Superimposed Fungal Ulcer after Fibrin Glue Sealant in Infectious Corneal Ulcer

• Published in: Korean journal of ophthalmology Vol. 25; no. 6; pp. 447 - 450
• Main Authors: Byun, Yong-Soo, Kim, Man Soo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Ophthalmological Society 01.12.2011; 대한안과학회
• Subjects: Adult; Case Report; Corneal Perforation - drug therapy; Corneal Ulcer - drug therapy; Corneal Ulcer - microbiology; Eye Infections, Fungal - microbiology; Female; Fibrin Tissue Adhesive - therapeutic use; Fusariosis - microbiology; Fusarium - isolation & purification; Humans; 안과학; Corneal ulcer; Corneal perforation; Fibrin glue; Tissue glue; Tissue adhesives
• ISSN: 1011-8942; 2092-9382; 2092-9382
• DOI: 10.3341/kjo.2011.25.6.447

A healthy 27-year-old woman with a corneal ulcer underwent fibrin gluing with a bandage contact lens twice, due to an impending perforation. The ulcer lesion slowly progressed, unresponsive to topical antibiotics and amphotericin B. We removed the gluing patch and performed a corneal or scraping or biopsy with multiple amniotic membrane grafts to seal the thinned or perforated cornea. Three days after the surgery, the corneal cultures grew Fusarium, as well as Enterococcus faecalis. Three weeks after surgery, the outermost layer of amniotic membranes, serving as a temporary patch, was removed. The anterior chamber was clear without cells. The signs of infection clinically and symptomatically cleared up four weeks later. Two months after surgery, the lesion became enhanced by amniotic membranes. The use of fibrin glue in infectious keratitis should be avoided, because it not only masks the underlying lesion, but it also interferes with drug penetration into the underlying lesion.