Fungal endophthalmitis following transscleral cyclophotocoagulation

Abstract

Most cases of refractory glaucoma not amenable to filtration surgery or glaucoma drainage device are managed by cyclodestructive procedures. An 84-year-old female had undergone oculus sinister (OS) transscleral cyclophotocoagulation (TSCPC) after a diagnosis of OS closed angle stage of neovascular glaucoma was made. On the 1st week post-TSCPC, discharge on the conjunctival surface was noted along with a 6 mm hypopyon in the anterior chamber and associated vitritis. Treatment on the lines of fungal endophthalmitis was initiated. At 1 month review, the reaction had reduced significantly. Cases with significant reaction and vitritis post-TSCPC must be treated aggressively on the lines of endophthalmitis to salvage the globe. A rather safe approach to the management of such cases, TSCPC does have rare complications such as inadvertent sclerostomy or panophthalmitis, being reported as isolated case reports. To the best of our knowledge, this is the first case of fungal endophthalmitis being reported post-TSCPC.