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Management of recurrent postoperative fungal endophthalmitis

Anand Vinekar, Mangat R Dogra1, Kavitha Avadhani

  • 1Department of Ophthalmology, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Indian Journal of Ophthalmology
|March 13, 2014
PubMed
Abstract

Insights

Recurrent postoperative fungal endophthalmitis (POFE) often requires repeat treatments. Combined intraocular lens (IOL) explantation and pars plana vitrectomy (PPV) effectively managed recurrent POFE in this study.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Postoperative fungal endophthalmitis (POFE) can be challenging to manage, especially when recurrent.
  • Conventional treatments like pars plana vitrectomy (PPV) and antifungal therapy may fail in refractory cases.

Purpose of the Study:

  • To evaluate the efficacy of intraocular lens (IOL) explantation combined with re-pars plana vitrectomy (PPV) for recurrent postoperative fungal endophthalmitis (POFE).

Main Methods:

  • A retrospective case series of six patients with microbiologically proven recurrent POFE refractory to standard treatments.
  • Patients underwent IOL explantation and re-PPV for their final recurrence.
  • Outcomes assessed included globe anatomy preservation, visual acuity, and retinal status.

Main Results:

  • All six patients experienced recurrent POFE despite multiple prior PPVs and intravitreal amphotericin B treatments.
  • Following IOL explantation and re-PPV, no further recurrences were observed during a median follow-up of 37 months.
  • Anatomical success was achieved in 83.3% of patients, and functional success (attached retina, BCVA > 20/400) in 50%.

Conclusions:

  • Combined IOL explantation and PPV is an effective strategy for managing recurrent postoperative fungal endophthalmitis.
  • This combined approach offers a potential solution for cases refractory to conventional management.

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