Visual outcomes of post-cataract endophthalmitis caused by Mycobacterium fortuitum

Background: Endophthalmitis caused by Mycobacterium fortuitum as a complication of cataract surgery is rare in China and globally. This study aimed to report the clinical features, surgical treatment strategies, antibiotic susceptibilities and treatment outcomes in patients with endophthalmitis caused by Mycobacterium fortuitum. Patients and methods: A case series of 15 patients (15 eyes) with post-cataract endophthalmitis caused by Mycobacterium fortuitum treated at the Ophthalmology Clinic of Shengjing Hospital between June 2008 and June 2017 was reviewed retrospectively. Information about Mycobacterium fortuitum culture results, clinical features, surgical procedures, and final visual acuity were obtained. Results: The vitreous samples were all positive. These eyes underwent total capsulectomy and intraocular lens explantation and vitrectomy combined with intravitreal and intravenous injections of antibiotics. Finally, 14 eyes had controlled inflammation and retained eyeballs. One eye had panophthalmitis and enucleation of the eyeball. Presenting visual acuity ranged from counting fingers to no light perception. Final visual acuity was better than 20/400 in 4 of 15 eyes (26.67%), 20/400 to hand motions in 7 of 15 eyes (46.67%), and light perception to no light perception in 4 of 15 eyes (26.67%) at 6-month follow-up visit. Conclusion: Mycobacterium fortuitum might be an etiologic agent in postoperative endophthalmitis. The Mycobacterium fortuitum endophthalmitis might be treated with early vitrectomy and targeted antibiotic therapy approach.