Zhao J, Xu HT, Yin Y, Li YX, Zheng YJ. Fungal corneal ulcer after repair of an overhanging filtering bleb: A case report. World J Clin Cases 2023; 11(27): 6573-6578 [PMID: 37900231 DOI: 10.12998/wjcc.v11.i27.6573]
Corresponding Author of This Article
Ya-Juan Zheng, MD, PhD, Chief Physician, Professor, Department of Ophthalmology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130022, Jilin Province, China. zhengyajuan124@126.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jing Zhao, Hai-Tao Xu, Yuan Yin, Yan-Xia Li, Ya-Juan Zheng, Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130022, Jilin Province, China
Author contributions: Zhao J collected patient information and drafted the manuscript; Xu HT provided patient information and guided treatment; Yin Y and Li YX collected the examination information; Zheng YJ critically revised the manuscript for intellectual content and supervised the project.
Supported bythe Science and Technology Project of Education Department of Jilin Province, No. JJKH20201089KJ.
Informed consent statement: Written informed consent was obtained from the patients for publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Juan Zheng, MD, PhD, Chief Physician, Professor, Department of Ophthalmology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130022, Jilin Province, China. zhengyajuan124@126.com
Received: June 30, 2023 Peer-review started: June 30, 2023 First decision: August 9, 2023 Revised: August 23, 2023 Accepted: September 4, 2023 Article in press: September 4, 2023 Published online: September 26, 2023
Abstract
BACKGROUND
Overhanging filtering bleb is a common complication after trabeculectomy and surgical repair is an effective treatment when the patient presents with apparent symptoms. Filtering bleb relevant infection including in the filtering bleb itself and even endophthalmitis in some severe cases has been reported. However, corneal fungal infection after filtering bleb repair is rarely reported.
CASE SUMMARY
A 57-year-old Chinese man who had sensations of redness and foreign body sensations in the left eye 3 wk after repair of overhanging filtering bleb. 3 wk ago, due to sensations of a foreign body in the left eye for 3 years with worsening for 3 mo. The patient was diagnosed as overhanging filtering bleb and underwent a repair of overhanging filtering bleb. Postoperative, the filtering bleb formed well and the intraocular pressure is normal. But the patient gradually develop redness, pain and a grey infiltrate of the cornea in the eye. Finally it developed into fungal corneal ulcer. Through asking the medical history, we found the patient had irregularly self-medicated for years with glucocorticoid eye drops for years to relieve the foreign body sensation in the eye caused by filtering bleb overhanging. Because the glucocorticoid eye drops he used years ago had provide normal sensation to the eye. After 3 mo of anti-fungal treatment, the inflammation was controlled.
CONCLUSION
In addition to avoiding the development of overhanging filtering bleb after trabeculectomy, the present case report also suggests that clinicians should pay more attention to the patient’s ocular self-medication history. Particularly in patients with a history of glaucoma or eye surgery. Because these patients may be exposed to more types of eye drops than other individuals, they may select the wrong medications for long-term use, based on their previous experience.
Core Tip: Overhanging filtering bleb is a common complication after trabeculectomy. Filtering bleb relevant infection including in the filtering bleb itself and even endophthalmitis in some severe cases has been reported. However, corneal fungal infection after filtering bleb repair is rarely reported. Here, we report a case of fungal keratitis occurring after the repair of a filtering bleb because the patient has long time irregularly self-medicated with glucocorticoid eye drops. Through the analysis of the case, we suggests clinicians pay more attention to the patient’s ocular self-medication history.
