To describe a case of Alternaria keratitis in a 30-year-old male patient who presented with bilateral vascularised central corneal opacity and underwent deep anterior lamellar keratoplasty (DALK) in the left eye. Patient was treated for recurrent epithelial defect with a bandage contact lens in the follow-up visits after DALK. Subsequently, patient presented with pigmented fungal keratitis, which on culture examination of the corneal scrapping demonstrated Alternaria species. Patient had to undergo a repeat DALK as the keratitis did not resolve with medical therapy alone. Patient did not have a recurrence for 11 months following the regraft. This case report highlights the importance of considering the Alternaria species as a possibile cause of non-resolving fungal keratitis after DALK.
Context: Correction of compound myopic astigmatism is a challenge in keratoconic eyes post-CXL using traditional approaches such as spectacles and contact lens. Toric Implantable Collamer Lenses (ICL's) are fast emerging as an efficacious treatment modality in such cases. Aim:To analyze the visual outcomes achieved with implantation of Toric Implantable Collamer Lens (ICL) in patients of keratoconus pretreated with Corneal Collagen Crosslinking with Riboflavin (C3R). Settings and design: Retrospective interventional studyMethods and material: Twelve eyes of seven patients underwent planned toric ICL implantation following 3-6 months post C3R. All surgeries were performed at Lotus Eye Care Institute, Coimbatore, TN, India between October 2009 and August 2011. Follow up examinations were performed at 1 month, 3-6 months and 1 year. Statistical analysis used:The mean and standard deviation were calculated for the age and follow-up of the patients.Results: The mean age was 24 years (range 20-30 years). There were 4 female and 3 male patients. Minimum and maximum follow up was 1 month and 30 months respectively. All patients maintained a UCVA of 6/9 or better. Conclusion:Implantation of a toric ICL in keratoconus patients previously stabilized with C3R is an effective and safe method to provide these patients glass free vision.
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