Cryotherapy on Refractory Fungal Corneal Ulcer: A Case Report

Purpose: We report a case of cryotherapy for fungal corneal ulcers that did not respond to antifungal agents. Case summary: A 58-year-old man was transferred to our hospital with a left eye corneal ulcer due to pain and visual impairment in his left eye for two weeks, and he was suspected to have a history of fungal infection. At the time of admission, corneal opacity and progressive ulcerative lesions were observed at 5 o'clock in the left eye and visual acuity was 0.025, uncorrected. The corneal ulcer marginal resection, bacterial culture, and potassium hydroxide preparation (KOH) test were performed on lesion sites. Cultures of Candida albicans were reported to grow, topical antibiotics (Fortified tobramycin, Fortified cefazolin, moxifloxacin), and anti-fungal agents (fortified amphotericin B, 0.5%, Natamycin) were administered, but no improvement was observed for 2 weeks. On the 14th day after admission, Cryotherapy was performed. After surgery, eye drops were equally applied, and there was no other discomfort other than pain for 3 days after the operation. He discharged 10 days after surgery, the corneal lesion was healed and the visual acuity was improved to 0.32, uncorrected. Conclusions: We report a case of cryotherapy for fungal corneal ulcers that did not react with topical antifungal drugs and improved visual acuity and symptom improvement.