Aspergillus Keratitis after Deep Anterior Lamellar Keratoplasty

392 A 17‐year‐old female with a several‐year history of bilateral keratoconus was visited about 1 year prior to deep anterior lamellar keratoplasty (DALK) in her right eye (OD). History‐wise, she was intolerant to glasses and contact lenses and her past medical history and family history were unremarkable. On ocular examination, she had visual acuity (VA) of 2 meters counting fingers (CF) in each eye without correction and 4 meters CF after best spectacle correction of −17.50−5.0× 10° and −12.50−5.0× 165° in the right and left eyes, respectively. Slit lamp biomicroscopy showed normal ocular adnexa but bulged clear corneas with typical signs of keratoconus in both eyes. Remaining ocular examinations in both eyes were unremarkable. The patient underwent DALK in her right eye; a recipient corneal bed size of 7.50 mm received a 7.75 mm graft, which was preserved in optisol solution and had been obtained from a 39‐year‐old male donor died from trauma. Death to preservation time was about 27 h and the time interval between graft preservation and DALK was 3 days. After removing its endothelium, the donor cornea was sutured to the recipient bed using 10‐0 nylon double running torque‐antitorque method. At the end of the surgery, subconjunctival injection of betamethasone‐cephazolin was given without placing a bandage contact lens on the cornea. Postoperatively, the patient received betamethasone eye drops (every 4 hours), chloramphenicol eye drops (every 6 hours) and preservative-free artificial tears (every 2 hours). One week post operatively, the patient was found to have moderately red right eye and on examination, mild melting of the graft was observed at 12‐1.50 Aspergillus Keratitis after Deep Anterior Lamellar Keratoplasty