Harry W. Flynn, Jr., MD (Miami, FL), David Callanan, MD (Arlington, TX), Ingrid U. Scott, MD, MPH (Hershey, PA), Timothy G. Murray, MD (Miami, FL), Karen W. Oxford, MD (San Francisco, CA), Bradley Bowman, MD (Dallas, TX)


To report a series of patients who developed early onset endophthalmitis caused by Aspergillus following cataract surgery.


A retrospective, consecutive case series of all patients with endophthalmitis caused by Aspergillus after cataract surgery treated at the authors’ practices between 1992-2004.


All patients presented with decreased vision and eye pain following phacoemulsification and IOL insertion. Five patients were identified; two were immunocompromised. Visual acuity at presentation ranged from 20/40 to hand motions. Surgery was uncomplicated in 4 (80%) eyes and complicated by posterior capsular without vitreous loss in one eye. The mean and median number of days between cataract surgery and endophthalmitis diagnosis was 29 (range 10-62). Three (60%) eyes were enucleated despite various treatments. In addition to vitrectomy and injection of antifungal agents, the other two eyes underwent surgical debridement of a localized necrotic nidus. Final vision was 20/30 in one eye and 20/200 in the remaining eye.


Aspergillus should be considered in the differential diagnosis of early onset endophthalmitis following cataract surgery. Early treatment, including removal of any nidus of infection, should be considered. Visual outcomes are generally poor and enucleation is common in these patients.