Aspergillus keratitis after photorefractive keratectomy: a case report

Fungal keratitis is an uncommon condition that can occur after refractive surgery. Herein, we report a case of early postoperative Aspergillus keratitis in an immunocompetent patient following photorefractive keratectomy (PRK). We report a case of a 21-year-old white man with no past ocular or systemic diseases who underwent bilateral PRK for myopia. Seven days after surgery, he presented to his surgeon, complaining of eye redness and blurred vision that had started 3 days prior. First, empirical antibiotic therapy was initiated, and antifungal agents were subsequently added based on the direct microscopic smear examination of corneal scrapings. The polymerase chain reaction test revealed an Aspergillus corneal infection, and after 7 days of antifungal treatment, significant clinical improvement was observed. This case revealed the necessity of considering atypical microorganisms, such as fungi, in the differential diagnosis of early post-PRK keratitis and highlights the role of direct smear and polymerase chain reaction tests in diagnosis, timely treatment initiation, and subsequently favorable clinical outcomes.