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Kim, Lim, and Koh: Cryotherapy on Refractory Fungal Corneal Ulcer: A Case Report
Case Report

Journal of the Korean Ophthalmological Society 2017; 58(10): 1194-1198.

Published online: 11 October 2017

DOI: https://doi.org/10.3341/jkos.2017.58.10.1194

Cryotherapy on Refractory Fungal Corneal Ulcer: A Case Report

Hyun Ju Kim, MD, Hwa Rang Lim, MD, Jae Woong Koh, MD, PhD

Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea.

Address reprint requests to Jae Woong Koh, MD, PhD. Department of Ophthalmology, Chosun University Hospital, #365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea. Tel: 82-62-220-3190, Fax: 82-62-225-9839, ophkoh@hanmail.net

Received 10 August 2017       Revised 28 August 2017       Accepted 20 September 2017

©2017 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of cryotherapy for fungal corneal ulcers that did not respond to antifungal agents.

Case summary

A 58-year-old man was transferred to our hospital with a left eye corneal ulcer due to pain and visual impairment in his left eye for two weeks, and he was suspected to have a history of fungal infection. At the time of admission, corneal opacity and progressive ulcerative lesions were observed at 5 o'clock in the left eye and visual acuity was 0.025, uncorrected. The corneal ulcer marginal resection, bacterial culture, and potassium hydroxide preparation (KOH) test were performed on lesion sites. Cultures of Candida albicans were reported to grow, topical antibiotics (Fortified tobramycin, Fortified cefazolin, moxifloxacin), and anti-fungal agents (fortified amphotericin B, 0.5%, Natamycin) were administered, but no improvement was observed for 2 weeks. On the 14th day after admission, Cryotherapy was performed. After surgery, eye drops were equally applied, and there was no other discomfort other than pain for 3 days after the operation. He discharged 10 days after surgery, the corneal lesion was healed and the visual acuity was improved to 0.32, uncorrected.

Conclusions

We report a case of cryotherapy for fungal corneal ulcers that did not react with topical antifungal drugs and improved visual acuity and symptom improvement.

Keywords: Cryotherapy, Refractive fungal cornea ulcer

Figures and Tables

Figure 1

Anterior segment photo of the patient who did not show improvement in medical treatment for 2 weeks. 2 weeks after medical treatment, (A) corneal opacity and progressive infiltrative lesion still observed at 5 o'clock in the left eye. (B) Cornea epithelial defect with ulcerative lesion observed in the cornea at 5 o'clock after stining.

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Figure 2

Photo of cryotherapy. Cryotherapy was performed on 5 o'clock of progressive ulcerative and infiltrative lesion refractory to previous medical treatment.

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Figure 3

2 months after cryotherapy. (A) Corneal neovascularization and corneal opacity remain, since 5 o'clock cornea lesion completely healed. (B) Corneal epithelium defect was fully recovered.

jkos-58-1194-g003

Notes

This study was supported by research funds from Chosun University Hospital 2017.

Conflicts of Interest The authors have no conflicts to disclose.

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