| Title | Deep Anterior Lamellar Keratoplasty to Treat Microsporidial Stromal Keratitis. | | Author(s) | Ang M, Mehta JS, Mantoo S, Tan D | | Institution | From the *Singapore National Eye Centre, Singapore; daggerSingapore Eye Research Institute, Singapore; and double daggerDepartment of Pathology, Singapore General Hospital, Singapore. | | Source | Cornea 2009 Jul 1. | | Abstract | PURPOSE:: To describe deep anterior lamellar keratoplasty (DALK) as a surgical option to treat a case of severe microsporidial stromal keratitis in an immunocompetent patient.
MATERIALS AND METHODS:: This study is a descriptive case report. A 42 year-old Pakistani woman had an 8-year history of symptoms in the left eye. She had been previously provisionally diagnosed as suspected herpes simplex keratitis or Thygeson keratitis. At presentation, her best-corrected visual acuity was 20/20 OD and 20/200 OS. Examination of the left cornea revealed irregular, central, deep stromal opacification with keratitic precipitates and occasional cells in the anterior chamber. Investigations for mycobacteria, syphilis, and a tetraplex test were normal; all other hematological/biochemistry/virology investigations were normal-she was not found to be immunocompromised.
RESULTS:: A corneal biopsy confirmed microsporidial infiltration of the stroma. After intensive medical treatment with topical fumagillin and oral albendazole without resolution, DALK was performed with total stromal replacement using the big-bubble technique. One year postoperatively, the graft remained clear with no evidence of recurrence and best-corrected visual acuity was 20/40 OS.
CONCLUSIONS:: Microsporidial stromal keratitis is rare. Conventional surgical treatment for such a condition has been penetrating keratoplasty. DALK may be considered an option for visual rehabilitation in these cases. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19574897 |
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