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Cornea. 2007 Jul;26(6):762-3.

Aspergillus-induced malignant glaucoma.

Author information

1
Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt Ltd, Wadala, Mumbai, India. docvandanajain@rediffmail.com

Abstract

PURPOSE:

To report a case of Aspergillus flavus-induced keratomycotic malignant glaucoma.

METHODS:

A 48-year-old woman presented with a severe corneal ulcer. She had received topical steroids for 10 days before presentation.

RESULTS:

Microbiological studies revealed A. flavus as the offending pathogen. Nonresponsive high intraocular pressure with associated shallow anterior chamber was present. With a diagnosis of keratomycotic malignant glaucoma, the patient underwent therapeutic keratoplasty with cataract extraction with posterior chamber wash. However, there was a recurrence of malignant glaucoma in the postoperative period. Patient underwent limited pars plana vitrectomy.

CONCLUSIONS:

Keratomycotic malignant glaucoma is a rare complication of severe fungal ulcer. We believe that the use of topical steroids in this case probably led to increased fungal penetration, with the formation of a lens-iris fungal mass and subsequent malignant glaucoma. Nonresponse to medical therapy warrants urgent surgical intervention. To the best of our knowledge, Aspergillus-induced keratomycotic glaucoma has never been reported previously. This report also highlights that therapeutic keratoplasty with cataract extraction alone may not be sufficient for management of such cases, and a limited pars plana vitrectomy may be needed.

PMID:
17592335
DOI:
10.1097/ICO.0b013e31805fc37b
[Indexed for MEDLINE]

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