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Epidemic Bacillus endophthalmitis after cataract surgery II: chronic and recurrent presentation and outcome
Objective:
To report the clinical outcome of chronic Bacillus endophthalmitis after cataract surgery.
Design:
Retrospective, noncomparative case series.
Participants:
Five eyes of five patients with late-onset or recurrent inflammation after exposure to bacteria-contaminated viscoelastic material were studied.
Intervention:
Repeated vitrectomies, wide excision of the remnant posterior capsule, and intravitreal injections of antibiotics in five patients. Eventual explantation of the intraocular lens in four patients.
Main Outcome Measures:
Final visual acuities and results of microbiologic studies of aqueous and vitreous specimens as well as pathologic studies using hematoxylin-eosin, Gram, and periodic acid-Schiff (PAS) stain of explanted capsular remnants were obtained.
Results:
Final visual acuity of 20/40 or better was obtained in three patients. Bacillus species were grown from two cases. PAS- and Gram-positive microorganisms were identified in the capsular tissue in three of four patients who had explantation of the intraocular lens.
Conclusions:
A chronic form of Bacillus endophthalmitis is described for the first time. The clinical outcome is similar to chronic endophthalmitis caused by other organisms.