Fungal keratitis after small incision lenticule extraction (SMILE): a case report and review of the literature

Abstract

To report a case of perforated fungal keratitis after small incision lenticule extraction (SMILE) treated with penetrating keratoplasty (PKP). Case report and literature review. A 41-year-old woman presented with culture-proven unilateral fungal keratitis 4\u2009days after uneventful SMILE. Her visual acuity was hand motion. The patient was treated with voriconazole irrigation (50\u2009μm/0.1\u2009ml) of the pocket and intrastromal voriconazole injection, in addition to systemic and topical antifungals. Despite aggressive management and decreased infiltration, the cornea was perforated and subsequently treated with PKP. Infectious keratitis after SMILE is unusual. To our knowledge, this is the first report of perforated fungal keratitis post-SMILE. PKP eradicated the infection.