{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:09:00Z","timestamp":1780405740138,"version":"3.54.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose To establish the importance of using a sufficiently large corneal graft in primary penetrating keratoplasty in order to prevent recurrence of fungal keratitis.<\/jats:p><jats:p>\n          Oberservations A 58-year-old female patient underwent emergency penetrating keratoplasty (diameter 7.0\u2009mm, double running suture) for therapy-resistant fungal keratitis (Fusarium\n          solani) at an external eye clinic. Despite intensive antifungal therapy, new fungal infiltrates appeared in the host cornea after a few days. The patient was referred to our department\n          for further treatment. On first presentation, circular infiltrates were seen around the corneal graft with anterior chamber involvement and therapy-resistant hypopyon. We performed an\n          emergency penetrating repeat keratoplasty (diameter of 13.0\u2009mm, 32 interrupted sutures) combined with anterior chamber lavage and intracameral and intrastromal drug injection.<\/jats:p><jats:p>\n          Conclusion and Importance Fungal keratitis sometimes has a frustrating clinical course. Therefore, early diagnosis with effective therapy initiation is of the utmost importance. In\n          cases of penetrating keratoplasty, optimal planning and timing (before anterior chamber involvement) should be provided. Sufficient safety distance must be ensured in the choice of graft\n          diameter, fixation with multiple interrupted sutures, and anterior chamber lavage, as well as intracameral and intrastromal drug administration. Incomplete excision carries a risk of\n          recurrence and endophthalmitis in the course. Close postoperative control is necessary to detect early recurrences.<\/jats:p>","DOI":"10.1055\/a-1756-5147","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T23:56:03Z","timestamp":1648079763000},"page":"1098-1102","source":"Crossref","is-referenced-by-count":8,"title":["Recurrent Filamentous Fungal Keratitis Caused When the Primarily Selected Graft Diameter was Too Small"],"prefix":"10.1055","volume":"240","author":[{"given":"Tim","family":"Berger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8204","authenticated-orcid":false,"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fidelis","family":"Flockerzi","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Allgemeine und Spezielle Pathologie, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Daas","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1038\/sj.eye.6700557","article-title":"Fungal infections of the cornea","volume":"17","author":"P A Thomas","year":"2003","journal-title":"Eye (Lond)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1016\/S1473-3099(20)30448-5","article-title":"The global incidence and diagnosis of fungal keratitis","volume":"21","author":"L Brown","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1097\/ICO.0b013e318191695b","article-title":"Fungal keratitis: changing pathogens and\u00a0risk factors","volume":"28","author":"U Jurkunas","year":"2009","journal-title":"Cornea"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1055\/s-0035-1546032","article-title":"[Keratomycosis \u2013 Therapy Standards and New Developments]","volume":"232","author":"W Behrens-Baumann","year":"2015","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1007\/s00347-020-01207-1","article-title":"[Coinfections in contact lens-associated mycotic keratitis with Pseudomonas or Acanthamoeba]","volume":"118","author":"C J Farah","year":"2021","journal-title":"Ophthalmologe"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103802","DOI":"10.1016\/j.micpath.2019.103802","article-title":"Fungal keratitis: Pathogenesis, diagnosis and prevention","volume":"138","author":"L Niu","year":"2020","journal-title":"Microb Pathog"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s00347-016-0270-4","article-title":"[Confocal microscopy as an early relapse marker after keratoplasty due to Fusarium solani keratitis]","volume":"114","author":"L Daas","year":"2017","journal-title":"Ophthalmologe"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1007\/s00347-015-0206-4","article-title":"[Confocal microscopy for the diagnostics of fungal keratitis]","volume":"113","author":"L Daas","year":"2016","journal-title":"Ophthalmologe"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/1469-0691.12126","article-title":"Mycotic keratitis: epidemiology, diagnosis and management","volume":"19","author":"P A Thomas","year":"2013","journal-title":"Clin Microbiol Infect"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1001\/jamaophthalmol.2013.1497","article-title":"The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs. voriconazole","volume":"131","author":"N V Prajna","year":"2013","journal-title":"JAMA Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/0002-9394(67)92847-4","article-title":"Mycotic keratitis. A histopathologic study of 73 cases","volume":"64","author":"G Naumann","year":"1967","journal-title":"Am J Ophthalmol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/ICO.0000000000000644","article-title":"Corneal Collagen Cross-Linking for Infectious Keratitis: A Systematic Review and Meta-Analysis","volume":"35","author":"L Papaioannou","year":"2016","journal-title":"Cornea"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1007\/s00347-013-2981-0","article-title":"[Acanthamoeba keratitis \u2013 a rare and often late diagnosed disease]","volume":"110","author":"N Szentm\u00e1ry","year":"2013","journal-title":"Ophthalmologe"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1097\/ICO.0b013e318221cec7","article-title":"Treatment of fungal keratitis from fusarium infection by corneal cross-linking","volume":"31","author":"G 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