title: Postoperative hemorrhagic occlusive retinal vasculitis associated with intracameral vancomycin prophylaxis during cataract surgery.
abstract: We present the case of a 75-year-old man who had uneventful cataract surgery and administration of intracameral vancomycin for endophthalmitis prophylaxis, followed by the same procedure in the fellow eye 1 week later. The patient subsequently developed bilateral hemorrhagic occlusive retinal vasculitis, resulting in profound vision loss in both eyes. A second case of hemorrhagic occlusive retinal vasculitis previously reported from our institution is summarized. That case was characterized by a far milder course, with rapid resolution of vision loss. The 2 cases illustrate the broad range of toxicity potentially associated with intracameral vancomycin, suggest that bilateral administration results in a worse prognosis, and indicate that this disorder may be underrecognized due to the potential for a mild course. We recommend that intracameral vancomycin not be used for endophthalmitis prophylaxis.
  
  
  
  None of the authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA. Electronic address: matthew-a-miller@uiowa.edu.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Miller
authors.affiliation: From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA.
authors.forename: Lucas T
authors.initials: LT
authors.lastname: Lenci
authors.affiliation: From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA.
authors.forename: Chittaranjan V
authors.initials: CV
authors.lastname: Reddy
authors.affiliation: From the Department of Ophthalmology and Visual Sciences (Miller, Lenci, Russell), University of Iowa Hospitals and Clinics, Iowa City, Iowa, and the Retina Consultants of Central Illinois (Reddy), Peoria, Illinois, USA.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Russell
mesh_terms: D000368:Aged; D000867:Anterior Chamber; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D002386:Cataract; D002387:Cataract Extraction; D009877:Endophthalmitis; D015818:Eye Infections, Bacterial; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D031300:Retinal Vasculitis / Q000209:etiology*; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin