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Bulgarian Review of Ophthalmology

Cataract surgery in toxoplasmosis-associated panuveitis: a case report

Georgi Markov, Yani Zdravkov, Alexander Oscar


Introduction: Cataract is one of the most frequent complications of uveitis. In the cases with toxoplasmosis, it is more common in the congenital form. Cataract surgery in the setting of uveitis is associated with a higher risk of postoperative complications and of reactivation of uveitis.

Aim: Our aim is to present a clinical case of successful cataract surgery in toxoplasmosis-associated panuveitis.

Case Report: A 74-year-old Caucasian man presented to our clinic with complaints of decreased vision in his left eye (OS). He had been treated for toxoplasmosis-associated panuveitis. The diagnosis was based on the clinical exam and ancillary serologic tests. On admission to the hospital, best-corrected visual acuity of OS (BCVA) was 0.4. He had posterior subcapsular cataract in OS. There were no signs of inflammation in the anterior and posterior segments. We did phacoemulsification with implantation of a foldable, hydrophobic acrylic intraocular lens. There were no intraoperative complications. Postoperatively, BCVA was 0.9. He was treated for 1.5 months with oral trimethoprim/sulfamethoxazole 2 x 960 mg and frequent topical tobramycin/dexamethasone. We did not observe reactivation of the uveitis. Three years following surgery, he developed a secondary cataract.

Conclusion: We demonstrated a case of successful surgical therapy of complicated cataract in toxoplasmosis-associated panuveitis. In the setting of postoperative therapy with trimethoprim/sulfamethoxazole, reactivation of uveitis was not observed. The only late complication was secondary cataract. 


toxoplasmosis, phacoemulsification, corticosteroids, trimethoprim/sulfamethoxazole

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About The Authors

Georgi Markov
Department of Ophthalmology, Alexandrovska Hospital

Yani Zdravkov
Clinic of Ophthalmology, Department of Ophthalmology, Alexandrovska University Hospital, Medical University of Sofia

Alexander Oscar
Clinic of Ophthalmology, Department of Ophthalmology, Alexandrovska University Hospital, Medical University of Sofia