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Luis J. Haddock, Sander R. Dubovy, Harry W. Flynn, Jr.; Histopathologic Correlation of Enucleated Globes following Aspergillus Endophthalmitis after Uncomplicated Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1679.
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To demonstrate the histopathological findings of viable fungal organisms in multiple intraocular structures following enucleation for Aspergillus endophthalmitis after uncomplicated cataract surgery.
Consecutive case series of two patients with Aspergillus endophthalmitis after cataract surgery seen at Bascom Palmer Eye Institute. The clinical course, surgical history, and date of enucleation were recorded and the histological outcomes were reviewed.
Two patients presented with pain, redness, and decreased vision within one week after uncomplicated cataract surgery. In both patients, vitreous aspiration and intravitreal injections were the initial treatment. Because of worsening clinical condition pars plana vitrectomy was performed and Aspergillus was isolated from the vitreous samples. Despite repeated surgical and medical interventions, the clinical course in both patients was prolonged, unsuccessful and resulted in enucleation for a blind painful eye. In spite of prolonged local and systemic therapy the histological examination of the enucleated specimens using gomori methamine silver stain showed persistent diffuse infiltration of the anterior chamber, iris and ciliary body by a filamentous mold. In addition the histological specimens showed retinal detachments, cyclitic membranes and fibrous plaques.
Persistent fungal organisms were identified histologically in the intraocular structures of the enucleated globes using gomori methamine silver stain. These histological findings suggest that despite repeated treatment with intravitreal injections of amphotericin B and voriconazole and vitrectomy, viable fungal organisms can be identified in the intraocular structures of patients undergoing enucleation for Aspergillus endophthalmitis.
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