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INTRASTROMAL VORICONASOL TREATMENT FOR FUNGAL INFECTION AFTER PENETRATINGKERATOPLASTYA. Pašalić, N. Drača, M. Pauk Gulić, A. Bišćević, I. DekarisSpecial Eye Hospital Svjetlost, Department of Ophthalmology, School of Medicine in Rijeka, University of Rijeka, CroatiaBackground: Decompensated keratoconus is one of the most common indications for Penetratingkeratoplasty (PKP). Success of the procedure as well as the visual rehabilitation in such patient isoften satisfying for both patient and surgeon, but still there are some risk for graft rejection as well asinfections due to prolonged steroid treatment. We present a case report of fungal keratitis after PKP.Treatment of post-graft infections can be challenging, especially in case of fungal keratitis.Methods: Case report. 44 years old female patient presented with preperforation of the cornea dueto decompensated keratoconus grade IV and underwent PKP in our institution. The transplant wasobtained from a donor age of 56 years, with endothelial cell count of 2937 cells/mm2. Postoperativelypatient was treated with topical steroid/antibiotics and artificial tears drops. At each visit BCVA wasmeasured and full eye examination was performed.Results: 6 months following PKP the graft was clear and transparent and the patient obtained the bestBCVA of 0.8. Eleven months postoperatively, patient presented with persistant erosion of the transplantand asymptomatic white infiltrate at the graft-host interface. BCVA decreased to 0.25. Microbiologicaltesting of her corneal swab revealed Candida species. Patient was treated with topical and systemicvoriconasols, ciprofoxacin drops and chloramphenicol ointment which led to improvement of clinicalpicture but not to a full regresion of the infiltrate. At 22nd day of treatment patient recived intrastromalvoriconasol injections after which complete resolution of corneal infiltrates occured and visual acuityincreased to 0.9.Conclusions: Fungal infections are rare infections seen after PKP. The asymtomatic and nonspecificclinical picture may postpone the diagnosis and consequently the treatment. Therefore, in peristenterosion of the transplant after PKP, or in cases of infiltrates on the transplant, one should considerfungal keratitis.84