Clinical features, management strategies, and visual acuity outcomes of Candida endophthalmitis following cataract surgery

Ophthalmic Surg Lasers Imaging. 2007 Sep-Oct;38(5):378-85. doi: 10.3928/15428877-20070901-04.

Abstract

Background and objective: To report the clinical features, management, and visual outcome in patients with Candida endophthalmitis following cataract surgery.

Patients and methods: The Bascom Palmer Eye Institute Microbiology Laboratory database and corresponding medical records were reviewed from 1980 to 2006.

Results: Five patients were identified. Endophthalmitis developed 7 to 60 days postoperatively (median, 14 days). Presenting visual acuity was 20/200 to counting fingers and final visual acuity was 20/25 to light perception. Whitish material was noted on the intraocular lens or lens capsule (4 of 5) or within the cataract wound (1 of 5). All patients received intravitreal amphotericin B and more than one pars plana vitrectomy procedure; four received systemic antifungal agents and four underwent intraocular lens removal.

Conclusions: Given whitish material on the intraocular lens, lens capsule, or cataract wound, Candida should be included in the differential diagnosis of early- or delayed-onset endophthalmitis following cataract surgery. Initial pars plana vitrectomy and intravitreal and oral antifungal medications may not achieve infection resolution. Intraocular lens explantation may assist in organism eradication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Candidiasis / etiology*
  • Candidiasis / therapy*
  • Cataract Extraction / adverse effects*
  • Device Removal
  • Endophthalmitis / diagnosis
  • Endophthalmitis / microbiology*
  • Endophthalmitis / physiopathology*
  • Female
  • Humans
  • Lens Capsule, Crystalline / pathology
  • Lens Implantation, Intraocular
  • Male
  • Reoperation
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy
  • Vitreous Body

Substances

  • Antifungal Agents
  • Amphotericin B