title: Fungal endophthalmitis following cataract surgery: clinical presentation, microbiological spectrum, and outcome.
abstract: OBJECTIVE
  To determine the clinical presentation, microbiological spectrum, and outcome in cases of fungal endophthalmitis following cataract surgery.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  Retrospective analysis of 27 cases of smear- and culture-proven fungal endophthalmitis.
  
  
  METHODS
  Pars plana vitrectomy in 18 eyes, where the corneal condition did not preclude the same. All eyes received intravitreal amphotericin B and dexamethasone along with systemic antifungal agents.
  
  
  METHODS
  Functional success: Final visual acuity of 3/60 or better with attached retina. Anatomical success: Final visual acuity of better than light perception with preserved anatomy of globe.
  
  
  RESULTS
  The majority of the eyes (22 of the 27) had early onset and diffuse presentation (that is, anterior segment as well as posterior vitreous exudates). Substantial corneal involvement was seen in 14 eyes (51.85%). Aspergillus sp. was the most common isolate. Multivariate analysis using forward stepwise logistic regression showed corneal involvement as the single most important risk factor in determining final visual outcome (P =.0429).
  
  
  CONCLUSIONS
  Early onset and diffuse presentation, which mimics bacterial endophthalmitis, stresses the importance of both bacterial and fungal cultures from intraocular fluids to reach a diagnosis apart from the clinical judgment. Corneal involvement was the most important predictor of outcome in cases of fungal endophthalmitis.
authors.affiliation: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Narang
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: V
authors.initials: V
authors.lastname: Gupta
authors.forename: M R
authors.initials: MR
authors.lastname: Dogra
authors.forename: J
authors.initials: J
authors.lastname: Ram
authors.forename: S S
authors.initials: SS
authors.lastname: Pandav
authors.forename: A
authors.initials: A
authors.lastname: Chakrabarti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D002387:Cataract Extraction / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D003907:Dexamethasone; D000666:Amphotericin B