Our Summary

This research paper discusses a case where a 42-year-old woman who regularly wore contact lenses developed a stubborn eye infection (Acremonium keratitis). Initially, she complained about feeling like there was something in her eye and experiencing pain. Upon examination, the doctors found an infection on a particular area of her eye and attempted to treat it with a drug called voriconazole for a month.

Unfortunately, the infection was resistant to this treatment, leaving the doctors to try another method known as corneal collagen cross-linking. This procedure was able to stop the pain, but did not improve the overall condition. Finally, the doctors performed a corneal transplant a month later, which effectively treated the infection and improved the patient’s vision. The transplant was free of any microorganisms.

In conclusion, this case suggests that while corneal collagen cross-linking may help with the symptoms of a stubborn Acremonium keratitis infection, a corneal transplant may ultimately be necessary for full recovery and restoration of vision.

FAQs

  1. What was the initial treatment attempted for the Acremonium keratitis infection in this case?
  2. What is corneal collagen cross-linking and how successful was it in treating the infection?
  3. Why was a corneal transplant ultimately required and how effective was it in treating the patient’s condition?

Doctor’s Tip

A doctor might tell a patient undergoing a corneal transplant to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding activities that may put strain on the eye. It is important to protect the eye from injury and infection during the healing process to ensure successful recovery and optimal outcomes.

Suitable For

Patients who are typically recommended for a corneal transplant include those with:

  1. Corneal scarring: Scarring on the cornea can significantly impact vision and may require a transplant to restore clarity.

  2. Keratoconus: This is a condition where the cornea thins and bulges outwards, causing vision problems that may require a transplant for correction.

  3. Fuchs’ dystrophy: This is a genetic disorder that causes the cornea to swell and cloud over time, eventually leading to vision impairment that may necessitate a transplant.

  4. Corneal ulcers: Severe or recurrent corneal ulcers that do not respond to conventional treatment may require a transplant to prevent further damage.

  5. Corneal infections: Stubborn infections like Acremonium keratitis, as seen in the case study mentioned above, may require a transplant if they are resistant to other treatments.

  6. Corneal injuries: Traumatic injuries to the cornea, such as chemical burns or deep cuts, may require a transplant to repair the damage and restore vision.

  7. Corneal dystrophies: Inherited conditions that affect the cornea, such as lattice dystrophy or macular dystrophy, may progress to a point where a transplant is necessary for vision preservation.

Overall, patients who have exhausted other treatment options for corneal conditions or whose vision is significantly impaired may be recommended for a corneal transplant to improve their quality of life and vision.

Timeline

Timeline:

  • Patient initially experiences discomfort and pain in the eye, along with the sensation of something being in the eye.
  • Examination reveals an infection (Acremonium keratitis) in the eye, which is treated with voriconazole for a month.
  • Infection proves resistant to voriconazole treatment, leading doctors to perform corneal collagen cross-linking to alleviate pain.
  • Corneal collagen cross-linking does not improve the overall condition, prompting doctors to perform a corneal transplant a month later.
  • Corneal transplant successfully treats the infection and improves the patient’s vision, with the transplant being free of any microorganisms.

What to Ask Your Doctor

Some questions a patient should ask their doctor about corneal transplant include:

  1. What is a corneal transplant and how does it work?
  2. Why is a corneal transplant necessary for my condition?
  3. What are the risks and potential complications associated with a corneal transplant?
  4. What is the success rate of corneal transplants for treating Acremonium keratitis infections?
  5. How long is the recovery process after a corneal transplant?
  6. Will I need to take any medications or follow any special precautions after the transplant?
  7. Are there any alternative treatments to a corneal transplant that I should consider?
  8. How often will I need follow-up appointments after the transplant?
  9. What are the chances of rejection of the transplanted cornea and how can I prevent it?
  10. Can I expect an improvement in my vision after the corneal transplant?

Reference

Authors: Yagci A, Palamar M, Polat Hilmioglu S, Irkec M. Journal: Exp Clin Transplant. 2016 Oct;14(5):580-583. doi: 10.6002/ect.2014.0187. Epub 2015 Nov 23. PMID: 27452505