A Rare Microsporidial Infection in Lamellar Corneal Tissue, following Transepithelial Photorefractive Keratectomy

Abstract The aim of this study was to report a unique case of microsporidial keratitis over deep anterior lamellar keratoplasty after transepithelial photorefractive keratectomy surgery that was successfully treated with therapeutic lamellar keratoplasty without recurrence at King Khaled Eye Special...

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Bibliographic Details
Published in:Case reports in ophthalmology 2023-01, Vol.14 (1), p.127-133
Main Authors: Alabduljabbar, Mohammad, Sirajuddin, Fatima, Maktabi, Azza, AlShabeeb, Rawan
Format: Article
Language:English
Subjects:
Case Report
Case reports
Contact lenses
Corneal transplantation
deep anterior lamellar keratoplasty
Edema
Emergency medical care
Eye surgery
Immunocompetence
Infections
keratoconjunctivitis
microsporidia
Patients
Polymerase chain reaction
Stains & staining
Steroids
stromal keratitis
Surgical outcomes
Visual acuity
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Summary:Abstract The aim of this study was to report a unique case of microsporidial keratitis over deep anterior lamellar keratoplasty after transepithelial photorefractive keratectomy surgery that was successfully treated with therapeutic lamellar keratoplasty without recurrence at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. The patient presented with recurrent attacks of eye pain, redness, photophobia, and decreased vision. The patient was initially treated as a case of presumed herpetic keratouveitis using antiviral medication and topical steroids with partial improvement. During the last episode, the condition deteriorated and patient underwent therapeutic lamellar keratoplasty. Histopathology indicated an infected graft with evidence of microsporidial infection. The patient was discharged with complete corneal epithelial healing and no signs of recurrence during follow-up. Microsporidial infection is a rare cause of stromal keratitis that affects both immunocompetent and immunosuppressed patients. Microsporidia should be suspected after surface ablation refractive surgery if the patient presents with recurrent symptoms of keratoconjunctivitis or stromal keratitis that are partially responsive to topical steroid therapy.
ISSN:1663-2699
1663-2699
DOI:10.1159/000528894