scholarly journals Intravitreal Daptomycin for Recalcitrant Postoperative Endophthalmitis

2016 ◽  
Vol 7 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Jennifer M. Sim ◽  
Kapil G. Kapoor ◽  
Alan L. Wagner
Keyword(s):  
Pars Plana Vitrectomy ◽  
Vancomycin Resistance ◽  
Occurrence Rate ◽  
Postoperative Endophthalmitis ◽  
First Case ◽  
Pars Plana ◽  
Exogenous Endophthalmitis ◽  
Postoperative Findings ◽  
Negative Conclusion ◽  
Culture Negative

Purpose: To report the first case to our knowledge of intravitreal daptomycin used to successfully treat culture-negative vancomycin resistant to exogenous endophthalmitis. Methods: Case report with preoperative, intraoperative, and postoperative findings. Results: A 63-year-old Caucasian male underwent routine pars plana vitrectomy with epiretinal membrane peeling. He developed acute postoperative endophthalmitis, and underwent vitreous tap and injection of intravitreal vancomycin/ceftazidime/dexamethasone. Gram stain showed Gram-positive cocci, but cultures were negative. His infection subsequently proved very recalcitrant and his treatment course involved pars plana vitrectomy with anterior chamber washout and repeat injection of antibiotics, followed by repeat intravitreal vancomycin and ceftazidime. Ultimately, a second vitrectomy with intravitreal daptomycin controlled his intraocular infection. On each occasion, cultures were negative. Conclusion: This case suggests that vancomycin resistance should be considered in culture-negative postoperative endophthalmitis, and intravitreal daptomycin should be considered as an important treatment alternative. Although vancomycin resistance is fairly rare in endophthalmitis, acknowledgment of its increasing occurrence rate is critical for optimal management.

scholarly journals Postprocedural Endophthalmitis or Postprocedural Intraocular Inflammation: A Diagnostic Conundrum

2021 ◽  
pp. 418-424
Author(s):  
Aisha Al Busaidi ◽  
Ahmed Al-Hinai
Keyword(s):  
Pars Plana Vitrectomy ◽  
Povidone Iodine ◽  
Complete Recovery ◽  
Neovascular Glaucoma ◽  
Intraocular Inflammation ◽  
Aqueous Samples ◽  
Patient Counseling ◽  
Pars Plana ◽  
Culture Negative ◽  
Office Procedures

We experienced an atypical endophthalmitis occurring post consecutively performed in-office procedures; an intravitreal injection (IVI) of ranibizumab followed by an anterior chamber (AC) paracentesis performed twice in an eye with neovascular glaucoma (NVG). A 52-year-old diabetic male who was asymptomatic developed signs of endophthalmitis and decreased vision without pain in his left eye a few days post-IVI and AC paracentesis. The condition worsened after an initial vitreous tap and injection of antibiotics. Cultures of vitreous and aqueous samples were negative. Complete resolution occurred after a pars plana vitrectomy with IVI of antibiotics and steroid with removal of a dense “yellowish-brown” fibrinous plaque. The absence of pain, presence of a peculiar colored fibrin, mild-to-moderate vitritis without retinitis, negative cultures, and complete recovery despite the fulminant presentation; favor a diagnosis of inflammation over infection. We hypothesize that a micro-leak from a 26-gauge AC tap tract might have served as an entry port for 5% povidone-iodine from the ocular surface thus inciting inflammation. However, an exuberant inflammatory response that can be typically seen in NVG eyes after intraocular procedures cannot be excluded. Various causes of inflammation post-procedures, both toxic and nontoxic should be considered in atypical culture-negative fulminant endophthalmitis cases with good outcome posttreatment. Any minor ocular procedure may carry a risk of such complication. Patient counseling and care must be exercised in performing these procedures.

scholarly journals First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1046
Author(s):  
Robert Kuthan ◽  
Anna K. Kurowska ◽  
Justyna Izdebska ◽  
Jacek P. Szaflik ◽  
Anna Lutyńska ◽  
...  
Keyword(s):  
Contact Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Ocular Infection ◽  
Corneal Perforation ◽  
Purpureocillium Lilacinum ◽  
First Case ◽  
Pars Plana ◽  
Tof Ms

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.

