[Endophthalmitis phakoanaphylactica with anterior uveitis of the partner eye].
Phakoanaphylactic endophthalmitis is a rare but deleterious complication of surgical, traumatic, or spontaneous lens capsule perforation. The authors describe a 79-year-old patient who developed severe endophthalmitis four days after extracapsular cataract extraction and implantation of a posterior chamber lens. The inflammation, which led to phthisis and eventually necessitated enucleation, was characterized by an atypical hypopyon in the form of a conglomerate of fibrin and cellular elements originating at pupillary level. The laboratory workup revealed a chronic lympho-granulomatous inflammation with epitheloid cells and polynuclear giant cells near the lens capsule, confirming the clinical diagnosis of a phakoanaphylactic endophthalmitis. Ten weeks after the cataract extraction a persistent iridocyclitis developed in the fellow eye, which had been free of inflammation up to that point. Hypotonia of the globe, a previous opacification of the first eye, the close chronological relationship with the phakogenic inflammation of the first eye, and clues from the literature suggest a sympathizing phakoanaphylactic endophthalmitis in the fellow eye. Differential diagnosis to rule out other postoperative inflammatory reactions, e.g., bacterial endophthalmitis, toxic lens syndrome, pseudo-phakoanaphylactic endophthalmitis, and sympathetic ophthalmia is described.
Necker
H P
HP
Abteilung I, Universitäts-Augenklinik Tübingen.
Weidle
E G
EG
Steuhl
K P
KP
D000368:Aged; D001327:Autoimmune Diseases / Q000473:pathology*; D009877:Endophthalmitis / Q000473:pathology*; D004728:Endothelium, Corneal / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D015863:Iridocyclitis / Q000473:pathology; D007903:Lens Capsule, Crystalline / Q000473:pathology; D007908:Lens, Crystalline / Q000276:immunology*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000473:pathology*; D014602:Uvea / Q000473:pathology; D014606:Uveitis, Anterior / Q000473:pathology*
Endophthalmitis phakoanaphylactica mit Uveitis anterior am Partnerauge.