Sutureless wound infection by unusual acid-fast organisms.
OBJECTIVE
To report infection of self-sealing wounds in cataract surgery by unusual acid-fast organisms.


METHODS
Two patients who underwent phacoemulsification and developed corneal tunnel infection by acid-fast organisms were included. Both were managed with appropriate medical and surgical treatment modalities.


RESULTS
Diagnosis was facilitated in the first case by diagnostic and therapeutic lamellar keratoplasty and in the second case by the analysis of scrapings obtained from the inner lip of the tunnel. Ziehl-Neilsen staining helped diagnosis of acid-fast bacteria and implementation of adequate therapy. Nonresponse to appropriate susceptibility-guided medical therapy in the second case was controlled by timely surgical keratectomy as a peripheral patch graft.


CONCLUSIONS
Tunnel infection after phacoemulsification is a serious complication and can be caused by relatively uncommon acid-fast bacteria. Appropriate diagnostic work-up will help in the identification and institution of appropriate therapy.
Jain
Vandana
V
Cornea and Anterior Segment Service, Aditya Jyot Eye Hospital Pvt Ltd, Mumbai, India. docvandanajain@rediffmail.com
Garg
Prashant
P
Sharma
Savitri
S
Vemuganti
Geeta K
GK
D003131:Combined Modality Therapy; D016039:Corneal Transplantation; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016926:Mycobacterium chelonae; D009617:Nocardia Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D009616:Nocardia asteroides / Q000302:isolation & purification; D018918:Phacoemulsification; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013536:Suture Techniques