Comparative outcomes of pars plana vitrectomy in acute postoperative endophthalmitis with 25-gauge and 20-gauge techniques

2009 ◽  
Vol 53 (5) ◽  
pp. 506-511 ◽  
Author(s):  
Tugrul Altan ◽  
Ziya Kapran ◽  
Ilker Eser ◽  
Nur Acar ◽  
Yaprak Banu Ünver ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Postoperative Endophthalmitis ◽  
Pars Plana

scholarly journals Postoperative Endophthalmitis following Cataract Surgery in Asia

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jin A Choi ◽  
Sung Kun Chung
Keyword(s):  
Risk Factors ◽  
Cataract Surgery ◽  
Pars Plana Vitrectomy ◽  
Causative Organism ◽  
Postoperative Endophthalmitis ◽  
Asian Populations ◽  
Initial Visual Acuity ◽  
Culture Positivity ◽  
History Of ◽  
Pars Plana

Postoperative endophthalmitis is a rare clinical occurrence. However, it remains one of the most serious complications following cataract surgery because of its poor prognosis. We investigated the epidemiologic trends in postoperative endophthalmitis following cataract surgery, particularly in Asian populations. The incidence of postcataract endophthalmitis was generally consistent with epidemiologic data reported from Caucasian populations. The most frequently occurring causative organism was coagulase-negative Staphylococci in most studies of Asian populations. However, Pseudomonas aeruginosa and Nocardia were found to be the most common microorganisms in several studies. The rates of culture positivity were slightly lower than in Caucasian studies. In the evaluation of risk factors of poor visual outcomes, initial visual acuity and virulence of the causative microorganisms were generally found to be the most important risk factors. A history of pars plana vitrectomy was found to be the major risk factors for developing endophthalmitis in several studies.

scholarly journals Exogenous Endophthalmitis in Diabetic Patients: A Systemic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Georges M. El-Mollayess ◽  
Joanna S. Saadeh ◽  
Haytham I. Salti
Keyword(s):  
Pars Plana Vitrectomy ◽  
Systemic Disease ◽  
Bacterial Flora ◽  
Cataract Extraction ◽  
Systemic Review ◽  
Inflammatory Factors ◽  
Diabetic Patients ◽  
Hand Motion ◽  
Pars Plana ◽  
Exogenous Endophthalmitis

Diabetes mellitus is a systemic disease that increases the risk of infections. Exogenous endophthalmitis is an inflammatory disease to which diabetic patients are more predisposed to than nondiabetic patients undergoing any intraocular intervention. This might be because of the change in the immune and inflammatory factors that intervene in wound healing and in the bacterial flora of the ocular adnexa. We conducted a literature review to assess the risk of exogenous endophthalmitis in diabetic patients undergoing cataract extraction, pars plana vitrectomy, and intravitreal injections and to check whether its treatment differ from in non-diabetics. We found that diabetic patients are more predisposed to virulent organisms and that the incidence of ophthalmic symptoms was not substantially different in diabetic versus nondiabetic patients. Regarding treatment, all patients with light perception should receive pars plana vitrectomy, while those with hand motion and better vision should be given an intravitreal antibiotics injection. Some authors recommend vitrectomy to diabetic patients with even counting figure vision.

Pars Plana Vitrectomy Results of Exogenous Endophthalmitis in Children

2010 ◽  
Vol 20 (2) ◽  
pp. 424-428 ◽  
Author(s):  
Mehmet Çakir ◽  
Osman Çekiç ◽  
Gökhan Pekel ◽  
Ömer F. Yilmaz
Keyword(s):  
Pars Plana Vitrectomy ◽  
Pars Plana ◽  
Exogenous Endophthalmitis

scholarly journals Postoperative Endophthalmitis Caused by Cutibacterium (Formerly Propionibacterium) Acnes: Case Series and Review

2021 ◽  
pp. 1-10
Author(s):  
Benjamin J. Fowler ◽  
Darlene Miller ◽  
Xiaohe Yan ◽  
Nicolas A. Yannuzzi ◽  
Harry W. Flynn Jr.
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Features ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Postoperative Endophthalmitis ◽  
Cutibacterium Acnes ◽  
Pars Plana ◽  
Microbiologic Diagnosis

