To report a case of perforated fungal keratitis after small incision lenticule extraction (SMILE) treated with penetrating keratoplasty (PKP). Case report and literature review. A 41-year-old woman presented with culture-proven unilateral fungal keratitis 4 days after uneventful SMILE. Her visual acuity was hand motion. The patient was treated with voriconazole irrigation (50 μm/0.1 ml) of the pocket and intrastromal voriconazole injection, in addition to systemic and topical antifungals. Despite aggressive management and decreased infiltration, the cornea was perforated and subsequently treated with PKP. Infectious keratitis after SMILE is unusual. To our knowledge, this is the first report of perforated fungal keratitis post-SMILE. PKP eradicated the infection.

中文翻译：

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小切口微透镜摘除术（SMILE）后真菌性角膜炎1例报告并文献复习

报告一例穿透性角膜移植术 (PKP) 治疗小切口微透镜提取术 (SMILE) 后穿孔真菌性角膜炎的病例。病例报告和文献综述。一名 41 岁女性在 SMILE 平安无事后 4 天出现经培养证实的单侧真菌性角膜炎。她的视力是手部运动。除了全身和局部抗真菌药外，患者还接受了袋状伏立康唑冲洗（50 μm/0.1 ml）和基质内伏立康唑注射液的治疗。尽管积极管理和减少浸润，角膜被穿孔并随后用 PKP 治疗。SMILE 后感染性角膜炎并不常见。据我们所知，这是 SMILE 术后穿孔真菌性角膜炎的首次报告。PKP 根除感染。