Rare And Challenging Case Of Cataract Surgery Complicated With Fungal Endophthalmitis

To present a challenging case of cataract surgery complicated with fungal endophthalmitis 2 days after cataract surgery, management and satisfied results.

University Hospital Center of Tirana “Mother Teresa”

Department of Ophthalmology

University of Medecine, Tirana

We present a challenging case of cataract surgery complicated with fungal endophthalmitis 2 days after cataract surgery. The 70 years old  patient, 2 days after cataract surgery, was presented to the emergency room with headache, nausea, blurred vision. In the objective examination was observed BCVA hand motion, corneal edema, 2 small fungal masses attached to the iris, and vitritis according to b-scan. The patient was hospitalized and treated with sol amphotericin B 6x2 long-term drops, intravenous fluconazole, 1 time intravitreal injection with amphotericin b, 2 times subconjunctival injection with amphotericin b, cleaning of fungal masses attached to the iris in the operating room. After the treatment BCVA is 8/10.

Treatment of the patient with fungal endophthalmitis at the right time gave satisfactory results increasing BCVA from the hand 
motion  to 16/200 without pars plana vitrectomy. The treatment was with sol amphotericin B 6x2 long-term drops, intravenous fluconazole, 
1 time intravitreal injection with amphotericin b, 2 times subconjunctival injection with amphotericin b, cleaning of fungal masses attached 
to the iris in the operating room.

Fungal endophthalmitis is a rare fungal infection involving the intraocular fluids. In this case, after the patient presented 2 days after the cataract surgery with fungal endophthalmitis with BCVA = hand motion, he was treated appropriately in the hospital and BCVA= 8/10 was achieved without pars plana vitrectomy.