Use of voriconazole in the surgical management of chronic postoperative fungal endophthalmitis.

Management of postoperative mycotic endophthalmitis remains challenging. This study reports successful management of postoperative chronic fungal endophthalmitis with vitrectomy surgery and voriconazole. A retrospective interventional case series of four eyes of four patients with chronic fungal endophthalmitis treated with pars plana vitrectomy and oral and intravitreal voriconazole is described. Pars plana vitrectomy, en bloc capsulectomy, and explantation of the intraocular lens were then performed combined with one to four intravitreal injections of voriconazole and oral voriconazole for up to 5 weeks. Identified fungal species included Aspergillus, Acremonium, Penicillium, and Verticillium. Voriconazole may have affected the clinical and surgical management of fungal endophthalmitis.