A Rare Case of Postoperative Acanthamoeba Endophthalmites after Uneventful Cataract Surgery

Author(s): Antonio Berarducci, Martina Colasante, Mariateresa Laborante, Antonio Laborante

Purpose: To report a rare case of postoperative Acanthamoeba endophthalmites after uncomplicated cataract surgery in an otherwise healthy patient.

Case Description: A patient with preexisting glaucoma and CNV in both eyes underwent uneventful cataract surgery (PHACO + IOL + intracamerular cefuroxima) in his right eye. Nine days after surgery, patient presented in eye casualty complaining drop in vision, eye pain and violent diarrhoea. Pars plana vitrectomy was performed and Acanthamoeba protozoa was isolated. Empirical therapy including intravenous voriconazole 2, 5 mg twice a day, a single shot of intravitreal voriconazole 1% in 0,1 ml and topical chlorhexidine 0,02% topical was started immediately.

Conclusions: sixteen days from the initial symptoms a complete resolution of the endophthalmites was reported as well as an improvement in the visual acuity. Physicians should be aware of Acanthamoeba infection as a cause of eye infection in any patient, not just contact lens wearers; intravitreal and systemic administration of voriconazole can be successfully used to treat Acanthamoeba endophthalmitis