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Voriconazole-refractory fungal infection of phacoemulsification tunnel

Vikas Mittal1, Ruchi Mittal, P C Sharma

  • 1Sanjivni Eye Care, Model Town, Ambala, Haryana, India.

Indian Journal of Ophthalmology
|August 7, 2010
PubMed

Insights

This case study highlights a rare fungal infection following cataract surgery caused by Aspergillus flavus. Voriconazole therapy proved challenging, indicating potential resistance in fungal tunnel infections.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Cataract surgery, specifically phacoemulsification, can rarely lead to postoperative complications.
  • Fungal keratitis and wound infections are significant causes of vision loss after ocular surgery.

Observation:

  • A 44-year-old male presented with multiple pinpoint infiltrates at the cataract surgery wound site 28 days post-operation.
  • Corneal scraping identified Aspergillus flavus, a fungus known to cause opportunistic infections.

Findings:

  • Initial treatment with oral and topical voriconazole, along with intracameral injections, showed limited efficacy.
  • Despite aggressive treatment, the fungal infiltrates progressed, necessitating a full-thickness patch graft.

Implications:

  • This case underscores the therapeutic challenges posed by fungal tunnel infections post-cataract surgery.
  • The observed resistance to voriconazole suggests the need for alternative or combination therapies for Aspergillus infections.

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