ALTERNARIA KERATITIS AND ENDOPHTALMITIS AFTER CLEAR-CORNEA PHAKOEMULSIFICATION

ESPOSITO E; P MACCIO,; MONTI R; CERVI L; SERRA H M; JA URRETS-ZAVALIA,

JOURNAL OF CATARACT AND REFRACTIVE SURGERY.

ELSEVIER SCIENCE INC

Lugar: Amsterdam; Año: 2014 p. 331 - 334

0886-3350

We report a case of Alternaria keratitis and hypopyon following clear cornea cataract surgery. An adult woman presented with a painful and red left eye several months after an uneventful self-sealing clear-cornea phacoemulsification, unresponsive to prolonged treatment with topical/oral quinolones and topical corticosteroids. A full thickness stroma white dense infiltrate in the area of the intrastromal tunnel incision and extending centrally with fernlike margins, filaments in the anterior chamber, and a 2 mm hypopyon were observed. Culture from corneal scrapings revealed Alternaria species. Treatment included topical instillation of amphotericin-B (5mg/ml), 2 adjacent subconjuctival injections of same drug and concentration, and 200mg twice a day of oral ketoconazol. Complete resolution of corneal infiltration and hypopyon was observed after 30 days of treatment without recurrences during 6 years of follow-up. To our knowledge, this is the first report of an Alternaria species keratitis complicating a self-sealing clear-cornea cataract surgery. Topical and subconjunctival injection of amphotericine-B and oral ketoconazol were effective in resolving corneal abscess and anterior chamber inflammatory reaction