Argon laser phototherapy in the treatment of refractory fungal keratitis.

PURPOSE: To report the beneficial properties of argon laser as an adjunctive therapy in 2 patients with refractory fungal keratitis.

METHODS

Case reports and a review of the literature. Two cases of Fusarium keratitis refractory to topical and systemic antifungals were further treated with argon laser. Before laser treatment, the eye was medicated with proparacaine 0.5%, lidocaine 4%, and a single drop of fluorescein sodium 0.25%. Argon laser irradiation of the affected cornea was performed using argon blue-green wavelength (Coherent Ultima 2000; Coherent, Inc). A spot size of 500 μm, pulse duration of 0.10 seconds, and power ranging from 500 to 900 mW were used.

RESULTS

During the first week after laser treatment, both patients showed complete resolution of the infiltrates. Two signs were observed during the procedure: a blanching of the corneal stroma and small cavitations that reached the middle stroma. No adverse effects were observed.

CONCLUSIONS

Argon laser phototherapy is useful as an adjunctive treatment of refractory fungal keratitis. More cases are needed to validate our findings.