amphotericin-b and Myopia

Topics: Adult; Amphotericin B; Antifungal Agents; Combined Modality Therapy; Corneal Ulcer; Debridement; Drug Therapy, Combination; Exophiala; Eye Infections, Fungal; Female; Humans; Itraconazole; Keratomileusis, Laser In Situ; Microbial Sensitivity Tests; Mycoses; Myopia; Natamycin; Postoperative Complications; Surgical Flaps

A 52-year-old man had laser in situ keratomileusis in March 2002 and 2 weeks later had a corneal infection that was found to be caused by Exophiala dermatitidis. This infection waxed and waned for 9 months despite therapy with natamycin, itraconazole, and fluconazole but eventually responded to topical amphotericin. He recovered good visual acuity in this eye with a rigid gas-permeable lens. This case shows the importance of selecting the appropriate agent in fungal keratitis.

Topics: Amphotericin B; Antifungal Agents; Exophiala; Eye Infections, Fungal; Humans; Keratitis; Keratomileusis, Laser In Situ; Male; Microbial Sensitivity Tests; Middle Aged; Mycoses; Myopia; Postoperative Complications; Recurrence

A fungal infection in the right eye after retina detachment on an immunocompetent patient is reported. After surgery, she developed an infection that was empirically treated with antibiotics and corticoids. Later the patient developed another retina and choroid detachment. The infection evolved to endophthalmitis and a sample was sent to the microbiology laboratory, where Aspergillus fumigatus was isolated. In spite of treatment with intravenous and intravitreous amphotericin B, the eye was eventually removed by enucleation.

Topics: Amblyopia; Amphotericin B; Aspergillosis; Aspergillus fumigatus; Atropine; Combined Modality Therapy; Cryosurgery; Disease Susceptibility; Endophthalmitis; Eye Enucleation; Female; Humans; Immobilization; Laser Therapy; Liposomes; Mydriatics; Myopia; Prednisone; Retinal Detachment; Surgical Wound Infection; Tobramycin; Vitrectomy

To report a case of fungal keratitis resulting after laser in situ keratomileusis (LASIK).. A 38-year-old white man in good health developed a corneal infiltrate with laboratory confirmation of fungal keratitis after LASIK. Corneal scrapings were taken. Silver stain was positive for hyphae. Culture was positive for Curvularia sp. The patient was started on intensive natamycin 5% and amphotericin 0.15% topical therapy.. The patient's keratitis was successfully treated with intensive antifungal therapy.. Infectious keratitis is a rare but a serious potential complication after LASIK. To our knowledge, no previous case of fungal keratitis after LASIK has been reported. This case emphasizes the importance of surveillance for infection after LASIK.

Topics: Adult; Amphotericin B; Antifungal Agents; Cornea; Corneal Ulcer; Drug Therapy, Combination; Eye Infections, Fungal; Humans; Keratomileusis, Laser In Situ; Male; Mitosporic Fungi; Mycoses; Myopia; Natamycin; Ophthalmic Solutions; Visual Acuity

In isolated rabbit corneas that had undergone lamellar keratectomy or myopic keratomileusis, the stimulation of chloride transport by 10(-5) M epinephrine was completely inhibited at 1 week following surgery. At 28 days following surgery, both groups responded to 10(-7) M epinephrine. The response to 10(-5) M amphotericin B was normal both at 1 week and at 28 days following surgery. We conclude that, although the Na-K pump was not affected by the lamellar keratectomy and cryolathing, that either the epithelial beta receptors and/or the cAMP pathway were temporarily inhibited for at least 1 week following surgery. A lamellar keratectomy, therefore, can have an adverse effect on the epithelial transport system of the corneal epithelium even though the epithelium may appear normal clinically.

Topics: Amphotericin B; Animals; Biological Transport, Active; Chlorides; Cornea; Cyclic AMP; Epinephrine; Epithelium; Ion Channels; Myopia; Rabbits; Receptors, Adrenergic, beta