Suture-Related Corneal Abscess caused by Enterococcus casseliflavus following Complicated Phacoemulsification Surgery
Patricia Kaye T. Sy, MD, MBA, Karlo Marco D. Claudio, MD
Department of Ophthalmology, Quirino Memorial Medical Center, Quezon City, Philippines
Correspondence: Patricia Kaye T. Sy, MD, MBA
Office Address: Quirino Memorial Medical Center, JP Rizal cor P Tuazon, Project 4, Quezon City
Office Phone Number: +639178467750
Email Address: patriciakayesy2003@gmail.com
Disclosure: The authors report no conflict of interest.
ABSTRACT
Objective: To report a case of a suture-related corneal abscess caused by Enterococcus casseliflavus on a phacoemulsification corneal incision.
Method: This is a case report.
Results: An elderly female underwent complicated phacoemulsification surgery on the left eye requiring sutures to seal the corneal incisions. Suture removal was incomplete at the side port, and a suture abscess developed after 9 weeks. Cultures revealed heavy growth of Enterococcus casseliflavus which was initially treated with an empiric broad-spectrum antibiotic (levofloxacin 1.5%) administered via intrastromal and subconjunctival injections, followed by culture-guided topical and oral medications. The corneal infection resolved but significant corneal thinning led to perforation, requiring a modified Gunderson flap procedure to repair the defect.
Conclusion: Intrastromal and subconjuctival injection of levofloxacin 1.5% may be a viable empiric treatment option for Enterococcus casseliflavus suture-related corneal abscess.
Keywords: suture abscess, Gunderson flap, phacoemulsification, intrastromal antibiotics, Enterococcus casseliflavus