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Propionibacterium acnes endophthalmitis after intracapsular cataract extraction
A M Chien1, I M Raber, D H Fischer
1Cornea Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
Ophthalmology
|April 11, 1992
Summary
Propionibacterium acnes endophthalmitis can cause chronic inflammation after cataract surgery. Surgical removal of the corneal plaque and antibiotics were necessary for resolution.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Cataract surgery, specifically intracapsular cataract extraction with intraocular lens (IOL) implantation, can be complicated by endophthalmitis.
- Propionibacterium acnes (P. acnes) is a bacterium that can cause persistent intraocular infections.
Observation:
- A patient experienced chronic, treatment-resistant inflammation for 5 years post-cataract surgery.
- The inflammation correlated with a white plaque on the posterior corneal surface.
- Anterior chamber cultures revealed P. acnes after anaerobic incubation.
Findings:
- P. acnes was identified as the causative agent of chronic endophthalmitis.
- The posterior corneal plaque served as the infection's nidus.
- Resolution was achieved through surgical plaque removal and combined intravitreal/oral antibiotic therapy.
Implications:
- This case highlights the importance of considering P. acnes in chronic endophthalmitis.
- Surgical intervention to remove infectious foci is crucial for refractory cases.
- Effective management requires a combination of surgical and targeted antibiotic treatments.