Clinical Outcomes Of Corneal Fungal Phaco-Tunnel Infections Following Phacoemulsification
Published 2023 - 41st Congress of the ESCRS
Reference: PP07.01 | Type: Free paper | DOI: 10.82333/yz5y-pb66
Authors: Arpita Kulshrestha* 1 , Amit Gupta 1 , Arun K Jain 1 , Chintan Malhotra 1 , Anchal Thakur 1 , Muskaan Bansal 1 , Sraddha Limbu 1
1Ophthalmology,Post Graduate Institute of Medical Education & Research, PGIMER,Chandigarh,India
Purpose
To study the clinical presentation and management outcomes of fungal phaco-tunnel infections.
Setting
This case series of fungal phaco-tunnel infection following phacoemulsification reports successful outcomes using a variety of aggressive surgical management strategies including the role of early PPV, IOL explantation and PACK-CXL.
Methods
Clinical records of 8 eyes of 8 patients with corneal fungal phaco-tunnel infection after phacoemulsification were reviewed. Demographics, clinical features, management strategies and outcomes were analyzed.
Results
Median interval to onset of symptoms was 18.5 days. 6 (75%) had corneal infiltrates with endophthalmitis, 2 had only corneal involvement. Corneal scrapings were positive in 5 (62.5%), aqueous tap panfungal PCR in 1 and vitreous tap culture in 2 eyes. Besides oral and topical antifungal therapy, intracameral or intrastromal antifungal injections (average 4 and 2.43 injections per eye respectively) were given in 7 (87.5%) eyes. One eye required pars plana vitrectomy (PPV), 2 (25%) PPV with IOL explantation, 1(12.5%) PPV with IOL explantation with graft, 2 (25%) underwent PACK-CXL. Corneal infiltrates resolved in 6 (75%) eyes and 2 (25%) had atrophic bulbi.
Conclusions
Aggressive surgical management is required to salvage eyes with fungal phacotunnel infections.