A CDC alert flagged a 2024 outbreak of Purpureocillium lilacinum keratitis in three patients who underwent laser vision correction (LVC) in New York — and experts say the threat is growing. This drug-resistant fungal infection can cause severe corneal damage and is increasingly hard to treat. Refractive surgical teams are urged to tighten infection control practices and stay alert to atypical post-op presentations.
A rare but aggressive fungal pathogen is putting laser vision correction (LVC) patients at risk, and ophthalmologists are being urged to take notice. The CDC issued an alert following a late-2024 outbreak of Purpureocillium lilacinum keratitis in three patients who underwent surface ablation procedures at a New York ophthalmology clinic. Investigators traced the fungus to contaminated epikeratome suction tubing and identified multiple infection control failures at the facility — including the use of cool mist humidifiers, which have previously been linked to ocular mycobacterial infections.
P. lilacinum is notoriously difficult to treat. It resists standard antifungal agents like amphotericin B and natamycin, and aggressive off-label therapy with azole antifungals (topical and oral voriconazole, posaconazole) is recommended. Even with treatment, cases can progress to corneal perforation requiring transplant. Detection of this pathogen has been rising since 2019, possibly tied to its agricultural use as a bionematocide.
Key Takeaways:
Why it matters: As LVC procedures remain widely popular, even rare infections can have devastating, vision-threatening consequences. Surgical teams must stay vigilant about emerging pathogens and enforce strict aseptic protocols to protect patients.
