Bilateral Dematiaceous Mold Endophthalmitis After Cataract Surgery: Case Series
Narrative Responses:
Purpose
To report the clinical outcomes after medical and surgical management of bilateral dematiaceous mold endophthalmitis in two patients.
Methods
This retrospective case series examines four eyes of two patients who developed culture positive dematiaceous mold endophthalmitis after cataract extraction in India. Medical records were reviewed and cultures obtained from three eyes. Outcome measures include visual acuity, microbiological findings, culture sensitivities, interventions, and time to intervention.
Results
Four eyes of two patients, husband and wife, presented with bilateral fungal endophthalmitis five weeks after cataract extraction. All surgeries were performed at a single facility by a single surgeon. Cultures confirmed dematiaceous mold, cladophialophora species in three eyes. Outcomes at 6 months follow-up have been excellent. Visual acuity is 20/20 in four eyes (100%). Three eyes (75%) required surgical intervention in addition to medical therapy. Two eyes required pars plana vitrectomy and intravitreal injection of antifungal agents. One eye required an anterior chamber washout. One eye improved on medical management alone with topical and oral Voriconazole therapy.
Conclusion
This study demonstrates that excellent clinical outcomes can be achieved in dematiaceous mold endophthalmitis. Culture sensitivities are valuable in atypical courses of endophthalmitis as they may guide treatment. Regular follow up examinations and prompt intervention are recommended during treatment.