Fungal infections possible following sutureless cataract surgery

Fungal infections can develop in self-sealing wounds following cataract surgery, presenting possible diagnostic and therapeutic challenges, according to a recent retrospective case series.

The study, conducted by Prashant Garg, MS, and colleagues at the Prasad Eye Institute, India, reviewed the records of seven consecutive cataract patients who developed fungal infections of the surgical wound.

Patient symptoms initially developed an average of 5 days postop. Initial diagnoses included three cases of keratitis, three cases of excessive anterior chamber reaction, and one case of scleritis. The last four patients identified were treated with topical or systemic corticosteroids, or both, before referral. All cases subsequently developed deep keratitis.

In two cases, the researchers were able to identify infection with Aspergillus flavus, Aspergillus terreus and Aspergillus spp. In one case Candida albicans was also identified. Medical therapy resolved the infections in both cases.

The remaining five eyes progressed to endophthalmitis, with subsequent complete loss of vision. The source of the infection could not be identified in any of these cases, the authors noted.

The study was published in the November issue of Ophthalmology.