Clinicomicrobiological characteristics and treatment outcome of sclerocorneal tunnel infection.

PURPOSE: To analyze the clinical presentation, microbiological evaluation, and management of post-cataract surgery sclerocorneal tunnel infection.

METHODS

This is a retrospective chart review of 11 patients with sclerocorneal tunnel infection after cataract surgery, managed between November 2006 and October 2009. The clinical characteristics and treatment outcomes were analyzed.

RESULTS

All patients presented within 1 to 10 weeks of primary surgery. The presenting visual acuity ranged from hand motions to 20/50. Ten of 11 patients had sclerocorneal involvement, and 4 patients had associated endophthalmitis. The causative organisms were fungus (n = 6), bacteria (n = 4), or both (n = 1). Deroofing of the tunnel and sclerocorneal patch graft was done in 4 patients. Intensive medication was administered to all patients. The final visual acuity ranged from light perception to 20/50 at a mean follow-up of 119 days (median, 66 days; range, 2-357 days). Five patients had ≥20/100 vision. The mean interval between presentation to resolution of infiltrate and formation of peripheral scarring was 20 days (median, 11 days; range, 2-66 days).

CONCLUSIONS

Sclerocorneal tunnel infection must be microbiologically evaluated. Intensive medical management, wound revision and repair may lead to a favorable outcome.