Maintained transparency of preserved cornea after penetrating keratoplasty for fungal keratitis: A case report

Purpose: This report presents a case of fungal keratitis treated with penetrating keratoplasty using a cryopreserved cornea, highlighting the successful maintenance of corneal transparency post infection resolution.

Observations: A 57-year-old man complaining of pain in the right eye was referred to our hospital. Although diagnosed with fungal keratitis, his corneal scraping indicated the presence of Fusarium sp, and he was unresponsive to voriconazole, micafungin, and pimaricin treatments. His right visual acuity was hand motion. Therefore, we performed penetrating keratoplasty using a cryopreserved cornea. A cornea frozen and stored at -80 °C was used, with an 8.5-mm-diameter graft covering the infected area. Fungal keratitis subsided after corneal transplantation, and approximately 2 months later, corneal thickness gradually decreased, leading to improved corneal transparency. Therefore, a secondary optical corneal transplantation was deemed unnecessary. The final best-corrected visual acuity after additional cataract surgery was 20/40. Transparency was subsequently maintained for over a year.

Conclusions and importance: Cryopreserved corneas in penetrating keratoplasty may be viable for maintaining corneal transparency. Additionally, waiting several months for secondary optical corneal transplantation after therapeutic keratoplasty may be a good approach.