Three days after she had LASIK surgery at another institution, 19-year-old Amy Truong noticed a white spot in her right eye. When a three-week course of antibiotics failed to resolve the issue, her eye surgeon referred her to cornea and external disease specialist Gene Kim, MD, at the Robert Cizik Eye Clinic.
Using the clinic’s confocal microscope, Dr. Kim took high-resolution images without sacrificing any tissue from Truong’s cornea. Twenty minutes later, he knew she had a fungal infection. “We prescribed antifungal eye drops and an oral medication for a few days, but because the fungus had been there for three weeks prior to treatment, it damaged and eventually perforated the cornea,” he says. “We had to do an urgent corneal transplant on a Friday evening.”
Therapeutic corneal transplants are frequently done in cases of fungi or parasites, which are difficult to treat. “If one of the three medications we have available doesn’t work and the fungus spreads to other parts of the eye, the patient is at risk of losing the eye. Rather than waiting until no options are available, we remove the infection while it is still contained within the cornea.”
Following the transplant, Truong had issues with transplant rejection. To counter the rejection, Dr. Kim prescribed a medium dose of steroids. “We were light on the steroids because the medication can cause the fungus and infection to worsen. We want to remove all the fungus – if there’s even a small amount left, it will spread. So we have to find a good balance, which makes post-infection transplants difficult to manage. If you prescribe steroids to prevent rejection, the medication can cause the original problem to worsen. We watched her very closely and saw her often to find the right balance.”
Truong says getting rid of the infection was “such a relief. The surgery and recovery were nothing compared to dealing with the infection, which left me feeling emotionally unstable for a very long time.”
In September 2014, a year after Truong’s surgery, Dr. Kim removed the 16 sutures of her cornea transplant. Today, she’s 20 and fungus free. She’s also working through core courses at Lone Star College, with plans to complete her associate degree in nursing and go on to UTHealth School of Nursing for her B.S.N. Her eye looks normal and is doing well.
“Dr. Kim is literally my hero,” she says. “He knows how to care for people physically and emotionally. I felt I had had such bad luck, but then was so blessed to meet him. He was always honest and straightforward with me. I never once felt lost when I was with him.”