title: Post-cataract surgery endophthalmitis treated with core vitrectomy: a case report.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. tshiwa@nms.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shiwa
authors.forename: Katsuya
authors.initials: K
authors.lastname: Umeno
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hara
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yoshitomi
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin