: Infectious keratitis after SMILE is unusual. To our knowledge, this is the first report of perforated fungal keratitis post-SMILE. PKP eradicated the infection.

Keywords: Aspergillus; Fungal keratitis; Infectious keratitis; Penetrating keratoplasty; SMILE.