Epicorneal aspergilloma after penetrating keratoplasty

Purpose. To report an epicorneal aspergilloma in a postkeratoplasty patient with a bandage soft contact lens. Methods. Case report of a 77-year-old postkeratoplasty patient who presented with an epicorneal mass under a bandage soft contact lens placed for a nonhealing epithelial defect. On removal of the contact lens, a 4 × 4-mm placoid mass fell free from the corneal surface and was sent for culture and histopathology. Results. Gram stain demonstrated septated branching hyphae, and cultures confirmed the diagnosis of Aspergillus versicolor. Histopathologic sections of the epicorneal mass revealed a full-thickness aspergilloma. Conclusion. Contact lens removal and aggressive antimycotic treatment resulted in epithelial healing and resolution of the keratomycosis. The patient remained stable for 6 months followed by a successful repeat penetrating keratoplasty.