Delhi Journal of Ophthalmology

A Rare Case Of Acanthamoeba Endophthalmitis Following Cataract Surgery

Vishal Raval1, Rushil Saxena2, Joveeta Joseph3, Savitri Sharma3, Raja Narayanan2
1Department of Ophthalmology, L V Prasad Eye Institute, KVC campus, Vijayawada, India
2Department of Ophthalmology, Smt. Kannuri Santhamma Retina Vitreous Service, L V Prasad Eye Institute, KAR campus, Hyderabad, India
3Department of Ophthalmology, Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Vishal R Raval 
Consultant, Vitreo- Retina services 
LV Prasad Eye Institute, 
Kvc  Campus, Tadigadapa, Vijayawada, Andhra Pradesh, India
Email: drvishalraval@gmail.com


Received: 11-JUL-2020 Accepted: 21-SEP-2020 Published Online: 09-JUL-2021
DOI: https://dx.doi.org/10.7869/djo.670

Abstract
Acanthamoeba are ubiquitous microorganisms and are considered opportunistic pathogens in humans. Acanthamoeba infection involving the vitreous, retina or choroid is uncommon and is mostly seen following corneal infections or corneal transplant surgeries. (1,2) We present a rare case of post-operative endophthalmitis due to Acanthamoeba in a 30-year old gentleman who underwent cataract surgery in his left eye. The initial routine microscopy and culture reports were negative for bacteria and fungus, and inspite of empirical treatment for endophthamitis, the patient’s ocular condition worsened. Following multiple vitrectomy surgery and repeated negative culture as well as polymerase chain reaction (PCR) for bacteria, virus and fungi, PCR for Acanthamoeba species was reported positive. On starting the patient on intravitreal and topical voriconazole along with oral ketoconazole the patient’s eye condition improved with moderate recovery of visual acuity. To the best of our knowledge, this is the first case reported of Acanthamoeba endophthalmitis following cataract surgery. 

Keywords :Post Cataract Surgery Endophthalmitis; Pars Plana Vitrectomy