Results of extensive surgical treatment of seven consecutive cases of postoperative fungal endophthalmitis.
OBJECTIVE
Postoperative endophthalmitis is a dreaded outcome of any intraocular surgery. Fungal endophthalmitis is a particularly severe complication that poses a significant threat of blindness. We experienced seven consecutive cases of postoperative fungal endophthalmitis stemming from a single local clinic in which extensive early intervention resulted in favorable final visual acuity.


METHODS
The present study is retrospective observational case series of fungal endophthalmitis. The initial case, as diagnosed by fungal culture, resulted in blindness. In the ensuing eight months, seven consecutive cases were referred to our institution. All were presumed to be fungal endophthalmitis as the cases possessed similar inflammatory findings to the preceding case and occurred in the same environment. Extensive surgical and antifungal treatment was immediately administered, including complete vitrectomy with removal of the intraocular lens and lens capsule and Amphotericin B injections.


RESULTS
Retinal infiltration was identified in three cases and the lesion site was photocoagulated with an endolaser. All cases were confirmed fungal endophthalmitis by culture (4 cases: Candida parapsilosis, one case each: Fusarium, Acremonium, Candida tropicalis) and five cases required secondary intraocular lens implantation. Final corrected visual acuity ranged from 20/20 to 40/200 by the Snellen chart.


CONCLUSIONS
Early extensive surgical intervention and antifungal agent administration may result in favorable visual outcomes in patients with fungal endophthalmitis following cataract surgery.
Yang
Yun Sik
YS
Department of Ophthalmology, Wonkwang University School of Medicine and Hospital, #344-2 Sinyongdong, Iksan 570-711, Korea. ysyang@wonkwang.ac.kr
D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology; D002177:Candidiasis / Q000188:drug therapy; D020878:Device Removal; D009877:Endophthalmitis / Q000150:complications / Q000382:microbiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D007903:Lens Capsule, Crystalline / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy
D000935:Antifungal Agents