Dr.Tanvi Dilip Madia
Purpose: To demonstrate the role of tunnel deroofing with eccentric PK in the management of postoperative endophthalmitis with tunnel involvement.
History: A 50yrs old female patient presented with chief complaints of diminution of vision, watering & floaters in the left eye for 7 days with history of cataract surgery done 3wks back
O/E: B-scan USG(OS)- vitreous clumps of moderate echogenicity & increased retinochoroidal thickness. These features were suggestive of endophthalmitis.
Tunnel scrapping & intravitreal antibiotics &AC tap was done.
Following it,intravitreal & intrastromal injection of voriconazolewas given & vitreous aspirate was taken.
Direct smear examination of the aspirate was positive for gram positive & gram negative bacilli.
Conclusion: In tunnel infections, organism is inoculated in the potential space between floor & roof of the tunnel & may gain early access to anterior chamber & vitreous cavity, giving rise to endophthalmitis.
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