povidone-iodine and Fusariosis

We report the successful management of a rare case of bilateral post-laser in situ keratomileusis (LASIK) Fusarium oxysporum keratitis and propose a therapeutic strategy. A 19-year-old white man with no systemic diseases was referred to our emergency service 3 days after microkeratome-assisted myopic bilateral LASIK correction. He complained of blurred-vision, photophobia, and ocular pain. Clinical findings (satellite lesions, hypopyon) suggested fungal keratitis. Flaps were immediately lifted and rinsed with povidone-iodine 10%, and intensive topical and systemic and combined antifungal and antibacterial treatment was introduced. Topical cortisone drops were administered after 3 days. Despite initial deterioration of the clinical picture, all symptoms resolved quickly. Polymerase chain reaction indicated F oxysporum. Relapse occurred in the left eye, which was successfully managed. The final uncorrected distance visual acuity was 20/20 in both eyes. Fusarium oxysporum post-LASIK keratitis may occur in the early phase. Prompt diagnosis, interface irrigation with povidone-iodine solution, and intensive long-term treatment contribute to a favorable outcome.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Corneal Ulcer; DNA, Fungal; Drug Therapy, Combination; Eye Infections, Fungal; Fusariosis; Fusarium; Glucocorticoids; Humans; Keratomileusis, Laser In Situ; Lasers, Excimer; Male; Myopia; Polymerase Chain Reaction; Postoperative Complications; Povidone-Iodine; Prednisolone; Visual Acuity; Young Adult