Vitrectomy and systemic fluconazole for treatment of endogenous fungal endophthalmitis

BACKGROUND AND OBJECTIVE: To investigate the efficacy of pars plana vitrectomy and oral fluconazole without injection of intravitreal antimycotic agents in the treatment of vitritis resulting from Candida endophthalmitis. PATIENTS AND METHODS: Six eyes of five patients with suspected Candida endophthalmitis were treated with pars plana vitrectomy and systemic fluconazole for at least 3 weeks. Patients were observed postoperatively for at least 4 months. RESULTS: Clinical signs of infection cleared and visual acuity improved postoperatively in all six cases. One recurrent case was attributed to a retained indwelling venous catheter. CONCLUSIONS: Treatment of advanced endogenous Candida endophthalmitis with vitrectomy and systemic fluconazole offers an effective alternative to management with intravitreal amphotericin B in selected cases.