Palioura Sotiria, Relhan Nidhi, Leung Ella, Chang Victoria, Yoo Sonia H, Dubovy Sander R, Flynn Harry W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Am J Ophthalmol Case Rep. 2018 Jun 20;11:109-114. doi: 10.1016/j.ajoc.2018.06.011. eCollection 2018 Sep.
To describe a patient with late post-operative endophthalmitis and clear cornea tunnel infection caused by that was masquerading as chronic anterior uveitis.
A 62-year old woman with history of uncomplicated cataract surgery 7 months prior and chronic postoperative anterior uveitis, presented with an endothelial plaque, hypopyon, and infiltrates in the capsular bag and within the clear corneal tunnel. Anterior chamber cultures identified and pathology of the endothelial plaque showed fungus. Anterior chamber washout, scraping of the endothelial plaque, serial intracameral and intravitreal injections with amphotericin B (10 mcg) failed to control the infection. Pars plana vitrectomy, removal of the intraocular lens and capsular bag, a corneal patch graft, and administration of intravitreal antifungal agents were performed. One year later the patient remains free of recurrence and her best-corrected vision is 20/25 with a rigid gas permeable contact lens.
and Importance: Persistent intraocular and intracorneal inflammation after cataract surgery should raise suspicion of endophthalmitis caused by fungi non-responsive to topical and intravitreal antibiotics. Surgical intervention and removal of the nidus of infection, which is often the intraocular lens and capsular bag, may be necessary for a successful outcome.
描述一例术后晚期眼内炎及由其引起的透明角膜隧道感染病例，该病例曾被误诊为慢性前葡萄膜炎。
一名62岁女性，7个月前接受了无并发症的白内障手术，术后患有慢性前葡萄膜炎，出现了内皮斑块、前房积脓以及囊袋和透明角膜隧道内的浸润。前房培养鉴定出内皮斑块的病理显示为真菌。前房冲洗、内皮斑块刮除、多次前房和玻璃体腔内注射两性霉素B（10微克）未能控制感染。遂进行了玻璃体切割术、人工晶状体和囊袋摘除、角膜移植片修补术，并给予玻璃体腔内抗真菌药物治疗。一年后，患者未复发，佩戴硬性透气性角膜接触镜时最佳矫正视力为20/25。
白内障手术后持续的眼内和角膜内炎症应怀疑为由对局部和玻璃体腔内抗生素无反应的真菌引起的眼内炎。手术干预和去除感染病灶（通常是人工晶状体和囊袋）对于取得成功的治疗结果可能是必要的。
