VITRECTOMY AND SYSTEMIC FLUCONAZOLE FOR TREATMENT OF ENDOGENOUS FUNGAL ENDOPHTHALMITIS

BACKGROUND AND OBJECTIVE: To investigate the efficacy of pars plana vi trectomy and oral fluconazole without injection of intravitreal antimy cotic agents in the treatment of vitritis resulting from Candida endop hthalmitis. PATIENTS AND METHODS: Six eyes of five patients with suspe cted Candida endophthalmitis were treated with pars plana vitrectomy a nd systemic fluconazole for at least 3 weeks. Patients were observed p ostoperatively for at least 4 months. RESULTS: Clinical signs of infec tion cleared and visual acuity improved postoperatively in all six cas es. One recurrent case was attributed to a retained indwelling venous catheter. CONCLUSIONS: Treatment of advanced endogenous Candida endoph thalmitis with vitrectomy and systemic fluconazole offers an effective alternative to management with intravitreal amphotericin B in selecte d cases.