We report the clinical features, treatment strategies and outcomes in a series of patients with infectious endophthalmitis after cataract surgery caused by <i>Cutibacterium acnes (C. acnes)</i>, formerly known as <i>Propionibacterium acnes (P. acnes)</i>. This retrospective case series includes six eyes of six patients with chronic postoperative endophthalmitis caused by culture-proven <i>C. acnes</i>from December 2010 to July 2019 at a University referral center. All patients underwent prior cataract extraction with intraocular lens (CE/IOL) implantation. The mean time between cataract surgery and the microbiologic diagnosis of endophthalmitis was 7.4 ± 5.2 months (range 1.5–17 months). The average time from obtaining the specimen to culture positivity was 7.7 ± 4.4 days (range 3–15 days). Three eyes (50%) presented with hypopyon and three eyes (50%) presented with prominent keratic precipitates without hypopyon. Presenting visual acuity ranged from 20/25 to 2/200. Initial treatments included intravitreal antibiotics alone (<i>n</i> = 2), pars plana vitrectomy (PPV) with partial capsulectomy and intravitreal antibiotics (<i>n</i> = 3), and pars plana vitrectomy with IOL removal and intravitreal antibiotics (<i>n</i> = 1). Follow-up treatments included IOL removal (<i>n</i> = 2), intravitreal antibiotics (<i>n</i> = 1), and topical antibiotics (<i>n</i> = 1). The best-corrected visual acuity at last follow-up was 20/70 or better in all patients. In a literature review, the clinical features and treatment outcomes for all case series of delayed-onset postoperative endophthalmitis caused by <i>C. acnes</i>(<i>n</i> = 120) are listed<i>.</i> A definitive cure (the absence of recurrent inflammation) was achieved in 100% of patients that underwent IOL removal, in 77% of those that underwent PPV/partial capsulectomy and intravitreal antibiotics, and in 18% of cases treated with intravitreal antibiotics alone. Endophthalmitis after CE/IOL caused by <i>C. acnes</i>is characterized by slowly progressive intraocular inflammation and has a protracted course from surgery to microbiologic diagnosis. Visual outcomes are generally favorable, but IOL explantation may be necessary for definitive cure.

scholarly journals Visual Outcome in Pars Plana Vitrectomy for Acute Postoperative Endophthalmitis after Cataract Surgery

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Abdul Rafio Soomro ◽  
Fayaz Ahmed Soomro ◽  
Munawar Hussain ◽  
Abdul Qadeem Soomro ◽  
Nazia Qidwai ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Pars Plana Vitrectomy ◽  
Visual Outcome ◽  
Final Visit ◽  
P Value ◽  
Postoperative Endophthalmitis ◽  
Chi Square ◽  
Finger Counting ◽  
Pars Plana

Purpose: To determine the visual outcomes in patients undergoing pars plana-vitrectomy (PPV) for acute postoperative endophthalmitis after cataract surgery.Study Design: Quasi experimental study.Place and Duration of Study: Al- Ibrahim Eye Hospital, Malir, Karachi for a period of 2 years.Material and Methods: Thirty-three patients were selected using non-probability convenient sampling technique.Patients with acute postoperative endophthalmitis after cataract surgery diagnosed clinically and on B-scan, withvisual acuity of only perception of light were included while patients with better visual acuity and any other typesof endophthalmitis were excluded. PPV was performed in all cases and the patients were examined postoperativelyon 1st day, 3rd day, 1, 2 and 3 weeks after surgery. During these follow ups, visual acuity wasrecorded, detailed slit lamp and fundus examination was performed. Using SPSS version 20.0, chi-square testwas applied to test for significance keeping p-value of < 0.05 as significant.Results: Out of 33 patients 19 (57.6%) were males and 14 (42.4%) were females. Mean age of the patients was54.50 ± 14.14 years. On 1st post-operative day 8 patients (24.2%) showed improvement of visual acuity fromperception of light to finger counting while 02 (6.1%) patients reported visual acuity of 6/60. On final visit at 3rdweek postoperatively, 19 patients (57.6%) had visual acuity of finger counting, 08 patients (24.2%) had handmovement and 06 (18.2%) patients reported a visual acuity of 6/60.Conclusion: PPV for acute post-cataract endophthalmitis results in favourable outcomes in terms of visual acuity.

scholarly journals Cutaneous Malignant Melanoma Metastasis to the Pseudophakic Lens Capsule with Associated Granulomatous Intraocular Inflammation

2020 ◽  
Vol 6 (5) ◽  
pp. 339-343
Author(s):  
Hibba Quhill ◽  
Hardeep S. Mudhar ◽  
Kurt Spiteri Cornish ◽  
Ian G. Rennie
Keyword(s):  
Malignant Melanoma ◽  
Pars Plana Vitrectomy ◽  
Rare Event ◽  
Granulomatous Inflammation ◽  
Cutaneous Malignant Melanoma ◽  
Intraocular Inflammation ◽  
Lens Capsule ◽  
Melanoma Metastasis ◽  
First Case ◽  
Pars Plana

Intraocular cutaneous melanoma metastasis (ICMM) is a rare event, accounting for only 5% of all metastases to the eye and orbit. The vast majority of such metastases primarily affect the choroid and vitreoretinal structures. Only three previous cases of predominant lens structure ICMM have been reported in the literature. Histological examination, in all three past cases, was performed on enucleation specimens of painful blind eyes. We present the first case of ICMM to the lens capsule in a comfortable, seeing, pseudophakic eye. This was histologically confirmed following diagnostic pars plana vitrectomy and capsulotomy, and was found to be associated with background granulomatous intraocular inflammation. The potential causes of the granulomatous inflammation are discussed.

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