Acute post-cataract-surgery endophthalmitis after suture removal
Andrew Keat Eu Lim, FRCS, MMed1, Shueh Lin Lim, MRCP2, Elias Hussein, MS3
Objective
To report a case of acute post-cataract-surgery endophthalmitis after suture removal.
Methods
This is a case report.
Results
A 77-year-old Chinese male presented with sudden painless blurring of vision in the left eye (OS) of 3 days duration 22 days after cataract surgery and 15 days after corneal-suture removal. OS was injected with corneal striae and had a visual acuity of 1/60, 3+ anterior-chamber cells with small hypopyon, and hazy vitreous. Endophthalmitis was considered and immediate vitreous tap with intravitreal antibiotics were given. Intensive topical antibiotics were instituted, followed by a repeat intravitreal antibiotic injections 3 days later. Postoperatively, there was massive fibrin formation with cyclitic membrane and seclusio pupillae that required two peripheral iridotomies. Visual acuity slowly recovered from hand movement to 6/18.
Conclusion
Endophthalmitis can be successfully treated without pars plana vitrectomy, following the Endophthalmitis Vitrectomy Study (EVS) guidelines. Removal of corneal sutures must be followed with topical antibiotics to prevent the possibility of endophthalmitis secondary to introduction of microorganisms into the anterior chamber via the suture tract.