Acute endophthalmitis after 25-gauge sutureless vitrectomy.
OBJECTIVE
To report a case with acute endophthalmitis as a postoperative complication of 25-gauge transconjunctival sutureless vitrectomy.


METHODS
A 65-year-old gentleman, who underwent 25-gauge sutureless vitrectomy for an idiopathic epiretinal membrane at Beyoğlu Eye Research and Training Hospital, presented with painful loss of vision three days later. For the treatment of acute postoperative endophthalmitis, revitrectomy, phacoemulsification with total capsulectomy and silicone oil injection were performed with intravitreal vancomycin and ceftazidim injections. No predisposing risk factors for endophthalmitis or postoperative hypotony were present.


RESULTS
Cultures were positive for coagulase negative staphylococcus. He was treated with systemic moxifloxacin and topical ofloxacin, prednisolone acetate postoperatively. Intraocular inflammation resided in 10 days. Silicone oil was removed three months later. At the last visit after 10 months of follow-up, visual acuity increased to 20/63.


CONCLUSIONS
Postoperative endophthalmitis following 25-gauge sutureless vitrectomy occurred after 3 days in the absence of known predisposing factors. Endophthalmitis responded well to antibiotics and vitrectomy with a favorable visual outcome. Unsutured sclerotomies may provide a conduit for bacterial ingress. Preoperative prophylactic antibiotic usage may be considered as a preventive measure in sutureless vitrectomy.
Acar
Nur
N
Bereketzade Mah, Kuledibi, Cami Sok, Istanbul, Turkey. nur.nuracar@gmail.com
Unver
Yaprak Banu
YB
Altan
Tuğrul
T
Kapran
Ziya
Z
D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D019773:Epiretinal Membrane / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013536:Suture Techniques; D014821:Vitrectomy / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids