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[Post operative Enterococcus faecalis endophthalmitis: three case report].

M-L Le Lez1, Ph Lanotte, S Arsene

  • 1Service d'Ophtalmologie, CHU Bretonneau, Université François Rabelais, Tours.

Journal Francais D'Ophtalmologie
|March 25, 2004
PubMed
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Enterococcus faecalis causes severe post-cataract surgery endophthalmitis, leading to poor vision outcomes. Adherence to the capsular bag suggests chronic infection risk and highlights the need for patient hygiene education.

Area of Science:

  • Ophthalmology
  • Microbiology

Background:

  • Cataract extraction is a common surgical procedure.
  • Postoperative endophthalmitis is a rare but serious complication.

Observation:

  • Three cases of endophthalmitis following cataract extraction were reported.
  • Enterococcus faecalis was identified as the causative organism in all cases.
  • Scanning electron microscopy revealed enterococci adhered to the capsular bag four months post-infection.

Findings:

  • All patients presented with light perception visual acuity, with two progressing to no light perception.
  • One patient experienced exacerbated inflammation requiring evisceration.
  • Enterococcus faecalis can cause both acute and chronic postoperative endophthalmitis.
  • Bacterial toxins may contribute to the poor prognosis observed in these cases.

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Implications:

  • Postoperative contamination is suspected as Enterococcus faecalis is not a conjunctival commensal.
  • Patient education on hygienic practices is crucial to prevent this devastating complication.
  • Further experimental studies are needed to understand the pathogenesis and poor prognosis associated with Enterococcus faecalis endophthalmitis.