研究目的
To present a case of aggressive fungal keratitis caused by Aspergillus flavus following LASIK, associated with an environmental risk factor, and describe the treatment approach leading to a favorable outcome.
研究成果
Early flap amputation combined with empirical medical treatment led to a favorable visual outcome in a case of aggressive post-LASIK fungal keratitis, highlighting the importance of clinical judgment and prompt intervention in such rare infections.
研究不足
This is a single case report, limiting generalizability. The environmental risk factor (construction) is speculative and not definitively proven. The study relies on empirical treatment before culture results, which may not be optimal for all cases.
1：Experimental Design and Method Selection:
This is a case report detailing the clinical presentation, diagnosis, and treatment of a single patient with post-LASIK fungal keratitis. The methods include clinical examination, surgical intervention (flap-lift, culture, irrigation, and flap amputation), and medical therapy based on empirical and culture-guided approaches.
2：Sample Selection and Data Sources:
The sample is a 24-year-old female patient who underwent LASIK and developed keratitis. Data sources include clinical observations, slit lamp exams, cultures, histopathology, and antifungal sensitivity testing.
3：List of Experimental Equipment and Materials:
Slit lamp for examination, WaveLight FS-200 and Allegretto Eye-Q laser platform for LASIK, ultrasound pachymeter for corneal thickness measurement, operating room equipment for surgery, balanced salt solution for irrigation, and various medications (e.g., ciprofloxacin, dexamethasone, tobramycin, vancomycin, voriconazole, valacyclovir).
4：Experimental Procedures and Operational Workflow:
The patient underwent LASIK, developed symptoms on postoperative day 2, was examined with a slit lamp, taken to the operating room for flap-lift and cultures, underwent flap amputation, and received hourly topical and oral medications. Follow-up included repeated exams, cultures, and imaging.
5：Data Analysis Methods:
Clinical assessment of visual acuity and corneal appearance, culture results for bacterial and fungal identification, histopathology for confirmation, and antifungal sensitivity testing to guide treatment.
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WaveLight FS-200
FS-200
Alcon
Used for creating the corneal flap in the LASIK procedure.
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Allegretto Eye-Q
Eye-Q
Alcon
Laser platform used for the vision correction part of the LASIK procedure.
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ultrasound pachymeter
Used to measure central corneal thickness.
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slit lamp
Used for ophthalmic examination to observe corneal infiltrates.
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balanced salt solution
Used for irrigation of the flap interface during surgery.
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ciprofloxacin
Ciloxan
Antibiotic eye drops prescribed postoperatively.
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dexamethasone
Steroid eye drops prescribed postoperatively.
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tobramycin
Fortified antibiotic used in treatment.
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vancomycin
Fortified antibiotic used in treatment.
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voriconazole
Antifungal medication used topically and guided by sensitivity testing.
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valacyclovir
Oral antiviral medication prescribed due to patient history.
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prednisolone
Steroid therapy initially used and later discontinued.
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