AI Article Synopsis
- A 51-year-old man with Fuchs' dystrophy and cataracts underwent eye surgery and later developed redness and poor vision in his left eye, diagnosed as acute graft rejection.
- After worsening symptoms, his right eye showed similar issues, leading to a suspicion of infection confirmed by microscopy, revealing microsporidial spores.
- The patient was treated with topical fluconazole, highlighting the need for careful diagnosis to avoid mismanagement of eye complications post-surgery.
Article Abstract
A 51-year-old immunocompetent male with a history of Fuchs' endothelial dystrophy and immature cataract who underwent Descemet's stripping automated endothelial keratoplasty with intraocular lens implantation in both eyes presented with redness and defective vision of 1-day duration in his left eye. Slit lamp examination revealed coarse superficial punctate lesions with graft edema. He was diagnosed with acute graft rejection and treated with topical steroids. Two days later, symptoms worsened in his left eye with the involvement of his right eye showing a similar clinical picture. An infectious etiology was suspected and in vivo confocal microscopy ordered, which revealed hyperreflective dots, highly suggestive of microsporidial spores. The patient was prescribed topical fluconazole 0.3% in both eyes. This unique presentation of bilateral graft edema following microsporidial keratoconjunctivitis in postgraft patients requires a high index of suspicion as it can be easily be mistaken for and mismanaged as acute graft rejection.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5621273 | PMC |
| http://dx.doi.org/10.4103/ijo.IJO_295_17 | DOI Listing |
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