A Case of Corneal Endothelial Dysfunction Due to Coxsackievirus A24 Corneal Endotheliitis After Cataract Surgery

Abstract

Corneal endotheliitis causes endothelial decompensation and is associated with significant visual impairment. The goal of this article is to report a case of corneal endotheliitis associated with coxsackievirus A24 infection after cataract surgery in a patient who had no previous symptoms indicative of conjunctivitis. A 55-year-old man was admitted for cataract surgery when acute hemorrhagic conjunctivitis was prevalent. Because he did not show any signs of suspected conjunctivitis, the cataract surgery was performed. No intraoperative complications occurred, and he was discharged 1 day after the surgery. Three days later, he visited our clinic with complaints of ocular pain and decreased vision in the left eye. Slit-lamp examination showed corneal stromal edema and mild inflammatory reaction in the anterior chamber. On postoperative day 7, anterior chamber irrigation and viral culture from the aqueous humor sample were performed. Coxsackievirus A24 was detected in the viral culture. Electron photomicroscopic examination with immunohistochemical staining confirmed the presence of viral antigen. This is the first report of corneal endotheliitis caused by coxsackievirus A24 confirmed by viral antigen detection in the aqueous humor of an affected eye.