ABSTRACT
Mycotic keratitis is an extremely challenging pathology for clinicians in routine ophthalmological practice. This chapter focuses on the main related techniques in the literature. It highlights those which constitute the majority of surgical approaches: therapeutic penetrating keratoplasty, lamellar keratoplasty, conjunctival flap transposition, and cryotherapy. Therapeutic penetrating keratoplasty is the main surgical treatment reported for mycotic keratitis. The great challenge of the lamellar keratoplasty modality lies in the need to be sure of complete excision of the corneal tissue infiltrate, an indispensable prerequisite for therapeutic success of surgery for mycotic infections. In summary, surgical intervention is the only effective treatment for medically unresponsive mycotic keratitis. The best timing of surgical procedures remains uncertain but must precede deep corneal infection for decreasing subsequent surgical complications and preventing poor visual outcomes. Drug delivery systems based on nanotechnology approaches seem to be a promising adjunct modality in mycotic keratitis management, once it can improve corneal drug penetration, avoiding post-transplantation recurrence.
