Management of Candida glabrata infectious crystalline keratopathy with endophthalmitis following penetrating keratoplasty
Ritu Nagpal1, Sunita Chaurasia1, Joveeta Joseph2, Mudit Tyagi3, Padmaja Kumari Rani3, Muralidhar Ramappa1, Rikin Shah4
1 Cornea and Anterior Segment Services, Tej Kohli Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India 2 Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India 3 Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India 4 Department of Ophthalmology, Ministry of Health, Al Nahdha Hospital, Muscat, Oman
Correspondence Address:
Sunita Chaurasia Tej Kohli Cornea Institute, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Banjara Hills, Hyderabad - 500 034, Telangana India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_1106_17
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A 33-year-old male underwent an optical keratoplasty elsewhere in the right eye following which he developed endophthalmitis and subsequently underwent a pars plana vitrectomy and lensectomy. At presentation, he had a deep stromal crystalline infiltration along the graft–host junction. A large therapeutic keratoplasty was performed, and the excised corneal button was evaluated. Histopathology revealed gram-positive round-to-oval budding structures and microbiology identified the organism as Candida glabrata. He was treated with antifungals in the postoperative period. At 4 months after therapeutic keratoplasty, the patient developed recurrent endophthalmitis, following stoppage of antifungals. The treatment was reinstituted for another year, and the patient did well with a clear graft at 18-month-follow-up period after the recurrence episode. Management of infectious crystalline keratopathy with endophthalmitis is a challenging situation and requires long-term treatment.
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