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Published on: February 6, 2021

Fungal endophthalmitis following cataract surgery: clinical presentation, microbiological spectrum, and outcome

S Narang1, A Gupta, V Gupta

  • 1Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India.

American Journal of Ophthalmology
|November 13, 2001
PubMed
Abstract

Insights

Fungal endophthalmitis after cataract surgery often presents early and diffusely. Corneal involvement significantly predicts poor visual outcomes, highlighting the need for prompt diagnosis and treatment.

Area of Science:

  • Ophthalmology
  • Infectious Diseases

Background:

  • Fungal endophthalmitis is a serious complication following cataract surgery.
  • Early and accurate diagnosis is crucial for effective management and visual preservation.

Purpose of the Study:

  • To investigate the clinical features, causative fungi, and outcomes of fungal endophthalmitis post-cataract surgery.
  • To identify prognostic factors influencing visual outcomes in these cases.

Main Methods:

  • Retrospective analysis of 27 cases with smear- and culture-proven fungal endophthalmitis.
  • Treatment included pars plana vitrectomy, intravitreal amphotericin B and dexamethasone, and systemic antifungals.
  • Functional and anatomical success were defined by visual acuity and retinal status.

Main Results:

  • Most cases (22/27) exhibited early onset and diffuse presentation, mimicking bacterial endophthalmitis.
  • Corneal involvement was present in over 50% of eyes (14/27).
  • Aspergillus species was the most frequent fungal isolate, and corneal involvement was the strongest predictor of poor visual outcome (P=.0429).

Conclusions:

  • The clinical presentation can mimic bacterial endophthalmitis, emphasizing the need for fungal cultures.
  • Corneal involvement is a critical factor determining the final visual prognosis in fungal endophthalmitis.
  • Prompt diagnosis and appropriate treatment are essential for managing this sight-threatening condition.

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