Six Cases of Fungal Exogenous Endophthalmitis after Cataract Surgery

Abstract

Purpose: To report six cases of exogenous fungal endophthalmitis developed after cataract surgery.Case summary: Over about 1 month, eight patients were referred to our hospital under suspicion of fungal endophthalmitis arose after cataract surgery. We performed vitrectomy and intraocular lens removal. We intraoperatively sampled the anterior chamber, vitreous cavity, or intraocular lens surface, and performed staining and culture tests. Before the culture test results were available, we commenced empirical treatment under suspicion of fungal endophthalmitis (based on the clinical features). Five eyes were male and three female (eight eyes of eight patients); the mean patient age was 64 years. The time from cataract surgery to the commencement of appropriate treatment ranged from 13 to 36 days (average 28 days). The culture tests revealed Fusarium species in six of the eight patients. At the 1-month postoperative follow-up of these six patients, the best-corrected visual acuities were 20/20 (one eye), 20/40 (two eyes), 20/50 (one eye), and 20/100 (two eyes).Conclusions: Fungal endophthalmitis is very rare after cataract surgery but is associated with poor visual prognosis and requires long-term treatment. If fungal endophthalmitis is suspected, aggressive treatment with an appropriate selection of medication is important.