International ophthalmology · 2026
Candida pelliculosa cluster endophthalmitis: clinical profile and surgical outcomes in twelve eyes.
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Kannan Naresh Babu, Elamurugan Vignesh, Muthukrishnan V, Babu V Jawahar Satya, Ramasamy Kim
Аннотация
PURPOSE: To describe the clinical features and surgical outcomes of Candida pelliculosa cluster endophthalmitis following cataract surgery.
METHODS: Twelve eyes of ten patients developed endophthalmitis after uncomplicated phacoemulsification with intraocular lens (IOL) implantation performed at a single hospital. All underwent core vitrectomy, IOL explantation, and intravitreal injections of vancomycin, ceftazidime, and voriconazole. Explanted IOL-bag complexes and vitreous samples were analyzed microbiologically. Secondary scleral-fixated IOL (SFIOL) implantation was performed after disease quiescence. Minimum follow-up was three months.
RESULTS: The mean interval from cataract surgery to presentation was 28 days. Presenting symptoms included pain, redness, and mild vision loss. Mean presenting BCVA was 20/40 (0.3 LogMAR). All eyes showed mild congestion, keratic precipitates, fluffy capsular plaques, IOL deposits, and vitritis; three had corneal tunnel infiltrates and two had "string of pearls." Candida pelliculosa was isolated from all explanted IOL-bag complexes, while vitreous cultures were negative. All lenses were monofocal and from the same manufacturer. Mean post-vitrectomy BCVA was 20/60 (0.48 LogMAR; p = 0.718). Five eyes developed cystoid macular edema, one required sub-Tenon triamcinolone, and four developed epiretinal membranes. After a mean of 5.2 months, seven eyes underwent SFIOL implantation, achieving a final BCVA of 20/32 (p = 0.33).
CONCLUSION: This first reported series of postoperative Candida pelliculosa cluster endophthalmitis underscores its subtle presentation and delayed onset. Early vitrectomy with IOL-bag explantation ensures infection control and favorable visual recovery.
METHODS: Twelve eyes of ten patients developed endophthalmitis after uncomplicated phacoemulsification with intraocular lens (IOL) implantation performed at a single hospital. All underwent core vitrectomy, IOL explantation, and intravitreal injections of vancomycin, ceftazidime, and voriconazole. Explanted IOL-bag complexes and vitreous samples were analyzed microbiologically. Secondary scleral-fixated IOL (SFIOL) implantation was performed after disease quiescence. Minimum follow-up was three months.
RESULTS: The mean interval from cataract surgery to presentation was 28 days. Presenting symptoms included pain, redness, and mild vision loss. Mean presenting BCVA was 20/40 (0.3 LogMAR). All eyes showed mild congestion, keratic precipitates, fluffy capsular plaques, IOL deposits, and vitritis; three had corneal tunnel infiltrates and two had "string of pearls." Candida pelliculosa was isolated from all explanted IOL-bag complexes, while vitreous cultures were negative. All lenses were monofocal and from the same manufacturer. Mean post-vitrectomy BCVA was 20/60 (0.48 LogMAR; p = 0.718). Five eyes developed cystoid macular edema, one required sub-Tenon triamcinolone, and four developed epiretinal membranes. After a mean of 5.2 months, seven eyes underwent SFIOL implantation, achieving a final BCVA of 20/32 (p = 0.33).
CONCLUSION: This first reported series of postoperative Candida pelliculosa cluster endophthalmitis underscores its subtle presentation and delayed onset. Early vitrectomy with IOL-bag explantation ensures infection control and favorable visual recovery.