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Purpose <p>To describe the clinical presentation, microbiological evaluation, and management of post-cataract surgery corneal fungal tunnel infections.</p> Setting <p>Tertiary Eye Care Centre.</p> Methods <p>This was a retrospective observational study of 16 patients with corneal fungal tunnel infection post-cataract surgery. All were managed at a single tertiary eye care centre in India. Patients underwent corneal scrapings; anterior chamber taps or vitreous taps. Data reviewed included age, gender, onset of symptoms, examination findings, laboratory work up and the different management outcomes. Anatomical success was assessed in terms of globe integrity and functional success in terms of visual acuity.</p> Results <p>The median interval to onset of symptoms after cataract surgery was 11.5&#xa0;days (mean, 20.6&#xa0;days; range, 1–90&#xa0;days). Corneal infiltrates with endophthalmitis were present in 87.5%(14/16) of eyes. Microbiological work up revealed 53.3% positivity (8/15 patients); <i>Candida glabrata</i> (n = 1), <i>Aspergillus fumigatus</i> (n = 4), and the PCR <i>pan-fungal genome</i> (n = 3). No sample was taken in one patient given the nature of intrastromal infiltrates. Various management strategies were followed according to algorithm recommended by the authors. The infection resolved in 86.67% (13/15) patients, while one patient lost to follow up. The mean time of resolution of infiltrates was 9.7&#xa0;weeks (15 patients). The final visual acuity was 20/200 in 3 patients, 20/60 in 2 patients and 20/40 in 8 patients; while 2 patients progressed to phthisis.</p> Conclusion <p>Post-cataract surgery, fungal tunnel infections are a diagnostic as well as therapeutic challenge. A systematic management algorithm needs to be followed for a successful outcome.</p>

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Management of post-cataract surgery corneal fungal tunnel infections

  • 期刊论文

  • 发表日期：

    2025年7月17日

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  • Amit Gupta,
  • Anchal Thakur,
  • Chintan Malhotra,
  • Arun Kumar Jain,
  • Sonam Yangzes

摘要

Purpose

To describe the clinical presentation, microbiological evaluation, and management of post-cataract surgery corneal fungal tunnel infections.

Setting

Tertiary Eye Care Centre.

Methods

This was a retrospective observational study of 16 patients with corneal fungal tunnel infection post-cataract surgery. All were managed at a single tertiary eye care centre in India. Patients underwent corneal scrapings; anterior chamber taps or vitreous taps. Data reviewed included age, gender, onset of symptoms, examination findings, laboratory work up and the different management outcomes. Anatomical success was assessed in terms of globe integrity and functional success in terms of visual acuity.

Results

The median interval to onset of symptoms after cataract surgery was 11.5 days (mean, 20.6 days; range, 1–90 days). Corneal infiltrates with endophthalmitis were present in 87.5%(14/16) of eyes. Microbiological work up revealed 53.3% positivity (8/15 patients); Candida glabrata (n = 1), Aspergillus fumigatus (n = 4), and the PCR pan-fungal genome (n = 3). No sample was taken in one patient given the nature of intrastromal infiltrates. Various management strategies were followed according to algorithm recommended by the authors. The infection resolved in 86.67% (13/15) patients, while one patient lost to follow up. The mean time of resolution of infiltrates was 9.7 weeks (15 patients). The final visual acuity was 20/200 in 3 patients, 20/60 in 2 patients and 20/40 in 8 patients; while 2 patients progressed to phthisis.

Conclusion

Post-cataract surgery, fungal tunnel infections are a diagnostic as well as therapeutic challenge. A systematic management algorithm needs to be followed for a successful outcome.