title: Clinical features, management strategies, and visual acuity outcomes of Candida endophthalmitis following cataract surgery.
abstract: To report the clinical features, management, and visual outcome in patients with Candida endophthalmitis following cataract surgery.
  
  
  
  The Bascom Palmer Eye Institute Microbiology Laboratory database and corresponding medical records were reviewed from 1980 to 2006.
  
  
  
  Five patients were identified. Endophthalmitis developed 7 to 60 days postoperatively (median, 14 days). Presenting visual acuity was 20/200 to counting fingers and final visual acuity was 20/25 to light perception. Whitish material was noted on the intraocular lens or lens capsule (4 of 5) or within the cataract wound (1 of 5). All patients received intravitreal amphotericin B and more than one pars plana vitrectomy procedure; four received systemic antifungal agents and four underwent intraocular lens removal.
  
  
  
  Given whitish material on the intraocular lens, lens capsule, or cataract wound, Candida should be included in the differential diagnosis of early- or delayed-onset endophthalmitis following cataract surgery. Initial pars plana vitrectomy and intravitreal and oral antifungal medications may not achieve infection resolution. Intraocular lens explantation may assist in organism eradication.
authors.affiliation: Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
authors.forename: Ninel Z
authors.initials: NZ
authors.lastname: Gregori
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Darlene
authors.initials: D
authors.lastname: Miller
authors.forename: Ingrid U
authors.initials: IU
authors.lastname: Scott
authors.forename: Janet L
authors.initials: JL
authors.lastname: Davis
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Murray
authors.forename: Basil
authors.initials: B
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000209:etiology* / Q000628:therapy*; D002387:Cataract Extraction / Q000009:adverse effects*; D020878:Device Removal; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular; D008297:Male; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B