Related Experiment Videos
Stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation
N Horio1, M Horiguchi, K Murakami
1Department of Ophthalmology, Nagoya University School of Medicine, Japan. naoichi@med.nagoya-u.ac.jp
Background:
Stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus. Endophthalmitis induced by S. maltophilia has been described in only two cases after intraocular lens implantation. We report S. maltophilia endophthalmitis in two patients with diabetes mellitus after intraocular lens implantation and compare the characteristics of the S. maltophilia-induced endophthalmitis with two previous cases.
Methods:
A 68-year-old woman and a 74-year-old man with diabetes mellitus developed S. maltophilia endophthalmitis within 5 days of intraocular lens implantation. We performed intraocular lens removal and vitrectomy, which resolved the inflammation. No recurrences were found.
Results:
Cultures grew S. maltophilia in both cases, and one of the organisms was multi-resistant. The final visual acuity was counting fingers and 0.3. The first case revealed a tractional retinal detachment during vitrectomy.
Conclusions:
S. maltophilia is a potential opportunistic intraocular pathogen, and the incidence of multiresistant S. maltophilia is increasing. S. maltophilia causes acute endophthalmitis, and its prognosis may not be poor unless the eye has a history of serious disease before the cataract surgery. The combined procedure of intraocular lens removal and vitrectomy was useful in resolving the inflammation and preventing recurrences.
Insights
Stenotrophomonas maltophilia can cause severe eye infections after intraocular lens surgery, especially in diabetic patients. Prompt removal of the intraocular lens and vitrectomy effectively treated these cases of endophthalmitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Stenotrophomonas maltophilia is an opportunistic gram-negative bacillus.
- Endophthalmitis caused by S. maltophilia is rare following intraocular lens (IOL) implantation.
- This study investigates two new cases of S. maltophilia endophthalmitis in diabetic patients post-IOL implantation.
Observation:
- Two diabetic patients developed S. maltophilia endophthalmitis within five days of IOL implantation.
- One patient presented with tractional retinal detachment during vitrectomy.
- Cultures confirmed S. maltophilia, with one isolate exhibiting multi-resistance.
Findings:
- S. maltophilia is an emerging cause of acute endophthalmitis after IOL surgery.
- Final visual acuity varied, with one patient achieving 0.3 and the other counting fingers.
- The incidence of multi-resistant S. maltophilia is increasing.
Implications:
- S. maltophilia should be considered a potential opportunistic intraocular pathogen.
- Early intervention with IOL removal and vitrectomy can resolve inflammation and prevent recurrence.
- Prognosis may be favorable unless pre-existing severe ocular conditions are present.