[Vitreous surgery for mycotic endophthalmitis].

We treated eight eyes of five patients with mycotic endophthalmitis. Intraocular inflammatory changes in one of these eyes improved only by antifungal therapy with 21-day administration of miconazole and fluconazole. The other seven eyes underwent vitrectomy, and the preoperative periods between the onset of ocular complications and the operation ranged from one and a half months to three months, during which time fungi were isolated only in one case. Dense vitreous opacities caused by the colonies of the fungi were found in the all vitrectomized eyes. Vitrectomy in the three cases showing no retinal detachment was effective for the improvement of either visual acuity or ophthalmoscopic findings, whereas vitrectomy was not effective in the other two cases with the occurrence of the pre-retinal membrane causing traction retinal detachment. The present investigations suggest that persistent endophthalmitis and the appearance of total retinal detachment made the improvement of retinal changes difficult because of the inflammatory and fibrotic processes between the retina and the vitreous body. It, therefore, is shown that anti-fungal therapy should be initiated when mycotic endophthalmitis is suspected, but in cases without response to the drug, vitrectomy should be performed before retinal detachment occurs.