Povidone iodine-infused pars plana vitrectomy for severe Arthrographis kalrae fungal endophthalmitis

Purpose: Arthrographis kalrae is an opportunistic fungus that can cause a severe and atypical endophthalmitis. In limited studies, low-dose povidone iodine has been shown to be effective in treating fulminant bacterial endophthalmitis. In this case report, we describe the successful treatment of recalcitrant Arthrographis kalrae keratitis-associated endophthalmitis with intraocular povidone iodine during pars plana vitrectomy.

Observations: A patient with Arthrographis kalrae keratitis-associated endophthalmitis had persistent disease despite aggressive medical management. The infection resolved following pars plana vitrectomy with infusion of dilute povidone iodine. No toxicity was noted postoperatively.

Conclusions and importance: Povidone iodine-infused pars plana vitrectomy offers promise as a treatment for infectious endophthalmitis that fails medical management. This is the first report demonstrating eradication of fungal endophthalmitis using povidone iodine-infused pars plana vitrectomy.