Sutureless wound infection by unusual acid-fast organisms.

PURPOSE: To report infection of self-sealing wounds in cataract surgery by unusual acid-fast organisms.

METHODS

Two patients who underwent phacoemulsification and developed corneal tunnel infection by acid-fast organisms were included. Both were managed with appropriate medical and surgical treatment modalities.

RESULTS

Diagnosis was facilitated in the first case by diagnostic and therapeutic lamellar keratoplasty and in the second case by the analysis of scrapings obtained from the inner lip of the tunnel. Ziehl-Neilsen staining helped diagnosis of acid-fast bacteria and implementation of adequate therapy. Nonresponse to appropriate susceptibility-guided medical therapy in the second case was controlled by timely surgical keratectomy as a peripheral patch graft.

CONCLUSIONS

Tunnel infection after phacoemulsification is a serious complication and can be caused by relatively uncommon acid-fast bacteria. Appropriate diagnostic work-up will help in the identification and institution of appropriate therapy.