Recurrent Enterococcus faecalis endophthalmitis after phacoemulsification.

Published on Mar 1, 2005in Journal of Cataract and Refractive Surgery2.689
· DOI :10.1016/J.JCRS.2004.06.047
Stephen C. Teoh18
Estimated H-index: 18
(TTSH: Tan Tock Seng Hospital),
Jong-Jian Lee2
Estimated H-index: 2
+ 1 AuthorsKah-Guan Au Eong20
Estimated H-index: 20
Sources
Abstract
We present the first reported case of late recurrence of postoperative Enterococcus faecalis endophthalmitis after cataract surgery in a 45-year-old diabetic man. Culture-positive E faecalis endophthalmitis was diagnosed 2 days after uneventful phacoemulsification. Early vitrectomy with intravitreal and subconjunctival vancomycin and amikacin and topical vancomycin resulted in apparently complete clinical resolution after 4 months and a best corrected visual acuity of 20/25. Recurrent endophthalmitis with hypopyon occurred 7 months postoperatively and resolved with intravitreal vancomycin and topical prednisolone acetate 1%. However, the patient had a similar relapse at 9 months that resulted in deterioration of visual acuity to no light perception despite a repeat vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal antibiotics. The late recurrences could have been the result of persistent sequestration of the organism in the capsular bag.
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