Faculty Collaboration Database

Endophthalmitis in patients with retained lens fragments after phacoemulsification. Ophthalmology 1996 Apr;103(4):575-8

Date

04/01/1996

Pubmed ID

8618754

DOI

10.1016/s0161-6420(96)30651-9

Scopus ID

2-s2.0-0029920963 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

PURPOSE: To review the treatment and outcomes of patients presenting with concurrent endophthalmitis and retained lens fragments after phacoemulsification.

METHODS: A retrospective chart review was conducted on patients presenting with culture-proven endophthalmitis and retained lens fragments after phacoemulsification between 1990 and 1994.

RESULTS: Five patients were identified with culture-proven endophthalmitis and retained lens fragments after phacoemulsification. In all patients, coagulase-negative staphylococci were cultured from the vitreous fluid. One patient also had positive cultures for Proteus mirabilis and Escherichia coli. The interval between cataract surgery and treatment ranged from 5 days to 6 months. Echography was beneficial in showing retained lens fragments in five of five patients when media opacities obscured the view of the fundus. Four patients had vitrectomy and removal of retained lens fragments during their initial treatment. The fifth patient was treated with intravitreal antibiotics alone and continued to have marked inflammation, eventually requiring vitrectomy for removal of the retained lens fragments. A final visual acuity of 20/400 or better was achieved in four of the five patients.

CONCLUSIONS: Patients may present with endophthalmitis in the setting of retained lens fragments after phacoemulsification. In such cases, the preferred initial management may be pars plana vitrectomy, removal of retained lens fragments, and injection of intraocular antibiotics. In eyes with endophthalmitis and opaque media, echography is a useful screening modality.

Author List

Kim JE, Flynn HW Jr, Rubsamen PE, Murray TG, Davis JL, Smiddy WE

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Anti-Bacterial Agents
Endophthalmitis
Escherichia coli Infections
Eye Infections, Bacterial
Female
Humans
Lens, Crystalline
Male
Phacoemulsification
Postoperative Complications
Proteus Infections
Proteus mirabilis
Retrospective Studies
Staphylococcal Infections
Staphylococcus epidermidis
Visual Acuity
Vitrectomy
Vitreous Body