Post-cataract surgery endophthalmitis treated with core vitrectomy: a case report.
Postoperative endophthalmitis is one of the most serious complications after cataract surgery though its frequency may be low. We report a case with post-cataract extraction bacterial endophthalmitis treated favorably by core vitrectomy through pars plana with anterior vitrectomy cutter (A-vit). The patient, a 72-year-old woman, presented with blurred vision 7 days after phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. Her initial visual acuity was counting fingers. As hypopyon and corneal edema progressed in a few hours, we decided to perform vitectomy. Firstly, we performed IOL explantation and anterior vitrectomy through the corneal stab incision with A-vit attached to the phaco machine. The inflammation, however, appeared to be severe. Secondly we performed core vitrectomy with the same cutter as we used in the first operation through pars plana as well as intravitreal injection of vancomycin on the following day. The inflammation was gradually subsided and her corrected visual acuity was recovered to 30/20 at 7 months after the vitrectomy. The results is suggest that for cataract surgeons in the facilities that are not equipped with 3-port vitrectomy machine, post-cataract extraction bacterial endophthalmitis of the emergency stage can be successfully treated by core vitrectomy through pars plana as well as intravitreal injection of antibiotics with neither vitreous shaving at the vitreous base nor artificial posterior vitreous detachment.
Shiwa
Toshihiko
T
Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. tshiwa@nms.ac.jp
Umeno
Katsuya
K
Hara
Yuji
Y
Yoshitomi
Fumiaki
F
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002387:Cataract Extraction; D009877:Endophthalmitis / Q000601:surgery*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D011183:Postoperative Complications / Q000382:microbiology / Q000601:surgery*; D013203:Staphylococcal Infections; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage; D014821:Vitrectomy / Q000379:methods*
D000900:Anti-Bacterial Agents; D014640:Vancomycin