Fusarium endophthalmitis following refractive lens exchange for correction of high myopia

Abstract

We report a case of Fusarium endophthalmitis following refractive lens exchange (RLE) for the correction of high myopia that was initially diagnosed as lens-induced uveitis. Endophthalmitis is a rare but often devastating complication of intraocular lens surgery. In contrast to cataract surgery, in which the potential increase in visual acuity clearly outweighs the potential risks involved in the procedure, RLE has all the potential risks of conventional cataract surgery and the indication for surgery, "no more glasses or contact lenses," is not that straightforward.

FusariumEndophthalmitis following Cataract Surgery: Successful Treatment with Intravitreal and Systemic Voriconazole

“…Fusarium is a filamentous fungus found in the soil and on plant and vegetable matter that tends to affect mostly immunocompromised individuals [ 4 ]. Fusarium endophthalmitis following cataract extraction surgery is a rare intraocular fungal infection.…”

“…When it occurs, it is noticeably destructive because Fusarium species produce extracellular proteases that cause matrix degeneration. This explains the poor visual prognosis of fungal endophthalmitis [ 4 – 7 ].…”

“…However, in this case, the patient showed little improvement 5 days after its administration. Certain Fusarium strain resistance to amphotericin B is not uncommon, for it has been reported as one of the most drug-resistant fungi [ 4 – 7 ].…”

Refractive lens exchange in modern practice: when and when not to do it?

“…Patients with high myopia are often willing to have lens refractive procedure performed in order to be made independent from the use of spectacles or contact lenses. Many original studies [ 11 - 18 ] and reviews [ 19 - 27 ] have been made to assess the results of such procedures and risk of intraoperative and postoperative complications. Their results are shown in Table 2 .…”