International Ophthalmology

, Volume 32, Issue 4, pp 383–386

Candida interface keratitis following deep anterior lamellar keratoplasty

  • Ayse E. Bahadir
  • Tahir K. Bozkurt
  • Selda Aktay Kutan
  • Cemil A. Yanyali
  • Suphi Acar
Case Report

DOI: 10.1007/s10792-012-9545-1

Cite this article as:
Bahadir, A.E., Bozkurt, T.K., Kutan, S.A. et al. Int Ophthalmol (2012) 32: 383. doi:10.1007/s10792-012-9545-1

Abstract

The purpose is to report a case of Candida interface infection after deep anterior lamellar keratoplasty (DALK). A 23-year-old female patient underwent DALK surgery in the left eye for keratoconus. Four weeks after the surgery, she presented with asymptomatic white-cream colored deposits at the graft–host interface. Epithelial ingrowth was our first possible diagnosis because there were no symptoms or signs of inflammation. However, progression of the lesion under steroid treatment and the appearance of inflammation signs after tapering the steroid treatment raised suspicion of fungal keratitis. Anterior segment optical coherence tomography (OCT), ultrasound biomicroscopy, confocal microscopy and microbiologic examinations of the cornea were performed to evaluate the lesion. Anterior segment OCT and ultrasound biomicroscopy confirmed the lesion to be at the interface. The confocal scan disclosed hyper-reflective deposits and surrounding inflammatory cells but there were no hyphae-like structures. While taking a specimen from the lesion, the Descemet’s membrane ruptured so a penetrating keratoplasty was performed. The microbiologic examination revealed Candida infection. Candida interface keratitis is a rare infection seen after DALK. The asymptomatic clinical picture and the similarity to epithelial ingrowth may postpone the diagnosis and consequently the treatment. Therefore, in cases of interface deposits seen after lamellar surgery, one should consider Candida interface keratitis.

Keywords

CandidaDeep anterior lamellar keratoplastyEpithelial ingrowthFungal keratitisInterface infection

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Ayse E. Bahadir
    • 1
  • Tahir K. Bozkurt
    • 2
  • Selda Aktay Kutan
    • 3
  • Cemil A. Yanyali
    • 4
  • Suphi Acar
    • 5
  1. 1.Hendek State HospitalHendek, SakaryaTurkey
  2. 2.Umraniye Training and Research HospitalIstanbulTurkey
  3. 3.Zonguldak Eregli State HospitalZonguldakTurkey
  4. 4.Dr. Ates Yanyali Eye ClinicIstanbulTurkey
  5. 5.Haydarpasa Numune Training and Research HospitalIstanbulTurkey