The femtosecond laser may be useful in the treatment of advanced fungal keratitis, according to this case presentation.
Her history was complicated by the use of extended-wear soft contact lenses and avid gardening, including recent exposure to an herbicide that contains fungus. Her history included a progressive worsening of ocular pain, redness, and the development of white, circular infiltrate within the corneal stroma slightly temporal to the corneal center. Her vision was 20/30 at initial presentation.
Corneal cultures were performed, noting a nonsuppurative bed, and cultures were negative. The patient was treated with topical amikacin (20 mg/ml) and vancomycin (25 mg/ml) as well as topical prednisolone acetate 1% suspension.
At this point, the possibility of therapeutic penetrating keratoplasty (PK) was discussed. The patient said she preferred to exhaust all other options before cornea transplant. Further, concern existed regarding possible intraocular seeding of the infection with PK.
The procedure was as follows: