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POSTCATARACT ENDOPHTHALMITIS TREATED WITH SMALL GAUGE VITRECTOMY

Fassbender, Janelle M., MD, PhD; Jusufbegovic, Denis, MD; Schaal, Shlomit, MD, PhD

Retinal Cases and Brief Reports: October 2016 - Volume 10 - Issue 4 - p 320–322
doi: 10.1097/ICB.0000000000000346
Case Report
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Purpose: To discuss the use of minimally invasive, small gauge vitrectomy for acute postcataract endophthalmitis in patients with better than light-perception vision. Patient: 71-year-old man presented with redness, pain, and decreased vision of his left eye 11 days after cataract extraction. His visual acuity was counting fingers at 1 foot and slit-lamp examination revealed severe conjunctival injection, corneal edema, and hypopyon. The clinical impression was of acute postcataract endophthalmitis.

Methods: Patient was taken for immediate vitrectomy with simultaneous vitreous tap for culture, PCR, and injection of intravitreal vancomycin and ceftazidime.

Results: Culture and PCR of vitreous sample were positive for Staphylococcus epidermidis. Vision improved to 20/20 1 month postoperatively with complete resolution of vitreous inflammation and retinal vasculitis.

Conclusion: In postcataract endophthalmitis with dense vitritis and diffuse retinal vasculitis, immediate, 25-gauge vitrectomy may result in return of baseline visual acuity.

The Endophthalmitis Vitrectomy Study yielded results that saves vitrectomy for patients with light perception only vision due to postcataract endophthalmitis. However, with small-gauge vitrectomy systems, many more surgeons are performing immediate vitrectomy for patients with better than light perception vision with great results, as discussed in this case report.

Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky.

Reprint requests: Shlomit Schaal, MD, PhD, Department of Ophthalmology and Visual Sciences, University of Louisville, 301 E Muhammad Ali Boulevard, Louisville, KY 40202; e-mail: s.schaal@louisville.edu

Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc, New York, NY.

None of the authors have any conflicting interests to disclose.

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© 2016 by Ophthalmic Communications Society, Inc.