Abstract
Abstract: :
Purpose: Keratomycosis with large abscess, which sometimes needs therapeutic penetrating keratoplasty, is difficult to treat because of poor response to local and systemic anti– fungal agents. In this study, we investigate the degree of infection and fungal penetration in severe keratomycosis samples obtained from two cases. Methods: Case 1 was a 66 yo man suffered from keratomycosis with large abscess occupied total corneal stroma up to limbus. We performed therapeutic penetrating keratoplasty twice, but needed evisceration at last. Scedosporium sp. was isolated from the corneal specimen. Case 2 was a 36 yo woman suffered from corneal epithelial disorder due to lagophthalmus, followed by keratomycosis. We performed therapeutic keratoplasty because the large and deep abscess did not respond well to anti–fungal agents. However, the lesion recurred 1 month later, followed by another keratoplasty with larger sized graft. Fusarium sp. was isolated from the corneal specimen. We studied histologically these corneal specimens obtained by kearatoplasty. Results: At the first sample in case 1, the proliferated fungus body penetrated in the deep corneal stroma and made a granulation tissue. Besides, at the second sample, fungus body occupied all corneal stroma with some necrotic tissue and reached anterior chamber. The fungus body penetrated into the iris tissue in the specimen obtained at the evisceration. In the second case, the fungus body penetrated to the Descemet’s membrane at the first sample, furthermore it reached to anterior chamber at the second sample. Conclusions: It was demonstrated that the fungus body was likely to reach anterior chamber in large fungal corneal abscess covered total corneal stroma.
Keywords: cornea: clinical science • fungal disease • pathology: human